Endocarditis - Wikipedia

Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves. Other structures that may be ... Endocarditis FromWikipedia,thefreeencyclopedia Jumptonavigation Jumptosearch MedicalconditionEndocarditisBartonellahenselaebacilliincardiacvalveofapatientwithbloodculture-negativeendocarditis.Thebacilliappearasblackgranulations.SpecialtyCardiology,Infectiousdisease Endocarditisisaninflammationoftheinnerlayeroftheheart,theendocardium.Itusuallyinvolvestheheartvalves.Otherstructuresthatmaybeinvolvedincludetheinterventricularseptum,thechordaetendineae,themuralendocardium,orthesurfacesofintracardiacdevices.Endocarditisischaracterizedbylesions,knownasvegetations,whichisamassofplatelets,fibrin,microcoloniesofmicroorganisms,andscantinflammatorycells.[1]Inthesubacuteformofinfectiveendocarditis,thevegetationmayalsoincludeacenterofgranulomatoustissue,whichmayfibroseorcalcify.[2] Thereareseveralwaystoclassifyendocarditis.Thesimplestclassificationisbasedoncause:eitherinfectiveornon-infective,dependingonwhetheramicroorganismisthesourceoftheinflammationornot.Regardless,thediagnosisofendocarditisisbasedonclinicalfeatures,investigationssuchasanechocardiogram,andbloodculturesdemonstratingthepresenceofendocarditis-causingmicroorganisms. Signsandsymptomsincludefever,chills,sweating,malaise,weakness,anorexia,weightloss,splenomegaly,flu-likefeeling,cardiacmurmur,heartfailure,petechia(redspotsontheskin),Osler'snodes(subcutaneousnodulesfoundonhandsandfeet),Janewaylesions(nodularlesionsonpalmsandsoles),andRoth'sspots(retinalhemorrhages). Contents 1Infectiveendocarditis 2Non-infectiveendocarditis 3References 4Furtherreading 5Externallinks Infectiveendocarditis[edit] Mainarticle:Infectiveendocarditis Infectiveendocarditisisaninfectionoftheinnersurfaceoftheheart,usuallythevalves.[3]Symptomsmayincludefever,smallareasofbleedingintotheskin,heartmurmur,feelingtired,andlowredbloodcells.[3]Complicationsmayincludevalvularinsufficiency,heartfailure,stroke,andkidneyfailure.[4][3] Thecauseistypicallyabacterialinfectionandlesscommonlyafungalinfection.[3]Riskfactorsincludevalvularheartdiseaseincludingrheumaticdisease,congenitalheartdisease,artificialvalves,hemodialysis,intravenousdruguse,andelectronicpacemakers.[5]Thebacterialmostcommonlyinvolvedarestreptococciorstaphylococci.[3]Diagnosisissuspectedbasedonsymptomsandsupportedbybloodculturesorultrasound.[3] Theusefulnessofantibioticsfollowingdentalproceduresforpreventionisunclear.[6]Somerecommendtheminthoseathighrisk.[3]Treatmentisgenerallywithintravenousantibiotics.[3]Thechoiceofantibioticsisbasedonthebloodcultures.[3]Occasionallyheartsurgeryisrequired.[3] Thenumberofpeopleaffectedisabout5per100,000peryear.[5]Rates,however,varybetweenregionsoftheworld.[5]Malesareaffectedmoreoftenthanfemales.[3]Theriskofdeathamongthoseinfectedisabout25%.[5]Withouttreatmentitisalmostuniversallyfatal.[3] Non-infectiveendocarditis[edit] Mainarticle:Noninfectiveendocarditis Nonbacterialthromboticendocarditis(NBTE)ismostcommonlyfoundonpreviouslyundamagedvalves.[2]Asopposedtoinfectiveendocarditis,thevegetationsinNBTEaresmall,sterile,andtendtoaggregatealongtheedgesofthevalveorthecusps.[2]Alsounlikeinfectiveendocarditis,NBTEdoesnotcauseaninflammationresponsefromthebody.[2]NBTEusuallyoccursduringahypercoagulablestatesuchassystem-widebacterialinfection,orpregnancy,thoughitisalsosometimesseeninpatientswithvenouscatheters.