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they result from septic embolization of vegetations to the arterial vasa vasorum or the intraluminal space with subsequent spread of infection
splenic infarction is a common complication of left-sided ie 40 per cent of cases only 5 per cent of patients with splenic infarction will develop
occur in 10 per cent to 40 per cent of all native-valve ie and complicates aortic ie more commonly than mitral or tricuspid ie periannular infection
systemic embolization occurs in 22 per cent to 50 per cent of cases of ie emboli often involve major arterial beds including lungs coronary arteries
pericardial effusion indications for surgery pericardial effusion may be the result of peiicarditis due to infection autoimmune disease or
in native-valve ie acute chf occurs more frequently in aortic-valve infections 29 per cent than with mitral 20 per cent or tricuspid disease 8 per
within a week after initiation of effective antimicrobial therapy almost 75 per cent of patients with ie including those with pve are afebrile and 90
special studies to diagnose ie caused by fastidious bacteria and other organisms must be performed serological studies thereafter unless clinical or
two major objectives must be achieved to treat ie effectively the infecting micro-organism in the vegetation must be eradicated also invasive
results pericardiectomy used to have a mortality of 10-15 per cent in the earlier era at present it is around 3 to 5 per cent and does not
median sternotomy approach the preferred approach these days is through a median sternotomy pericardiectoiny proceeds in the same way as done
urine analysis - microhematuria with or without proteinuria may be seenecg - all patients with suspected ie should have baseline and follow up ecg
echocardiographic evaluation should be performed in all patients with clinically suspected ie including those with negative blood cultures not
in patients who have not received prior antibiotics and who will ultimately have blood culture positive endocarditis it is likely that 95 - 100 per
bull blood cultures are critical in the diagnosis and management of ie bull obtain blood cultures before starting antimicrobial therapy whenever
left antero lateral thoracotomy approach arterial and central venous pressure monitoring lines are placed a left antero lateral thoracotomy is
major criteria1 positive blood culturebull typical microorganism for infective endocarditis from two separate blood cultures viridans streptococci
a definitive infective endocarditis1 pathological criteriabull micro organism demonstrated by culture or histology in a vegetation or in a
indications for surgery once diagnosis of constrictive pericarditis is made and confirmed by chest x-ray ecg echocardiogram ct mri scan cardiac
the symptoms and signs of endocarditis are often constitutional and when localized often result from a complication of ie rather than reflect the
chf complicating ie is primarily the result of valve destruction or distortion or rupture of chordae tendinae intracardiac fistulas myocarditis or
constrictive pericarditis it is usually the end stage of inflammatory process involving pericardium in developing world infection with
neurological symptoms and signs occur in 30 to 40 per cent of patients with ie are more frequent when ie is caused by s aureus and are associated
oslers nodes are small tender subcutaneous nodules that develop in the pulp of the digits or occasionally more proximally in the fingers and persist
types of surgery pulmonary valve replacement using pulmonary or aortic allograft is the procedure of choice it increases rv ejection fraction