INFECTIVE

ENDOCARDITIS
Presented By:
Hemlata Lalia
. M.Sc Nursing 1st yr
INTRODUCTION
Infective endocarditis is an infection of the
valves and endothelial surface of the heart.
Endocarditis usually develops in people with
cardiac structural defects (eg, valve
disorders). Infective endocarditis is more
common in older people, probably because of
decreased immunologic response to infection
and the metabolic alterations associated with
aging..
DEFINITION:
Infective endocarditis (IE) is defined as an
infection of the endocardial surface of the
heart, which may include one or more heart
valves, endocardium.
Risk factors:
: Previous history of endocarditis
• Dental procedures which lead into the
introduction of bacterias
• Heart surgery
• Intubations
• Pacemaker
• Artificial valve
• Congenital heart defects
 Conti…
• Procedures involving gastro intestinal and
genitourinary tracts e.g. barium, enemas,
sigmoidoscopy, catheterization and
cystoscopy
• Reproductive conditions like delivery of
new babies, abortions and pelvic
inflammatory disease
• Drug abuse.
Causes
Causes
• Fungus
e.g. candida
• Bacteria
e.g. staphylococci
• Gram negative organisms e.g. pseudomonas
• Staphylococcus aureus
• Acute rheumatic fever which cause enlarged
and tender lymph nodes, damages the
valves
 Conti…
HACEK organisms
• Hemophilus, Actinobacillus,
• Cardiobacterium,
• Eikenella
• Kingella
• Pseudomonas aeruginosa
 Pathophysiology:

Bacteria or any other causing agents enter the

blood stream through invasive procedures like
dental procedures, surgery , urinary
catheterization

accumulate on the valves of the heart or

endocardium

•
 Form vegetation or crusters

Vegetation lead into damage heart valves by

perforating and deforming the valves leaflets

This at the end leads to tearing which means there

is poor flow of blood and lead into accumulation
of blood in chambers of the heart hence
endocarditis.
Clinical
manifestation
• Fever
• Dyspnea
• cough
• Chest pain
• Cardiac murmurs
• Petechiae
• Osler nodes
• Janeway lesions
Osler nodes
Janeway Lesions
 Conti…
• Splenic enlargement, infarction
• Septic or bland pulmonary embolism
• Splinter Hemorrhages
• Roth spots
• Splenomegaly
• Hematuria
• Proteinuria
• Malaise
Roth spots
Splinter Hemorrhages
DIAGNOSIS
 DIAGNOSIS
• History collection
• Physical examination
• Blood cultures
• Complete blood count
• ECG
• Echocardiogram
• Chest X-ray
• CT scan
 Medical Management:
Antibiotic:
• Amoxicillin
Antifungal agent:
• Amphotericin
Anticoagulant
Symptomatic management
SURGICAL
MANAGEMENT
 Surgical valve replacement
• Mechanical valve
• Biological valve
 Preventions of infective
endocarditis:
• special attention to your dental health —
brush and floss your teeth and gums often,
and have regular dental checkups.
• Avoid procedures that may lead to skin
infections, such as body piercings or tattoos.
 Conti…
• Aseptic technique should use during
procedures.
• Ask patient for medical attention if any type
of skin infection or open cuts or sores that
don't heal properly.
.
NURSING
MANAGEMENT
NURSING DIAGNOSIS:
• Infective breathing pattern related to
inflammation of heart muscle as evidenced
by use of accessory muscle, dyspnea.
• Impaired gaseous exchange related to fluid
accumulation in the lungs as evidenced by
shortness of breath.
• Impaired thermoregulation related to
infection as evidenced by increased body
temperature (fever).
 Conti…
• Decreased cardiac output related to valvular
dysfunction as evidenced by poor tissue
perfusion
• Imbalanced nuk.,trition less than body
requirement related to anorexia as
evidenced by loss of weight.
• .
 Conclusion:

A microbial infection of the endothelial

surface of the heart or valves .Its intra cardiac
effects include severe valvular insufficiency,
which may lead to intractable congestive heart
failure and myocardial abscesses if left
untreated.
 Summary:

• Discussed about definition, risk factors,

causes, clinical manifestations,
pathophysiology, diagnostic evaluations,
medical, surgical and surgical management
of infective endocarditis.
 Bibliography:

• Suddarth’s Bruner “Textbook Of Medical

Surgical Nursing” Published By “Wolter
Kluwer”11th Edition, Page No , 780-782
• Lewis “Text Book Of Medical Surgical
Nursing’’ Published By “Elseviere’’ 7th
Edition, Page No.762 – 765
• https://www.slideshare.net
• https://en.wikipedia.org/wiki
•