Endocarditis classification
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2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease |
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Risk calculators and risk factors for Endocarditis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Endocarditis is classified based upon the underlying pathophysiology of the process (infective versus non-infective) and the acuity of the process (acute versus subacute).
Pathophysiologic Classification
Infective Endocarditis
Given the poor vascular supply of the heart valves, entrance of infection fighting components of the bloodstream (such as white blood cells) are reduced. So if an organism (such as bacteria) establishes a foothold in the valves, the bodies ability to fight the infection inside the valve structures is reduced.
Normally, blood flows smoothly through these valves. If they have been damaged (for instance in rheumatic fever) the trauma of non-laminar flow can increase the risk of infection. Likewise, damage to the endothelium or lining of the vascular structures improves the ability of bacteria to bind to the surface.
Non-infective Endocarditis
Non-infective or marantic endocarditis is rare. A form of sterile endocarditis is termed Libman-Sacks endocarditis; this form occurs more often in patients with lupus erythematosus and the antiphospholipid syndrome. Non-infective endocarditis may also occur in patients with cancer, particularly mucinous adenocarcinoma.