[2]NBTEmayalsooccurinpatientswithcancers,particularlymucinousadenocarcinoma[2]whereTrousseausyndromecanbeencountered.TypicallyNBTEdoesnotcausemanyproblemsonitsown,butpartsofthevegetationsmaybreakoffandembolizetotheheartorbrain,ortheymayserveasafocuswherebacteriacanlodge,thuscausinginfectiveendocarditis.[2] AnotherformofsterileendocarditisistermedLibman–Sacksendocarditis;thisformoccursmoreofteninpatientswithlupuserythematosusandisthoughttobeduetothedepositionofimmunecomplexes.[2]LikeNBTE,Libman-Sacksendocarditisinvolvessmallvegetations,whileinfectiveendocarditisiscomposedoflargevegetations.[2]Theseimmunecomplexesprecipitateaninflammationreaction,whichhelpstodifferentiateitfromNBTE.AlsounlikeNBTE,Libman-Sacksendocarditisdoesnotseemtohaveapreferredlocationofdepositionandmayformontheundersurfacesofthevalvesorevenontheendocardium.[2] References[edit] ^KasperDL,BraunwaldE,FauciAS,HauserS,LongoDL,JamesonJL(May2005).Harrison'sPrinciplesofInternalMedicine.McGraw-Hill.pp. 731–40.ISBN 978-0-07-139140-5.OCLC 54501403. ^abcdefghijMitchellRS,KumarV,RobbinsSL,AbbasAK,FaustoN(2007).RobbinsBasicPathology(8th ed.).Saunders/Elsevier.pp. 406–8.ISBN 978-1-4160-2973-1. ^abcdefghijkl"InfectiveEndocarditis-CardiovascularDisorders".MerckManualsProfessionalEdition.September2017.Retrieved11December2017. ^Njuguna,B;Gardner,A;Karwa,R;Delahaye,F(February2017)."InfectiveEndocarditisinLow-andMiddle-IncomeCountries".CardiologyClinics.35(1):153–163.doi:10.1016/j.ccl.2016.08.011.hdl:1805/14046.PMID 27886786. ^abcdAmbrosioni,J;Hernandez-Meneses,M;Téllez,A;Pericàs,J;Falces,C;Tolosana,JM;Vidal,B;Almela,M;Quintana,E;Llopis,J;Moreno,A;Miro,JM;HospitalClinicInfectiveEndocarditis,Investigators(May2017)."TheChangingEpidemiologyofInfectiveEndocarditisintheTwenty-FirstCentury".CurrentInfectiousDiseaseReports.19(5):21.doi:10.1007/s11908-017-0574-9.PMID 28401448.S2CID 24935834. ^Cahill,TJ;Harrison,JL;Jewell,P;Onakpoya,I;Chambers,JB;Dayer,M;Lockhart,P;Roberts,N;Shanson,D;Thornhill,M;Heneghan,CJ;Prendergast,BD(June2017)."Antibioticprophylaxisforinfectiveendocarditis:asystematicreviewandmeta-analysis"(PDF).Heart.103(12):937–944.doi:10.1136/heartjnl-2015-309102.PMID 28213367.S2CID 25918810. Furtherreading[edit] TissièresP,GervaixA,BeghettiM,JaeggiET(2003)."ValueandlimitationsofthevonReyn,Duke,andmodifiedDukecriteriaforthediagnosisofinfectiveendocarditisinchildren".Pediatrics.112(6Pt1):e467–e471.doi:10.1542/peds.112.6.e467.PMID 14654647. MeineTJ,NettlesRE,AndersonDJ,CabellCH,CoreyGR,SextonDJ,WangA(2001)."CardiacconductionabnormalitiesinendocarditisdefinedbytheDukecriteria".AmericanHeartJournal.142(2):280–5.doi:10.1067/mhj.2001.116964.PMID 11479467. Externallinks[edit] EndocarditisatCurlie ScholiahasatopicprofileforEndocarditis. vteCardiovasculardisease(heart)IschaemicCoronarydisease Coronaryarterydisease(CAD) Coronaryarteryaneurysm Spontaneouscoronaryarterydissection(SCAD) Coronarythrombosis Coronaryvasospasm Myocardialbridge Activeischemia Anginapectoris Prinzmetal'sangina Stableangina Acutecoronarysyndrome Myocardialinfarction Unstableangina Sequelae hours Hibernatingmyocardium Myocardialstunning days Myocardialrupture weeks Ventricularaneurysm Dresslersyndrome LayersPericardium Pericarditis Acute Chronic/Constrictive Pericardialeffusion Cardiactamponade Hemopericardium