The occurrence, diagnosis and treatment of infective endocarditis, one lesson to learn!

Only for medical professionals to read for reference.
From medication to surgery to intracavitary treatment, everything is available! Infective endocarditis (IE) is caused by pathogenic microorganisms that circulate through the blood and migrate from other infected parts to the heart to cause infection.
It mostly occurs in patients with organic heart disease
.

Its main clinical manifestations include fever, heart involvement, vascular damage and immune response, etc.
, and are considered to be one of the "fatal infectious disease syndromes"
.

So what is the specific mechanism of IE? How to diagnose and treat clinically? For this reason, Xiaojie specially invited Mr.
He Jinshan from Peking University People's Hospital to make this course "How Does Infective Endocarditis Happen?" ", take us to learn about the occurrence, diagnosis and treatment of IE
.

1.
The occurrence mechanism of IE The occurrence process of IE is as follows: First, the pathogen enters the blood through intravenous injection, infusion and other processes, and comes to various parts of the body, especially the heart
.

After the inner lining of the heart is damaged, bacteria adhere and colonize the damaged inner lining
.

Then the bacteria multiply and diffuse in large quantities, and even clumps of colonies, which are bacterial neoplasms, can form on the inner lining of the heart
.

Like other diseases, the occurrence of IE is also the result of the combined effects of external and internal environments, based on internal environments such as poor immunity, congenital heart disease, and external environments such as bacteremia
.

In terms of pathogens, almost all pathogens can cause IE
.

The pathogen of community-acquired IE is mainly streptococcus, and the main pathogens of hospital-acquired IE are Staphylococcus aureus and Enterococcus
.

As the number of patients undergoing intravascular, gastrointestinal, urinary tract interventional procedures and dialysis increased, the proportion of Staphylococcus aureus, coagulase-negative staphylococci and enterococci among pathogens increased
.

In addition, Brucella and fungi can also cause IE
.

IE classification is diverse, it can be divided into acute (virulent, harmful) and subacute, native valve and prosthetic valve, such as left ventricular and right heart
.

Second, the clinical manifestations IE IE can be systemic symptoms, including intracranial thrombosis, mucosal bleeding, splenomegaly, bleeding under the nail, clubbing, hematuria
.

From the perspective of the process of IE, when the patient develops IE, bacteria enter the blood first, and bacteremia occurs.
At this time, there will be symptoms of risk factors such as diabetes, congenital heart disease, and fever
.

After the surface of the heart by bacteria vegetation, serious damage to the structure of the heart valve regurgitation may be caused, block, heart failure
.

With vegetation cardiac cycle continues to swing, or even fall off, transferred to a different location, can cause cerebral infarction, skin and mucous membrane bleeding
.

In addition, neoplasms, as exogenous substances, will face the human immune response process and produce immune damage, which will cause IE-related glomerulonephritis and Osler nodules
.

The most common symptoms and signs of IE can be memorized in two words: FROMF: Fever; R: Roth's spots; O: Osler's nodes (Osler nodules); M: Murmur (new noise)
.

JANEJ: Janeway lesions (Janeway lesions); A: Anemia (anemia); N: Nail haemorrhage (undernail bleeding); E: Embolism (embolism)
.

3.
Diagnosis and treatment Seeing this, everyone should already know that almost all pathogens can cause IE.
Bacterial neoplasms seriously damage the structure of the heart and can cause various symptoms throughout the body.
The main symptoms and signs can be "FROM" and "JANE" "Two words are simply memorized
.

Due to space reasons, Xiaojie will talk about this today.
Next, Mr.
He Jinshan will also share wonderfully on blood culture, imaging and other methods of diagnosing IE, as well as the principles of internal and external combined treatment.
Xiaojie sincerely invites you to move.
View the complete course at the doctor station
.

There are more exciting content, such as: How to deal with severe diseases with arrhythmia? How to accurately identify different types of pulmonary hypertension? How to recognize the critical value of ECG according to the HEARTS rule? How does the echocardiogram of the heart behave in the early stage of hypertension? If you want to know the answer, enter the doctor's station learning course with Xiaojie! How to get the course? Scan the QR code of the poster below to unlock for free