Term
| What is infective endocardititis? |
|
Definition
| A microbial infection of the endothelial surface of the heart or heart valve |
|
|
Term
| Whaat else can cause the infection besides bacteria? |
|
Definition
|
|
Term
| What is IE classified by? |
|
Definition
| causative microorganism and the type of valve that is infected, and sometimes the source |
|
|
Term
| What was believed to be the cause of IE? |
|
Definition
|
|
Term
| What is done before some invasive dental procedures to avoid it? |
|
Definition
|
|
Term
| What is the mortality rate of IE? |
|
Definition
| 40%- seen in middle age, older people, and more in men |
|
|
Term
| What is now the most common underlying condition among patients who acquire IE? What was the old one? |
|
Definition
-mirtal valve prolapse is believed to cause the most cases of IE(native valve E)
-old cause was believed to be rheumatic heart disease |
|
|
Term
| What is the common bacterias cause of IE? |
|
Definition
-staphylococcus aureus(most common for intravenous drug users)
-streptococcus(most common)
-enterococci |
|
|
Term
| What heart valve is usually affected? |
|
Definition
| the right(mitral heart valve) |
|
|
Term
| Is S. Auerus part of the normal flora of the oral cavity? |
|
Definition
|
|
Term
|
Definition
-damage occurs
-platelets and fibrin attach to damaged area
-bacteria attach to these masses
-additional platelets and fibrin attach over the bacteria and protect it
-bacteria is slowly released into the blood stream |
|
|
Term
| What is the usual treatment for IE? |
|
Definition
|
|
Term
| What is the most common complication and cause of death in IE? |
|
Definition
| heart failure(results from severe valvular dysfunction) |
|
|
Term
| What can embolism of the platelet and fibrin fragments cause? |
|
Definition
|
|
Term
| What are the classic findings of IE? (3) |
|
Definition
1.fever**most common(may be absent in old, heart, or renal failure)
2.heart murmur
3.positive blood culture |
|
|
Term
| What is the incubation period of IE? |
|
Definition
|
|
Term
| What is found in 80% of patients with IE? |
|
Definition
| new or changing heart murmurs |
|
|
Term
| What are some peripheral manifestations of IE due to emboli and/or immunologic responses? |
|
Definition
-Janeway lesions***
-petechiae
-splinter hemorrhages in nails
-roth spots
-enlarged spleen
-clubbing of digits |
|
|
Term
| What does diagnosis of IR require? |
|
Definition
A fever and one of the following:
-A predisposing cardiac lesion or behavior pattern
-Bacteremia
-Embolic phenomena
-Evidence of an active endocardial process |
|
|
Term
| What are the two major criteria that indicate IE? |
|
Definition
-positive blood test
-evidence of endocardial involvement
**other symptoms are considered minor** |
|
|
Term
| What are some lab tests for IE? (besides blood culturing) |
|
Definition
-A complete blood count with differential
-Electrolyte panels
-Renal function tests
-Urinalysis
-Plain chest radiograph
-Electrocardiogram (ECG) |
|
|
Term
| What is used to prevent death in IE? |
|
Definition
| antibiotics, death still occurs in 40% of cases |
|
|
Term
| What antibiotics treat IE? |
|
Definition
-penicillin(best)
-ceftriaxone
-vancomycin (best alternative for penecillin) |
|
|
Term
| What may require surgery in IE? |
|
Definition
-Moderate to severe heart failure caused by valvular dysfunction
-Unstable or obstructed prosthesis
-Infection uncontrollable by antibiotics alone
-Fungal endocarditis
-Intracardiac complications with PVE |
|
|
Term
| Is a premed needed for IE? |
|
Definition
| Prophylaxis is recommended only for those patients with the potentially most serious outcomes from IE(any dental treatment) |
|
|
Term
| Does undergoing dental procedures really make you more at risk for IE? |
|
Definition
| no, you are more at risk in your daily activities |
|
|
Term
| When should antibiotics be administered? |
|
Definition
| 30-60 mins before procedure |
|
|
Term
| Do antimicrobial rinses lower your risk of IE? |
|
Definition
|
|
Term
| WHat antibiotics should be given to those people already on penicillin? |
|
Definition
-Clindamycin
-azithromycin
-clarithromycin |
|
|
Term
| If a patient is undergoing cardiac surgery when should they get dental treatment? |
|
Definition
|
|
Term
| Who is at risk for IE who have normal heart valves? |
|
Definition
|
|
Term
| What is Viridans streptococci? |
|
Definition
-normal flora of the mouth
-accounts for most community associated cases of NVE |
|
|
Term
| What are the two MAJOR criteria/cardinal elements of IE? |
|
Definition
-positive blood culture
-evidence of endocardial involvement |
|
|
Term
| Does the AHA recommend routine antibiotic prophylaxis for patients with nonvalvular vascular devices? |
|
Definition
|
|
