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Healing may occur by fibrosis or the lesion may progress to a necrotising endcarditis and, in extreme cases, left atrial rupture.
Healing may occur by fibrosis or the lesion may progress to a necrotising endcarditis and, in extreme cases, left atrial rupture.
If renal sufficieny is re-established then healing of the endocardial lesion is possible.
If renal sufficieny is re-established then healing of the endocardial lesion is possible.
=from clinical=
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===Infective Endocarditis===
[[Image:Bacterial endocarditis.jpg|right|thumb|125px|<small><center>'''Bacterial endocarditis'''. Courtesy of A. Jefferies</center></small>]]
====Signalment====
'''Present in small animals:'''
Dogs: (uncommon); Males & Large Breeds (e.g. German Shepherd) most affected
Cats: (rare)
'''Present in large animals:'''
Cattle: (common); Adult cattle
Swine: (very common); Young pigs
Horse: (uncommon); Males more affected
====Description====
*Infective endocarditis is a bacterial infection of the cardiac endocardium. The infection can affect the valves (valvular endocarditis) and then spread to the heart wall (mural endocarditis).
*Bacteremia is essential for the development of endocarditis. Once bacteria colonize the valvular endocardium, vegetative lesions composed of platelets and fibrin are formed on the valves. Pieces of the vegetative lesions can detach as emboli. Most often these emboli travel to the kidneys and spleen.
====Diagnosis====
=====History & Clinical Signs=====
-Sings of Embolization:
*sudden death
*lameness
*seizure
*arrhythmias
*cold extremities
-Signs of Sepsis:
*Pyrexia
*Neck Pain
*Joint Pain
*Muscle Pain
*Anorexia
*Lethargy
-Signs of Cardiac Involvement:
*Syncope
*Weakness
*Exercise Intolerance
*Heart Failure
*Pulmonary edema
*Pulse deficits
=====Physical Exam=====
-Systolic Murmur (Mitral Valve Affected)
-Diastolic Murmur (Aortic Valve Affected)
-Pulmonary crackles (If edema is present)
=====Laboratory Findings=====
-'''Urine analysis'''
*If UTI is present, could be (+/-) for the same bacteria that caused endocarditis
*Proteinuria
*Casts
*Pyuria
*Hematuria
-'''Blood Culture'''
*collect blood from the jugular vein
*3-4 sterile samples taken 1 hour apart over 24 hours and grown in enhancement media
*Positive culture (Rare)
*Negative culture is not diagnostic
-'''Blood Profiles:'''
*Hematology=leukocytosis, neutrophilia, monocytosis, nonregenerative anemia, thrombocytopenia (See with development of: disseminated intravascular coagulation); clotting times may be prolonged
*Biochemistry=hypoalbumenemia, hypoglycemia (if septic), signs of complications from emboli
=====Radiography=====
-Usually normal unless severe damage is present
-Left atrial and ventricular enlargement (Mitral Valve Incompetence)
-Right atrial and ventricular enlargement (Aortic Valve Incompetence)
-Signs of congestive heart failure with chronic/severe valve damage
=====Electrocardiography (ECG)=====
-Usually normal
-Arrhythmias (especially ventricular premature complexes; AV node damage causes 3rd degree AV block)
=====Echocardiography=====
-Vegetative lesions on valves and/ mural surfaces
====Treatment====
-Antibiotic given I/V for at least five days and then given orally for at least six weeks
(Broad Spectrum or Culture/Sensitivity)
-Manage secondary problems:
(e.g. septic shock, congestive heart failure, embolization, D.I.C.)
====Prognosis====
-Guarded
(Possibility of recurrent infections, embolic complications, congestive heart failure)
[[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]
[[Category:Endocardial_Pathology]][[Category:Cardiovascular_System_-_Inflammatory_Pathology]][[Category:Cattle]][[Category:Pig]][[Category:Sheep]]
[[Category:To_Do_-_Cardiovascular]]
[[Category:To_Do_-_Cardiovascular]]