2. Endocarditis is an inflammation of the inner layer
of the heart, the endocardium. It usually involves
the heart valves (native or prosthetic valves).
4. Infective endocarditis
• Previously known as bacterial endocarditis
• Infectious endocarditis involves the heart valves
and is most commonly found in people who
have underlying heart disease
6. Subacute bacterial
endocarditis (SBE)
• usually develops insidiously and progresses
slowly (i.e, over weeks to months
• Typically affect those with preexisting valve
damage
7. Acute bacterial
endocarditis (ABE)
• usually develops abruptly and progresses
rapidly (ie, over days)
• A source of infection or portal of entry is often
evident.
8. Etiologic factors
• Causes by gram- ve, gram+ve bact & fungi.
• Most often caused by Staphylococcus aureus and
streptococcus viridans
• Fungi
candida albicans
• Viruses
coxsackie B virus
9. Predisposing factors
• Cardiac conditions
prosthetic valves
congenital heart diseases
pacemakers
cardiomyopathy
• Non cardiac conditions
IV Drug abuse
intravascular devices
procedures like dental extraction, tonsillectomy etc..
13. Vascular manifestations
splinter haemorrhages- black longitudinal streaks in
the nail beds
Oslers nodes- painful, tender, red , pea shaped
lesions found on the fingertips or toes
Janeway’s lesions- flat, painless, small, red spots
found on the palms and soles
Roth spots- haemorrhagic retinal lesions on
fundoscopic examination
14.
15.
16.
17.
18. Diagnosis
• History collection
dental, urologic,surgical gynaecological procedure
past 3-6 months
history of CVD, related procedures
• Physical examination
• laboratory test
blood culture
total blood count
ESR
CRP
• ECHOCARDIOGRAM
19. Duke Criteria
• Positive blood culture
presence of Cardiac murmer
intracardiac mass/vegetation on echo
• ECG- AV BLOCK
• XRAY- CARDIOMEGALY
20. MANAGEMENT
• Prophylatic treatment
2 g of amoxicillin (Amoxil) 1 hour before
dental, oral, respiratory, or esophageal
procedures.
• If the patient is allergic to penicillin, methicillin
clindamycin cephalexin ,azithromycin
,clarithromycin may be used
22. Surgical management
• After the patient recovers from the infectious process,
seriously damaged valves may need to be replaced
• Mitral valve replacement
• Aortic valve replacement
23. Nursing management
• Hyperthermia related to infection of cardiac tissue as
evidenced by elavated temp,chills,malaise, tachycardia
• Decreased cardiac output related to altered rhythm,
valvular insufficiency as evidenced by
tachycardia,murmer
• Deficient knowledge related to lack of experience and
exposure of information about disease and treatment
process