Bartonella henselae bacilli in cardiac valve of a patient with blood culture-negative endocarditis. The bacilli appear as black granulations.
Find information on thousands of medical conditions and prescription drugs.

Endocarditis, infective

Endocarditis is an inflammation of the inner layer of the heart, the endocardium. The most common structures involved are the heart valves. more...

Home
Diseases
A
B
C
D
E
Ebola hemorrhagic fever
Ebstein's anomaly
Eclampsia
Ectodermal Dysplasia
Ectopic pregnancy
Ectrodactyly
Edwards syndrome
Ehlers-Danlos syndrome
Ehrlichiosis
Eisoptrophobia
Elective mutism
Electrophobia
Elephantiasis
Ellis-Van Creveld syndrome
Emetophobia
Emphysema
Encephalitis
Encephalitis lethargica
Encephalocele
Encephalomyelitis
Encephalomyelitis, Myalgic
Endocarditis
Endocarditis, infective
Endometriosis
Endomyocardial fibrosis
Enetophobia
Enterobiasis
Eosinophilia-myalgia...
Eosinophilic fasciitis
Eosophobia
Ependymoma
Epicondylitis
Epidermolysis bullosa
Epidermolytic hyperkeratosis
Epididymitis
Epilepsy
Epiphyseal stippling...
Epistaxiophobia
EPP (erythropoietic...
Epstein barr virus...
Equinophobia
Ergophobia
Erysipelas
Erythema multiforme
Erythermalgia
Erythroblastopenia
Erythromelalgia
Erythroplakia
Erythropoietic...
Esophageal atresia
Esophageal varices
Esotropia
Essential hypertension
Essential thrombocythemia
Essential thrombocytopenia
Essential thrombocytosis
Euphobia
Evan's syndrome
Ewing's Sarcoma
Exencephaly
Exophthalmos
Exostoses
Exploding head syndrome
Hereditary Multiple...
Hereditary Multiple...
Hereditary Multiple...
Hereditary Multiple...
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Medicines

Endocarditis can be classified by etiology as either infective or non-infective, depending on whether a foreign micro-organism is causing the problem.

Infective endocarditis

As the valves of the heart do not actually receive any blood supply of their own, which may be surprising given their location, defense mechanisms (such as white blood cells) cannot enter. So if an organism (such as bacteria) establish hold on the valves, the body cannot get rid of them.

Normally, blood flows pretty smoothly through these valves. If they have been damaged (for instance in rheumatic fever) bacteria have a chance to take hold.

Read more at Wikipedia.org


[List your site here Free!]


Identifying infective endocarditis
From Nursing, 12/1/03 by Wisniewski, Amy

CHARACTERIZED BY inflammation of the endocardium, especially the heart valves, endocarditis is a serious infection that's usually caused by invading bacteria. Infection causes lesions (called vegetations) to form at the site of infection, which can damage intracardiac structures. A patient who has valvular heart disease or who's received a valve replacement is particularly vulnerable to endocarditis. Early diagnosis and treatment helps prevent complications, such as heart failure from damaged valves and organ damage from systemic emboli, which can occlude cerebral or coronary arteries.

Identifying the causes

Although causative microorganisms may vary according to the port of entry, endocarditis is most commonly caused by Gram-positive bacteria; alpha-hemolytic Streptococcus viridans and Staphylococcus aureus cause 80% of cases.

Predisposing factors include injection drug use, central vascular catheters, arterial catheters, and heart conditions such as mitral regurgitation and aortic stenosis.

Clues to diagnosis

Signs and symptoms may appear slowly or acutely (see Identifying Signs and Symptoms of Infective Endocarditis). Symptom acuity depends on the pathogen and the site of infection. For example, endocarditis involving the aortic valve may lead to severe aortic insufficiency and heart failure.

The health care provider will base the diagnosis on the patient's history, physical exam, signs and symptoms, and diagnostic test results.

* Blood cultures will be positive for causative microorganisms.

* An echocardiogram will detect anatomic defects, assess function, size vegetation, and show intracardiac complications. A transthoracic echocardiogram doesn't show vegetations less than 2 mm in diameter and can't be used in certain patients. A transesophageal echocardiogram is optimal for diagnosis of prosthetic endocarditis or detecting myocardial abscess, valve perforation, or intracardiac fistulae.

Early treatment

If endocarditis is treated early, the prognosis is good. For bacterial endocarditis, the health care provider will choose an antibiotic based on the results of blood cultures and sensitivities. In some patients, intracardiac and central nervous system complications of infective endocarditis may require surgical intervention.

Nursing considerations

Provide a calm, quiet environment for the patient and document his vital signs every 2 to 4 hours. Prepare him for insertion of a new I.V. line or a peripherally inserted central catheter for medication administration. Consider removing existing venous access lines because they may be contaminated.

Continually check the patient's SpO^sub 2^. Monitor him for a worsened or returning fever and assess for signs and symptoms of heart failure, such as dyspnea, orthopnea, and crackles. Also perform multisystem assessments to identify systemic embolization that may occur in the brain, spleen, bowel, extremities, or kidneys.

Before discharge, teach him the importance of checking with his primary care provider about taking prophylactic antibiotics before dental work or procedures that involve the respiratory, genitourinary, or gastrointestinal tract. Also tell him to notify his dentist and all other health care providers about his condition.

BY AMY WISNIEWSKI, RN, BSN

Amy Wisniewski is a case manager for Lehigh Valley Hospital in Allentown, Pa.

Copyright Springhouse Corporation Dec 2003
Provided by ProQuest Information and Learning Company. All rights Reserved

Return to Endocarditis, infective
Home Contact Resources Exchange Links ebay