Cardiac Valve Infection and Inflammation

Info

🌱 來自: Huppert’s Notes

Cardiac Valve Infection and Inflammation🚧 施工中

Cardiac Valve Infection and Inflammation

Rheumatic fever

•   Etiology: Complication of inflammatory reaction to group A strep spp. Jones criteria: Strep infection and two major criteria OR one major criteria and two minor criteria:

-   Major criteria: Migratory polyarthritis, erythema marginatum, cardiac problems (pericarditis, CHF, valve), chorea, subcutaneous nodules

-   Minor criteria: Fever, ESR ≥60 mm/hr or CRP ≥3 mg/L, p[.omicron]lyarthralgias, prolonged PR interval on ECG

•   Treatment: Treat strep pharyngitis with penicillin; NSAIDs or steroids. Consider penicillin prophylaxis to prevent recurrence.

Endocarditis

•   Infectious endocarditis: See Infectious Diseases Chapter 8

•   Nonbacterial thrombotic endocarditis (marantic endocarditis): Rarely, malignancy can cause sterile depositions of fibrin/platelets that attach to the cardiac valves. Treatment: Anticoagulation.

•   Nonbacterial verrucous endocarditis (Libman-Sacks endocarditis): Noninfectious endocarditis that occurs in the setting of systemic lupus erythematosus, typically with vegetations on both sides of the valve. Treatment: Anticoagulation, treat lupus or underlying condition.