Rheumatic Fever & Infective Endocarditis
This autoimmune disease occurs after untreated Streptococcus pyogenes infection and primarily damages cardiac connective tissue.
What is Rheumatic Fever?
An aneurysm is defined as dilation of a vessel to at least this multiple of its normal diameter.
What is 1.5 times normal diameter?
This is the most common cause of aortic stenosis in the elderly.
What is Degenerative Sclerosis?
Aortic insufficiency occurs during this phase of the cardiac cycle.
What is Diastole?
This autoimmune process can cause both valvular stenosis and regurgitation due to commissural fusion and collagen deposition.
What is RF?
This structure becomes hyperechoic and thickened when rheumatic valve disease progresses.
What are the valve leaflets/cusps?
This is the name of the second lumen created when blood tears through the intimal layer of an artery.
What is a false lumen?
Pressure overload from aortic stenosis causes this specific type of LV hypertrophy.
What is concentric hypertrophy?
Chronic AI leads to this specific type of ventricular hypertrophy.
What is eccentric Hypertrophy?
This congenital defect is associated with both aortic stenosis AND increased risk of infective endocarditis.
What is a bicuspid Aortic Valve?
This bacterium, commonly found in the mouth, is the most common cause of subacute infective endocarditis.
What is Streptococcus viridans?
This term describes a thrombus that forms along the vessel wall, commonly within aneurysms.
This post-valvular change of the ascending aorta occurs due to high-velocity systolic jet strain.
What is Post Stenotic Dilatation (PSD)?
This M-mode finding is caused by the regurgitant jet striking the anterior mitral leaflet.
What is Diastolic flutter of the AMVL?
What is the severity scale for AI using PHT method?
What is mild = >500 ms, moderate = 200-500 ms, and severe = <200 ms
In acute infective endocarditis, this organism—commonly found on the skin—is the most common culprit
What is Staphylococcus aureus?
This congenital narrowing of the thoracic aorta is often located near the ductus arteriosus.
This blood pressure pattern is classic in significant aortic insufficiency.
What is Wide pulse pressure?
With Aortic Stenosis, under ASE guidelines, you must interogate the valve using this piece of equipment.
This complication occurs when a vegetation breaks free and travels downstream, potentially causing “Blue Toe Syndrome.”
What is Embolization?
A 67-year-old male with a 40-year smoking history and uncontrolled hypertension presents with sudden onset left flank pain and purple discoloration of multiple toes.
Ultrasound reveals:
4.8 cm infrarenal abdominal aortic aneurysm
Eccentric mural thrombus occupying ~40% of lumen
No evidence of rupture
Triphasic flow in the proximal aorta
Monophasic flow in distal tibial arteries
No atrial fibrillation. No cardiac vegetations.
What is the most likely hemodynamic mechanism responsible for the toe discoloration in this patient?
What is microembolization of unstable mural thrombus in AAA?
Patient's echo shows the following measurements:
AV VMax = 3.6
MPG = 29
AVA = 1.4
What is the severity of stenosis?
What is moderate?
Acute aortic insufficiency leads to this dangerous LV hemodynamic state.
What is a pressure overload?
A 24-year-old patient with a history of untreated streptococcal pharyngitis at age 8 presents with:
Thickened, hyperechoic mitral leaflets
Mild aortic regurgitation
Enlarged left atrium
New low-grade fever
Positive blood cultures after recent dental surgery
TTE reveals a small, mobile echodensity on the atrial side of the mitral valve.
Despite normal LV systolic function, the patient now develops acute pulmonary edema.
What is the most likely pathophysiologic mechanism that explains the sudden pulmonary edema in this patient?
What is Rheumatic fever and infective endocarditis?