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By origin, primary and secondary infective endocarditis is distinguished. Primary usually occurs in septic conditions of various etiologies against the background of unchanged heart valves. Secondary - develops against the background of existing pathology of crestor pills vessels or valves due to congenital defects, rheumatism, syphilis, after valve replacement surgery or commissurotomy. According to the clinical course, the following forms of infective endocarditis are distinguished.
The acute - duration up to 2 months, develops as a complication of an acute septic condition, severe injuries or medical manipulations on blood vessels and heart cavities. nosocomial (in-hospital) angiogenic (catheter) sepsis. It is characterized by a highly pathogenic pathogen and severe septic symptoms. subacute – duration more than 2 months, develops with insufficient treatment of acute infective endocarditis or the underlying disease. In drug addicts, the clinical features of infective endocarditis are young age, rapid progression of right ventricular failure and general intoxication, infiltrative and destructive lung damage.
In elderly patients, infective endocarditis is caused by chronic diseases of the digestive system, the presence of chronic infectious foci, and damage to the heart valves. There are active and inactive (healed) infective endocarditis. According to the degree of damage, endocarditis occurs with limited damage to the heart valves or with damage extending beyond the valve. The following forms of infective endocarditis are distinguished. Symptoms of infective endocarditis.
The course of infective endocarditis may depend on the duration of the disease, the age of the patient, the type of pathogen, as well as on previously administered antibacterial therapy. In cases of a highly pathogenic pathogen (Staphylococcus aureus, gram-negative microflora), an acute form of infective endocarditis and early development of multiple organ failure are usually observed, and therefore the clinical picture is characterized by polymorphism.
Most patients with infective endocarditis have damage to the heart muscle (myocarditis), functional murmurs associated with anemia and valve damage. When the cusps of the mitral and aortic valves are damaged, signs of their insufficiency develop. Sometimes angina is observed, and occasionally a pericardial friction rub is noted. Acquired valve defects and myocardial damage lead to buy crestor online.
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In the subacute form of infective endocarditis, embolism of the vessels of the brain, kidneys, and spleen occurs due to thrombotic deposits torn off from the heart valves, accompanied by the formation of infarctions in the affected organs. Hepato- and splenomegaly are detected, from the kidneys - the development of diffuse and extracapillary glomerulonephritis, less often - focal nephritis, arthralgia and polyarthritis are possible.
Complications of infective endocarditis.
Complications of infective endocarditis with a fatal outcome are septic shock, embolism in the brain, heart, respiratory distress syndrome, acute heart failure, and multiple organ failure.
Diagnosis of infective endocarditis.
When collecting anamnesis from the patient, the presence of chronic infections and past medical interventions is determined. The final diagnosis of infective endocarditis is confirmed by data from instrumental and laboratory studies. A clinical blood test reveals large leukocytosis and a sharp increase in ESR. Multiple tests have important diagnostic value.blood culture to identify the causative agent of infection. It is recommended to collect blood for bacteriological culture at the height of fever.
Biochemical blood test data can vary widely for a particular organ pathology. With infective endocarditis, changes in the protein spectrum of the blood are observed. (α-1 and α-2-globulins increase, later - γ-globulins), in the immune status (CEC, immunoglobulin M increases, the overall hemolytic activity of rosuvastatin pills, the level of anti-tissue antibodies increases).