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Pathophysiology
Clinical meaning
Infective endocarditis begins when bacteria enter the bloodstream and adhere to damaged endocardial surfaces, typically heart valves. Vegetations (fibrin-platelet-bacteria masses) form and can fragment, sending septic emboli to the brain, kidneys, spleen, and skin.
Exam Focus
Exam relevance
Risk factors:
- IV drug use (tricuspid valve)
- Prosthetic heart valves
- Structural heart defects
- Poor dental hygiene
- Rheumatic heart disease
- Immunosuppression
- Indwelling venous catheters
Diagnostics:
- Expect multiple blood cultures before antibiotics
- Expect echocardiogram (TEE preferred)
- Monitor temperature trends
- Expect CBC with differential (elevated WBC)
- Monitor for embolic events
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