Endocarditis - Cardiovascular - Medbullets Step 2/3

Snapshot
- A 25-year-old woman presents to the emergency room for a fever. She has a history of intravenous drug use and had previously been treated for osteomyelitis. On physical exam, she is febrile, and heart auscultation reveals a new systolic murmur at the lower left sternal border. An echocardiogram reveals tricuspid valve vegetations.

Summary
- Endocarditis is an acute cardiac condition characterized by inflammation of the heart valve, typically secondary to bacterial infection. It is typically the result of bacteremia, often due to surgery, dental procedures, or as a complication of congenital heart disease. Patients present with systemic symptoms such as fatigue, fever/chills, new onset cardiac symptoms (murmur, heart failure), and if severe enough, end-organ damage. Classic skin manifestations such as Osler nodes, Janeway lesions, and splinter hemorrhages are also characteristic of the condition.
- Diagnosis is made via the Duke criteria, which involves meeting 2 major criteria, 1 major and 3 minor criteria, or 5 minor criteria. Major criteria include two positive blood cultures and echocardiography evidence. Minor criteria include fever, embolic signs, one positive blood culture, and other immunologic phenomena such as skin manifestations or kidney damage.
- Treatment is antibiotics or surgical valve replacement depending on the severity and chronicity of the disease.

Anatomy
- Both native and prosthetic valves serve as the site for infection
  
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