(Infection)

Overview

• Infection of the endocardium that typically affects 1 or more heart valves
• M>F, >60 yrs old
• Risk Factors → prosthetic heart valves, congenital heart defects, dental procedures, IV drug use (more likely to present with right sided valve problems), post-heart transplant, previous IE, cardiac implanted electronic device (pacemaker), acquired degenerative valve disease (aortic stenosis)
• Mitral valve > Aortic valve > Tricuspid valve > Pulmonary valve (Tricuspid most likely in IV drug use)

Causative Agents:

• Staphylococcus aureus → most common cause of acute IE. IV drug use & patients with prosthetic valves
  • Staphylococcus epidermidis (coagulase negative) ****→ if <2 months post valve surgery
• Streptococcus Viridans → most common cause of subacute IE. Mainly in predamaged native valves. Common cause following dental procedures
• Streptococcus bovis → predisposes to both infective endocarditis and colorectal cancer.

(Staphylococcus = in clusters. Streptococcus = in chains)

Making Diagnosis

Clinical Features:

• Fever/chills
• New Heart murmur
• Night sweats, Malaise, Fatigue, Anorexia, Weight loss, Weakness, Headache, Tachycardia