Myocardium Myocarditis Chagasdisease Cardiomyopathy Dilated Alcoholic Hypertrophic Tachycardia-induced Restrictive Loefflerendocarditis Cardiacamyloidosis Endocardialfibroelastosis Arrhythmogenicrightventriculardysplasia Endocardium/valvesEndocarditis infectiveendocarditis Subacutebacterialendocarditis non-infectiveendocarditis Libman–Sacksendocarditis Nonbacterialthromboticendocarditis Valves mitral regurgitation prolapse stenosis aortic stenosis insufficiency tricuspid stenosis insufficiency pulmonary stenosis insufficiency Conduction/arrhythmiaBradycardia Sinusbradycardia Sicksinussyndrome Heartblock:Sinoatrial AV 1° 2° 3° Intraventricular Bundlebranchblock Right Left Leftanteriorfascicle Leftposteriorfascicle Bifascicular Trifascicular Adams–Stokessyndrome Tachycardia(paroxysmalandsinus)Supraventricular Atrial Multifocal Junctional AVnodalreentrant Junctionalectopic Ventricular Acceleratedidioventricularrhythm Catecholaminergicpolymorphic Torsadesdepointes Prematurecontraction Atrial Junctional Ventricular Pre-excitationsyndrome Lown–Ganong–Levine Wolff–Parkinson–White Flutter/fibrillation Atrialflutter Ventricularflutter Atrialfibrillation Familial Ventricularfibrillation Pacemaker Ectopicpacemaker/Ectopicbeat Multifocalatrialtachycardia Pacemakersyndrome Parasystole Wanderingatrialpacemaker LongQTsyndrome Andersen–Tawil JervellandLange-Nielsen Romano–Ward Cardiacarrest Suddencardiacdeath Asystole Pulselesselectricalactivity Sinoatrialarrest Other/ungrouped hexaxialreferencesystem Rightaxisdeviation Leftaxisdeviation QT ShortQTsyndrome T Twavealternans ST Osbornwave STelevation STdepression Strainpattern Cardiomegaly Ventricularhypertrophy Left Right/Corpulmonale Atrialenlargement Left Right Athleticheartsyndrome Other Cardiacfibrosis Heartfailure Diastolicheartfailure Cardiacasthma Rheumaticfever ClassificationDICD-10:I33ICD-9-CM:421MeSH:D004696DiseasesDB:4224ExternalresourcesMedlinePlus:001098eMedicine:emerg/164med/671ped/2511PatientUK:Endocarditis AuthoritycontrolGeneral IntegratedAuthorityFile(Germany) Nationallibraries France(data) UnitedStates Latvia Japan Retrievedfrom"https://en.wikipedia.org/w/index.php?title=Endocarditis&oldid=1062634631" Categories:ValvularheartdiseaseInflammationsRodent-carrieddiseasesHiddencategories:ArticleswithshortdescriptionShortdescriptionisdifferentfromWikidataArticleswithCurlielinksArticleswithGNDidentifiersArticleswithBNFidentifiersArticleswithLCCNidentifiersArticleswithLNBidentifiersArticleswithNDLidentifiers Navigationmenu Personaltools NotloggedinTalkContributionsCreateaccountLogin Namespaces ArticleTalk Variants expanded collapsed Views ReadEditViewhistory More expanded collapsed Search Navigation MainpageContentsCurrenteventsRandomarticleAboutWikipediaContactusDonate Contribute HelpLearntoeditCommunityportalRecentchangesUploadfile Tools WhatlinkshereRelatedchangesUploadfileSpecialpagesPermanentlinkPageinformationCitethispageWikidataitem Print/export DownloadasPDFPrintableversion Inotherprojects WikimediaCommons Languages العربيةБългарскиCatalàČeštinaDeutschΕλληνικάEspañolEsperantoEuskaraفارسیFrançaisGaeilgeՀայերենBahasaIndonesiaItalianoעבריתKurdîКыргызчаLietuviųМакедонскиNederlands日本語NorskbokmålOʻzbekcha/ўзбекчаPolskiPortuguêsRomânăРусскийShqipSimpleEnglishSlovenčinaکوردیSuomiSvenskaதமிழ்TürkçeУкраїнська中文 Editlinks