HEART SPECIALIST

The valvular disease causes a sharp drop in blood pressure and turbulent blood flow that damages the lining of blood vessels and the formation of blood clots. This environment of vascular damage and extra clot formation creates a focus for bacteria to grow. Any focal infection (eg, pyelonephritis, pneumonia, abscess) or surgery performed on patients can cause bacteremia. The combination of these factors creates an environment for the development of endocarditis. The onset of the disease is often misleading and suspicious when signs and symptoms of fever, chills, sweating, malaise, fatigue and palpitations appear. Endocarditis can be life-threatening. The emergency physician should be aware of the patient's underlying valve disease, as special precautions must be taken to prevent the development of infectious endocarditis. Recommended endocarditis antibiotic regimens developed by the American Heart Association depend on the procedure and the level of risk associated with heart damage (see Chapter 64, Pericarditis, Myocarditis, and Endocarditis).

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