Pathology of Endocarditis

Peter B. Baker, M.D.

Clinical Professor, Pathology

Cardiopulmonary Block Objective

Describe the pathologic features of bacterial and nonbacterial endocarditis

Objectives

List the features of acute and subacute infectious

endocarditis

Identify predisposing

factors for infectious

endocarditis

Describe the pathologic

features and list the morphologic complications of

infectious endocarditis.

Be able to identify 4 conditions

associated with sterile vegetations on cardiac valves

Infectious EndocarditisHandout X.B.1.a

Acute endocarditis

Short duration

Virulent organism

Large vegetations

Prominent tissue destruction

Previously normal valve

Subacute endocarditis

Longer duration

Low virulence organism

Small vegetations

Less tissue destruction

Previously abnormal valve

Infectious EndocarditisHandout X.B.1.b-c

Predisposing factors intracardiac shunts IV drug abuse valvular disease immunosuppression prosthetic valves

Pathogenesis endothelial damage

fibrin thrombi

organisms in the blood

Acute Bacterial EndocarditisAcute Bacterial Endocarditis

Bacterial Endocarditis

Vegetation

Valve

Bacterial Endocarditis

Valve

Vegetation

Infectious EndocarditisHandout X.B.1.d

Complications

rupture of chordae tendineae

contiguous spread

thromboembolism

septic emboli with abscesses

valvular regurgitation

Floppy Mitral Valve with Bacterial EndocarditisFloppy mitral valve with bacterial endocarditis

Aortic Valve with Bacterial endocarditisAortic Valve with Leaflet Perforation

Mitral Valve with Bacterial EndocarditisMitral Valve with Ruptured Chordae

Mitral Valve with Perivalvular Abscess

Abscess

Septic Embolus in Coronary ArterySeptic Embolus in Coronary Artery

Sterile Endocardial VegetationsHandout XII.B

Etiologies

1. Nonbacterial thrombotic endocarditis (marantic endocarditis)

2. Systemic lupus (Libman-Sacks endocarditis)

3. Acute rheumatic fever

4. Intra-cardiac devices (leads, catheters)

Nonbacterial Thrombotic EndocarditisNonbacterial Thrombotic Endocarditis

Histology of Nonbacterial Thrombotic EndocarditisNonbacterial Thrombotic Endocarditis

Valve Leaflet

Vegetation

Pathology of Endocarditis Quiz

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• I hope that I was able to teach the subject clearly.

• If you have any questions or feedback, write to me.

• Peter.Baker@ChildLab.com

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