cardiovascular disorders
Infective Endocarditis
Pathophysiology of Infective Endocarditis
Endocarditis has local and systemic consequences. Local consequences of infective endocarditis include Myocardial abscesses with tissue destruction and sometimes conduction system abnormalities (usually with low septal abscesses) Sudden, severe valvular regurgitation, causing Heart Failure (HF) and death (usually due to mitral or aortic valve lesions) Aortitis due to contiguous spread of infection Prosthetic valve infections are particularly likely to involve valve ring abscesses, obstructing vegetations, myocardial abscesses, and mycotic aneurysms manifested by valve obstruction, dehiscence, and conduction disturbances. Systemic consequences of endocarditis are primarily due to Embolization of infected material from the heart valve Immune-mediated phenomena (primarily in chronic infection) Right-sided lesions typically produce septic pulmonary emboli, which may result in pulmonary infarction, pneumonia, or empyema. Left-sided lesions may embolize to any tissue, particularly the kidneys, spleen, and central nervous system. Mycotic aneurysms can form in any major artery. Cutaneous and retinal emboli are common. Diffuse glomerulonephritis may result from immune complex deposition. 