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MYOCARDIAL LAYER
I
,-.
ENDOCA'RDITIS
Endocarditis is defined as an inflammatory process involving the endothelial layer of the heart including the cardiac valves.
- Davidson (2009)
Endoca,rdi·tls is defined as an lnfectlon of t,he endocardial surface of the heart
- Lewis (2007)
·:·Men are effected 2 to 3 times more than
women
.:. Mortality rate is 20% to 30%
·:·Incidence rate 4.7% per 100,000 people .:. Common in people with cardiac structural
defects & older people
BAC-TERIA
FUNGI
VIRUS
I.iln 1i!I~ [ .. ~.1II1d1i ilW:lhill~ In iI ~ilh'-I .-II II! lilllil.ii. ~ ..... !!1 .... Hi .. 11 ..... 1 ~ I J • iI j.i ... ,
IIL~; ::1[0[0. ..::I. I~ .........
Mo.uth
ORAL CAVITY
RESPIRATORY SYSTEM
GASTRO
~SKIN
....... -----,Il[fy~X ~~~~---, lrach,ea
CARDIAC CONDITIONS
. " "
NONCARDIAC CONDITIONS
1. Prior endocarditis
2.Prosthetic valves
1. Intravenous drug abuse
3.Acquired valve" disease
2. Nosocomial bacterimea
4~Rheumatic heart
" "
disease
5.Pace makers
6. Cardio myopathy
PROC·EDURE AS·SOCIATED RlSKS
INrRAVASCULAR ~ DEVICES
MED:ICAL ~. DIAGNOSTIC PROC'ED,URES
AB,DOMINAL ..---- SURG',ERIES
LAPROSCOPY .......-' PROCEDURES.
- - - _. ;c..
PATHOP~SIOL06Y
:Dam'age.to the endothelial su.rfaee. of'theheart
,Pri'rnar:y fOcus e~f intectien 'frOm causative e;~anism.s adhering lei valve sunce
Bacteria
Virus
-Bra'ili
-kidn~
-,Liver
-sp'leen
I
Lt sided heart ~
~~1IIIIIIII!!!!Ij
embolizatians
I
, "
i-_-: ..... Rt'sided Heart embo:lizations
Fannationsof¥egdaUons 'can$isting of fibrin, 'Ieuco~,
,
platelets & m,icrobes'
II
+ Lungs
Local valve
damage
Man age m,e,nt +,
Infiliratio., to supporting struetures,
Healing.
,,: ~: ~:
Sepsis Head Head
fiji,I'ure black
• Low grade fever
• Chills, weakness, malaise & fatigue • Arthralgia, back pain
• Weight loss
• Clubbing of fingers
Osler's nodules
Roth's spots
Janeway's lesions
History collection
DIAGNOSTIC EVALUATION
Physical assessment
Blood culture,
ChestX'ray
Echo cardiography
IllI!jsrra~ion of a :p'3!tient ~ffil:ing ;an ECG. ' -"N:lA.Jvt.
ECG
IIAlfAUM'KNT
DRUG THERAPY
• PencillirrG
• Cefriaxone
• Vancomycin
• Gentamycin
• Ampicillin
• Amphotericin
COMPLICATIONS
eaR fai'lqre
StroKe
'\1alyular stenosis