1. Pathology of Endocarditis Peter B. Baker, M.D. Clinical Professor, Pathology

2. Cardiopulmonary Block Objective  Describe the pathologic features of bacterial and nonbacterial endocarditis

3. 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

4. Infectious Endocarditis Handout 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

5. Infectious Endocarditis Handout 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

6. Acute Bacterial Endocarditis

7. Bacterial Endocarditis Vegetation Valve

8. Bacterial Endocarditis

9. Valve Vegetation

10. Infectious Endocarditis Handout X.B.1.d  Complications rupture of chordae tendineae contiguous spread thromboembolism septic emboli with abscesses valvular regurgitation

11. Floppy Mitral Valve with Bacterial Endocarditis Floppy mitral valve with bacterial endocarditis

12. Aortic Valve with Bacterial endocarditis Aortic Valve with Leaflet Perforation

13. Mitral Valve with Bacterial Endocarditis Mitral Valve with Ruptured Chordae

14. Mitral Valve with Perivalvular Abscess Abscess

15. Septic Embolus in Coronary Artery

16. Sterile Endocardial Vegetations Handout 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)

17. Nonbacterial Thrombotic Endocarditis

18. Histology of Nonbacterial Thrombotic Endocarditis Nonbacterial Thrombotic Endocarditis Valve Leaflet Vegetation

20. Thank you for completing this module 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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