Endocarditis pathophysiology: Difference between revisions
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====Nonbacterial thrombotic endocarditis==== | ====Nonbacterial thrombotic endocarditis==== | ||
[[Nonbacterial thrombotic endocarditis]] (NBTE), also called '''marantic endocarditis''' is most commonly found on previously undamaged valves.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> As opposed to infective endocarditis, the vegetations in NBTE are small, sterile, and tend to aggregate along the edges of the valve or the cusps.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> Also unlike infective endocarditis, NBTE does not cause an inflammation response from the body.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> NBTE usually occurs due to hypercoaguable states such as systemic bacterial infection or pregnancy.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> NBTE may also occur in patients with [[cancer]], particularly mucinous [[adenocarcinoma]].<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> [[Libman-Sacks endocarditis]] is another form of sterile endocarditis; this form occurs more often in patients with [[lupus erythematosus]] and is thought to be due to the deposition of immune complexes. [[Libman-Sacks endocarditis]] involves small vegetations, while infective endocarditis is composed of large vegetations.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> These immune complexes precipitate an inflammatory reaction, which helps to differentiate it from NBTE.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> Also unlike NBTE, Libman-Sacks endocarditis does not seem to have a preferred location of deposition and may form on the undersurfaces of the valves or even on the endocardium.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> | [[Nonbacterial thrombotic endocarditis]] (NBTE), also called '''marantic endocarditis''' is most commonly found on previously undamaged valves.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> As opposed to infective endocarditis, the vegetations in NBTE are small, sterile, and tend to aggregate along the edges of the valve or the cusps.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> Also unlike infective endocarditis, NBTE does not cause an inflammation response from the body.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> NBTE usually occurs due to hypercoaguable states such as systemic bacterial infection or pregnancy.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> NBTE may also occur in patients with [[cancer]], particularly mucinous [[adenocarcinoma]].<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> [[Libman-Sacks endocarditis]] is another form of sterile endocarditis; this form occurs more often in patients with [[lupus erythematosus]] and is thought to be due to the deposition of immune complexes. [[Libman-Sacks endocarditis]] involves small vegetations, while infective endocarditis is composed of large vegetations.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> These immune complexes precipitate an inflammatory reaction, which helps to differentiate it from NBTE.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> Also unlike NBTE, [[Libman-Sacks endocarditis]] does not seem to have a preferred location of deposition and may form on the undersurfaces of the valves or even on the endocardium.<ref name=endo> Endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015</ref> | ||
===Gross and Microscopic Pathology=== | ===Gross and Microscopic Pathology=== | ||
Revision as of 18:48, 28 September 2015
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Endocarditis Microchapters |
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Diagnosis |
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Treatment |
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2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease |
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Case Studies |
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Endocarditis pathophysiology On the Web |
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Risk calculators and risk factors for Endocarditis pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]
Overview
The pathogenesis of infective endocarditis includes valvular damage, altered and turbulent flow, bacteremia, and lack of blood supply to the valves.[1][2] Damaged endothelium becomes a site for attachment of infectious agents in infectious endocarditis. Nonbacterial thrombotic endocarditis is related to hypercoaguable states such as pregnancy or systemic bacterial infection. The characteristic lesion of endocarditis is a vegetation.[3] Vegetations are composed of fibrin, inflammatory cells, platelets, and microorganisms.[3]
Pathophysiology
Pathogenesis
Infective Endocarditis
The pathogenesis of infective endocarditis includes:[1][2]
| Pathogenic Factors | Mechanism |
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Nonbacterial thrombotic endocarditis
Nonbacterial thrombotic endocarditis (NBTE), also called marantic endocarditis is most commonly found on previously undamaged valves.[2] As opposed to infective endocarditis, the vegetations in NBTE are small, sterile, and tend to aggregate along the edges of the valve or the cusps.[2] Also unlike infective endocarditis, NBTE does not cause an inflammation response from the body.[2] NBTE usually occurs due to hypercoaguable states such as systemic bacterial infection or pregnancy.[2] NBTE may also occur in patients with cancer, particularly mucinous adenocarcinoma.[2] Libman-Sacks endocarditis is another form of sterile endocarditis; this form occurs more often in patients with lupus erythematosus and is thought to be due to the deposition of immune complexes. Libman-Sacks endocarditis involves small vegetations, while infective endocarditis is composed of large vegetations.[2] These immune complexes precipitate an inflammatory reaction, which helps to differentiate it from NBTE.[2] Also unlike NBTE, Libman-Sacks endocarditis does not seem to have a preferred location of deposition and may form on the undersurfaces of the valves or even on the endocardium.[2]
Gross and Microscopic Pathology
The characteristic lesion of endocarditis is a vegetation.[3] Vegetations are composed of fibrin, inflammatory cells, platelets, and microorganisms.[3] Characteristic features of endocarditis on gross pathology and histopathological analysis include:[4]
| Endocarditis Subtype | Features on Gross Pathology | Features on Histopathological Microscopic Analysis |
| Infective Endocarditis |
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| Nonbacterial Thrombotic Endocarditis |
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Pathology
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Heart; Breast intraductal papilloma metastasis. Thrombotic Nonbacterial Endocarditis (Infected): Gross mitral valve natural color vegetations well illustrated these were secondarily infected with staphylococcus case of 8 year survival breast intraductal papillary adenocarcinoma with extensive metastases. Aortic valve also involved
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Thrombotic Nonbacterial Endocarditis Infected: Micro low mag H&E fibrin vegetation with masses of staphylococci and inflammatory cells in valve secondarily infected case 8 year survival breast papillary intraductal adenocarcinoma with extensive metastases gross is aortic valve lesions.
Videos
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References
- ↑ 1.0 1.1 Infective endocarditis. Wikipedia (2015). URL=https://en.wikipedia.org/wiki/Infective_endocarditis#Pathogenesis Accessed on September 21, 2015
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Endocarditis. Wikipedia (2015). URL= https://en.wikipedia.org/wiki/Endocarditis Accessed on September 21, 2015
- ↑ 3.0 3.1 3.2 3.3 Mylonakis E, Calderwood SB (2001). "Infective endocarditis in adults". N Engl J Med. 345 (18): 1318–30. doi:10.1056/NEJMra010082. PMID 11794152.
- ↑ Infective Endocarditis. Libre Pathology (2015). URL=http://librepathology.org/wiki/index.php/Infective_endocarditis Accessed on September 21, 2015