Clinical Features of Infection Endocarditis

Posted by e-Medical PPT Tuesday, October 5, 2010
Infective endocarditis is an infection of the endocardial surface of the heart. The intracardiac effects of this infection include severe valvular insufficiency and myocardial abscesses. It also produces a wide variety of systemic signs and symptoms through several mechanisms, including both sterile and infected emboli and various immunological phenomena.
The classic clinical presentation and clinical course of Infective endocarditis has been characterized as either acute or subacute. Acute IE frequently involves normal valves. It is a rapidly progressive illness in persons who are healthy or debilitated. Subacute IE typically affects only abnormal valves. Its course, even in untreated patients, may extend over many months.
IE develops most commonly on the mitral valve, closely followed in descending order of frequency by the aortic valve, the combined mitral and aortic valve, the tricuspid valve, and, rarely, the pulmonic valve. Mechanical prosthetic and bioprosthetic valves exhibit equal rates of infection.Congestive heart failure due to aortic valve insufficiency is the most common intracardiac complication of subacute endocarditis.
The complication of arterial embolization is second in frequency to congestive heart failure for both subacute and acute IE. The most common areas of deposition include the coronary arteries, kidneys, brain, and spleen. Infarction at the site of embolization is common.Cerebral emboli occur in 33% of patients. The middle cerebral artery is involved most often.Other neurological embolic damage includes cranial nerve palsies, cerebritis, and mycotic aneurysms caused by weakening of the vessel walls and produced by embolization to the vasa vasorum. Mycotic aneurysms may occur in the abdominal aorta and the splenic, coronary, and pulmonary arteries.

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