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Case 2
History
- 35yo male
- ED admission, C/O: fever, sweats, palpitations, lethargy, dyspnoea, pleuritic chest pain
- PMX: Haemodialysis via RIJV Tunnelled Cath
- O/E:febrile, tachycardic, hypotensive,↓O2 sats
- CVS: S1,S2, diastolic murmur,
- RS: bibasal crepitations, bibasal dullness
Diagnosis
- SBE AV with severe AI + LVF, incidental PE
- 1885, William Osler first description of endocarditis in English.
- Infection of intravascular lines primary risk factor for Staph aureus bacteraemia → primary pathogen of endocarditis.
- Prosthetic valves , IVDA (TV), RF, sclerosis, MVP, iatrogenic
Treatment
- Antibiotics, anticoagulation
- Considering AVR
- Had pre-op coronary CTA as cor angio high risk Normal coronary