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endocarditis cardiology differential marantic checklist comparison criticalcare echocardiogram functional mitralvalve nbte noninfective pocus primary regurgitation stenosis table
What's the Dx? • 29-year-old male • Transfer community hospital • Hypotension • Renal failure • Altered mental status.
demonstrate a mobile mitral ... with a vegetation ... #Clinical #POCUS ... Echocardiogram #PLAX ... #MitralValve #Vegetation
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 Differentiating NBTE from Infective Endocarditis No pathognomonic signs/symptoms or echo features that are specific to NBTE, and
Differentiating NBTE from Infective ... high index of clinical ... false-negative results: vegetation ... already embolised, Vegetations ... in up to 30% of cases
Endocarditis checklist Initial evaluation • Peripheral blood cultures (three sets at three different sites) • Additional culture
Myocardial abscess • Vegetation ... cultures • Large vegetation ... repeat echo (to r/o vegetation ... #criticalcare #diagnosis ... #management
Causes of mitral stenosis Rheumatic heart disease - Most common cause worldwide. Commissural fusion, thick MV leaflets
Causes of mitral ... Whipple's disease Infective ... endocarditis (vegetations ... atrial myxoma)/ball valve ... #diagnosis #differential
Marantic Endocarditis Epidemiology: - Incidence of non-bacterial thrombotic endocarditis (marantic endocarditis if associated with cancer) is
cardiac valvular vegetations ... Clinical Findings ... irregularly shaped vegetations ... on mitral and aortic ... Vegetations mostly
Causes of Primary and Functional Mitral Regurgitation (MR) Causes of primary mitral regurgitation - Rheumatic heart
disease: Most common cause ... stenosis - Infective ... Vegetations seen ... valve - Secondary ... #Differential #Diagnosis
Endocarditis Summary Who? Infectious: • Pre-existing valvular disease • Prosthetic valve • Congenital heart disease • IV substance use • IV catheter • Recent
Involves aortic and mitral ... Septic Emboli Cause ... formation • Other vegetations ... -mm left sided vegetations ... #management #cardiology
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