๐งต of favorite Endocarditis notes compiled!
Elegant overview of differing presentations of Infective vs. Non-infective endocarditis by @CPSolvers.
Note: often no symptoms of non-infective endocarditis until embolization (eg stroke, mesenteric ischemia, renal infarcts) or valvular dysfunction (eg CHF).
Note: often no symptoms of non-infective endocarditis until embolization (eg stroke, mesenteric ischemia, renal infarcts) or valvular dysfunction (eg CHF).
Endocarditis Complications:
โฅ๏ธ Embolization +/- mycotic aneurysms
โฅ๏ธ Intra-cardiac abscess +/- heart blocks
โฅ๏ธ CHF via valvular dysfunction
Note:
โฅ๏ธ If suspicion for embolic stroke, it's prudent to add CNS vascular imaging to assess for CNS mycotic aneurysm. CONSULT NEURO.
โฅ๏ธ Embolization +/- mycotic aneurysms
โฅ๏ธ Intra-cardiac abscess +/- heart blocks
โฅ๏ธ CHF via valvular dysfunction
Note:
โฅ๏ธ If suspicion for embolic stroke, it's prudent to add CNS vascular imaging to assess for CNS mycotic aneurysm. CONSULT NEURO.
Manifestations of R.-sided endocarditis (in absence of PFO):
๐ซ Findings: cough, pleuritic chest pain, & (multi)focal lung auscultatory exam
๐ซ Imaging: (multi)focal peripheral lesions +/- cavitation
๐ซ Findings: cough, pleuritic chest pain, & (multi)focal lung auscultatory exam
๐ซ Imaging: (multi)focal peripheral lesions +/- cavitation
Comprehensive DDx of Infective (stratified by native vs. prosthetic valve) vs. Non-infective endocarditis by @AndreMansoor
Rheumatology & IE!
๐ฌ Low C3/C4 (indicating immune-complex disease)
๐ฌ (+) ANCAs
Result? Glomerulonephritis!
Note: nearly all patients in one study had circulating immune-complexes!
๐ฌ Cryoglobulinemia
๐ฌ (+) RF
Pearls from @AdamJBrownMD's @HRheuminations
๐ฌ Low C3/C4 (indicating immune-complex disease)
๐ฌ (+) ANCAs
Result? Glomerulonephritis!
Note: nearly all patients in one study had circulating immune-complexes!
๐ฌ Cryoglobulinemia
๐ฌ (+) RF
Pearls from @AdamJBrownMD's @HRheuminations
Dermatologic manifestations of endocarditis:
๐ฉธ Purpura & petechiae most common! Historically, under the eyelids (conjunctival) & on the palate
๐ฉธ Classic Janeway, Osler, & Splinter lesions much rarer given advent of echocardiography (earlier diagnosis)
๐ฉธ Purpura & petechiae most common! Historically, under the eyelids (conjunctival) & on the palate
๐ฉธ Classic Janeway, Osler, & Splinter lesions much rarer given advent of echocardiography (earlier diagnosis)
Surgical indications for endocarditis: V-HEART!
By @1min_idconsult
By @1min_idconsult
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