Moffitt Cardiology Report 9/8: Endocarditis and aortic regurgitation

Thanks as always to YY for a great discussion. See below for some of the major learning from our case about endocarditis.

Take-home pearl: according to HH, approx. 25-30% of patients with left-sided endocarditis go on to require a valve replacement, even if there was no acute indication for a valve initially

Management of aortic regurgitation

  • Valve surgery is the mainstay of treatment!
  • Afterload reduction is a temporizing measure (if allowed by the blood pressure.) Nitroprusside is a good agent to use, but beware in patients with renal disease
  • Balloon pumps are CONTRAINDICATED because inflation of the balloon in diastole will worsen the AR

What is Strep mitis?

  • A type of viridans Strep
  • Found in the oropharynx
  • When thinking about viridans strep endocarditis, ask yourself two things
  • Is it abscess forming? S. milleri, S. anginosus, S. intermedius
  • Is it penicillin sensitive? This will affect your choice of therapy and whether it requires aminoglycoside synergy when treating

Evernote link: http://www.evernote.com/l/APiCzsBC0z5L6qkRhuZnhzq7eDxHnzJwxqQ/

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