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6.heart pathology; endocarditis

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6.heart pathology; endocarditis

  1. 1. Heart -Pathology Endocarditis Infective Endocarditis Feature Acute IE Sub-acute IE Valve Previously normal Deformed Organism Highly virulent (Staph. Aureus) Less virulent (Strep. viridans) Course Rapid progression Slow Out –come Fatal Recover 1 Dr. Krishna Tadepalli, MD, www.mletips.com
  2. 2. Heart -Pathology Endocarditis  Infective Endocarditis  Prosthetic valves  Staph. epidermidis  Clinical  Fever, Murmurs ( changing quality), hemorrhages ( flame shaped – splinter h.ages at nail beds, Roth spotsRetina), osler’s node – subcutaneous at finger pulps  Morphology vegetations ( MC in left side- MV, AV,IV Drug abusers – Right side, septic )  Complications  Stenosis/Regrgitation, CHF, Bursting of Prosthetic valves, septic emboli, Glomerulonephritis  Diagnosis  Duke’s criteria ( serial Blood cultures, Echocardiography findings)  Prevention Prophylactic antibiotics in patients congenital heart diseases and prosthetic valves 2 Dr. Krishna Tadepalli, MD, www.mletips.com
  3. 3. Heart -Pathology Endocarditis  Non bacterial Thrombotic Endocarditis  Sterile vegetations/ thrombi  Seen in debilitated patients  Causes DIC & Mucinous adenocarcinomas  SLE  Libman – Sacks endocarditis  Affects  mainly MV and TV  Mechanism  Immunological ( like RHD)  Morphology  Fibrinoid necrosis  Location  vegetations on both sides of valve 3 Dr. Krishna Tadepalli, MD, www.mletips.com
  4. 4. Heart -Pathology Artificial Valves Types Feature Mechanical Bioprosthesis Material Synthetic Porcine aortic valve Thromboembolism Major problem - Structural damage + ++++ 4 Dr. Krishna Tadepalli, MD, www.mletips.com
  5. 5. Heart -Pathology Carcinoid Heart Disease  MC site of carcinoid tumor  Appendix  Secretes Serotonin or 5-HT  Serotonin from GI carcinoids  metabolized in liver  no carcinoid syndrome  If there are Liver metastasis  serotonin in venous circulation  carcinoid syndrome  Serotonin in Carcnoid syndrome pts. metabolized in Lungs  Only right side heart lesions  Bronchial and Gonadal carcinoids, patients with Rt. to Lt. heart shunts left heart lesions  Features of carcinoid syndrome 5 Dr. Krishna Tadepalli, MD, www.mletips.com
  6. 6. Heart -Pathology Carcinoid Heart Disease Features of carcinoid syndrome Vasodilatation  flushing of skin, face GI Hyper motility  cramps, nausea, vomiting, diarrhea Heart  mainly Rt. Side valve dysfunction ( due to thickening and Acid MPS deposits) 6 Dr. Krishna Tadepalli, MD, www.mletips.com
  7. 7. Heart -Pathology Carcinoid Heart Disease Features of carcinoid syndrome Vasodilatation  flushing of skin, face GI Hyper motility  cramps, nausea, vomiting, diarrhea Heart  mainly Rt. Side valve dysfunction ( due to thickening and Acid MPS deposits) 6 Dr. Krishna Tadepalli, MD, www.mletips.com

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