include rheumatic endo, infect endo, myocarditis, pericarditis

prevention (hygiene and handwashing)

early ID of risk factors are critical

prothetic cardiac valves

previous or recurrent IE

Cardiac transplantation

congential heart diseas-unrepaired cyanotic heart disease, complete repair w/in past 6 months (Need time for endothelial tissue healing), repaired but residual defects remain

IV drug abusers

immuno compromised/immuno supressed, (fungal endocardities)

prolonged hospitlization w/ indwelling catheters and prolonged IV access

foreign bodies: pacemakers, grafts, internal diaylisis shunts, fistulas

onset is severe

fever greater than 38 deg C

involves septicemia

staph aureus, most common cause of acute IE

vague sx: prolonged fatigue and malaise (2-6) weeks

fever greater than 38 deg

strep viridians the most common cause of subacute IE

early recog of patients signs and sx

blood cultures

echo

TEE-trans electro cardio electrogram

mult sets (usually x3 initally before px takes any meds) of blood cultures

repeat sets required w/ temp elevation

repeat sets are required to monitor px and resolution to infection

based upon id and admin of proper antimicrobial ther

px are instruct to finish course of antibx

px require teaching infec prevention and health promotion

s virdians-after dental work or URI

s auerus-drug abuse or cardiac surg

s epidermis-prothetic heart valves and IV access

enterococci-elderly, GU infections

can also be candidia cocci or aspergillis

important to know type of organism to do proper treatment

fever (Not always seen in elderly), diaphoresis, fatigue

non spec sx-anoexia, wt loss, fatigue

splenomegaly

neuro involve-alt ment status, TIAs, aphasia, confusion, nerve paralysis

new onset murmur, inc intensity of murmur

PE or lung infiltrates, cough, edema,

renal involvement: glomulonephritis, renal absess

roth's spots (retinal hemorrhages) on eye fundi

petchia: conjunctiva, mucous membranes

splinter hemorrhages in nailbeds

medical dx of infec endo requires

major: 2 pos blood cultures, endocardial enlargement, valve disease (as new murmur)

minor: hx of cardiac dx, IV drug use, fever 100.4>, immunocompromised state