Equis ISSN 2398-2977

Heart: endocarditis

Synonym(s): Bacterial endocarditis, valvular endocarditis, vegetative endocarditis

Contributor(s): Karen Blissit, Karen Blissitt, Christopher Brown, Lesley Young

Introduction

  • Inflammatory changes to valvular endocardium.
  • Cause: bacterial.
  • Signs: vary depending upon underlying etiology: lethargy, recurreent pyrexia, malaise, sudden onset cardiac murmurs, congestive heart failure.
  • Diagnosis: hematology - serial positive blood culture in cases of bacterial endocarditis; echocardiography to confirm irregular valve thickening (vegetations) and valvular regurgitation.
  • Treatment: early and agressive treatment necessary. Long-term antibiotics for bacterial endocarditis.
  • Prognosis: poor - in many cases valvular damage is too severe to allow successful return to athletic performance, even if a bacteriological cure can be achieved.
  • There may be involvement of other organs (joints, kidneys) if there is shedding of septic emboli.

Pathogenesis

Etiology

Bacterial endocarditis

Specific

  • Pre-existing valvular damage may predispose to bacterial endocarditis.

Pathophysiology

  • Bacteria invade valve surface facing the flow of blood.
Acute
  • Bacteria   →   invade normal valves   →   ulceration   →   exposes underlying collagen.
  • Platelets attach to ulceration   →   thrombus formation   →   organization   →   shortening and deformation of the valves   →   valvular regurgitation; more rarely stenosis.

Chronic

  • Bacteremia   →   invade valves previously damaged.
  • Autoimmune complexes may affect other organ systems.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Froehlich W, Wlaschitz S, Reidelberger K & Reef V B (2006)Tricuspid valve endocarditis in a horse with ventricular septal defect.Equine Vet Educ18(4), 172-176 VetMedResource.
  • Verdegaal D J M Met al(2006)A right-sided bacterial endocarditis of dental origin in a horse.Equine Vet Educ18(4), 191-195 VetMedResource.
  • Verdegaal E J M M & Sloet van Oldruitenborch-Oosterbaan M M (2006)Endocarditis in the horse.Equine Vet Educ18(4), 196-198 VetMedResource.
  • Ramzan P H L (2000)Vegetative bacterial endocarditis associated with septic tenosynovitis of the digital sheath in a Thoroughbred racehorse.Equine Vet Educ12(3), 120-123 VetMedResource.
  • Maxson A D & Reef V B (1997)Bacterial endocarditis in horses: ten cases (1984-1995).Equine Vet J29(5), 394-399 PubMed.
  • Travers C W & van den Berg J S (1995)Pseudomonas spp. associated vegetative endocarditis in two horses.J S Afr Vet Asoc66(3), 172-176 PubMed.
  • Dwart S, Brown C, Derksen F & Kufuor-Mensa E (1992)Serratia marcescens endocarditis in a horse.JAVMA200(7), 961-963 PubMed.
  • Nilsfors L, Lombard C W, Weckner D & Kvart C (1991)Diagnosis of pulmonary valve endocarditis in a horse.Equine Vet J23, 479-482 PubMed.
  • Hillyer M H, Mair T S & Holmes J R (1990)Treatment of bacterial endocarditis in a shire mare.Equine Vet Educ2, 5-7 VetMedResource.
  • Dedrick P, Reef V B, Sweeney R W & Morris D D (1988)Treatment of bacterial endocarditis in a horse.JAVMA193(3), 339-342 PubMed.
  • Buergelt C D, Cooley A J, Hines S A & Pipers F S (1985)Endocarditis in six horses. Vet Pathol22(4), 333-337 PubMed.
  • McCormick B S, Peet R L & Downes K (1985)Erysipelothrix rhusiopathiae vegetative endocarditis in a horse.Aust Vet J62(11), 392 PubMed.
  • Bonagura J D & Pipers F S (1983)Echocardiographic features of aortic valve endocarditis in a dog, a cow and a horse.JAVMA182(6), 595-599 PubMed.


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