In this episode, we break down infective endocarditis, a serious infection of the endocardial surface and heart valves that can lead to destructive vegetations and life-threatening complications. We walk through the underlying pathophysiology—from endothelial injury and platelet-fibrin deposition to bacteremia and vegetation formation—and highlight common pathogens such as Staphylococcus aureus and viridans streptococci. The episode emphasizes high-risk populations, including patients with prosthetic valves, prior endocarditis, IV drug use, and recent dental procedures. Clinically, we focus on key findings like fever, new or changing murmur, and classic embolic or immunologic signs (Osler nodes, Janeway lesions, splinter hemorrhages). We also review a practical diagnostic approach using blood cultures, echocardiography, and Duke criteria, along with management strategies centered on prompt, targeted IV antibiotics and surgical intervention when indicated. High-yield pearls reinforce early recognition and the importance of preventing devastating complications such as stroke, heart failure, and sepsis.

References

1. Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2. Nappi F. Native Infective Endocarditis: A State-of-the-Art-Review Microorganisms. 2024; 12(7):1481-.
3. McDonald EG, Aggrey G, Aslan AT, et al. Guidelines for Diagnosis and Management of Infective Endocarditis in Adults JAMA Netw Open. 2023; 6(7):e2326366-.