Presentation: A patient had a MVR (replacement) several years ago and is asymptomatic but had this echo loop.
#1: What is the definition of endocarditis?
#2: What is the diagnosis?
Explanation:
The definition of
endocarditis requires one of three following requirements being met:
(Duke
Criteria)
1 - Two major
criteria are present
2 - One major and
three minor criteria are met
3 - Five minor
criteria are met
Major Citeria
1. Positive Blood
Culture for Infective Endocarditis
2. Evidence of
Endocardial Involvement
- oscillating intracardiac mass on valve or supporting structures, in the path of regurgitant jets,
or on implanted material in the absence of an alternative anatomic explanation, or - abscess, or
- new partial dehiscence of prosthetic valve
- new heart murmur
Minor Criteria
1. Predisposition:
Predisposing heart condition or intravenous drug use
2. Fever:
temperature > 38.0 ° C (100.4 ° F)
3. Vascular
Phonomena: major arterial emboli, septic pulmonary infarcts, mycotic
aneurysm, intracranial hemorrhage, conjunctival hemorrhages, and
Janeway lesions
4. Immunologic
Criteria: glomerulonephritis, Osler's nodes, Roth spots, and
rheumatoid factor
5.Microbiological
Evidence: positive blood culture but does not meet a major criterion
as noted above or serological evidence of active infection with
organism consistent with IE
6. Echocardiographic Findings: consistent with IE but do not meet a major criterion as noted above
6. Echocardiographic Findings: consistent with IE but do not meet a major criterion as noted above
The patient does not
meet the above criteria so this mass is a thrombus.
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