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In the pathogenesis of infective endocarditis of the right chambers of the heart, trauma to the tricuspid valve with a subclavian catheter or frequent intravenous injections plays a decisive role. The latter mechanism is especially relevant in the development of infective endocarditis in drug addicts, when the adverse effects of intravenous injections, in which tiny air bubbles injure the endocardium, are added to the violation of asepsis. Vegetations are most often located in the left parts of misoprostol pills - on the mitral and aortic valves. In intravenous drug users, the tricuspid valve is predominantly affected. It must be taken into account that vegetations occur more often in the presence of valve insufficiency than in stenosis. However, they are located predominantly on the atrial side of the mitral valve or the ventricular side of the aortic valve.
Endocardial vegetations are represented by organized fibrin, settled platelets, and colonies of microorganisms. The aortic valve is often affected, less often the mitral valve (valve destruction - perforation, cusp separation, rupture of chordae tendineae). Mycotic aneurysms are characteristic as a result of direct invasion by microorganisms of the aortic wall, vessels of internal organs, and the nervous system. Infarctions, abscesses and microabscesses are found in the heart and in various organs.
Classification of infective endocarditis. Working classification of infective endocarditis. Clinical picture and diagnosis of the disease. The polymorphism of the clinical picture of infective endocarditis, caused by multiple organ damage, determines the long time it takes to buy misoprostol online a diagnosis. In 40% of patients, the disease remains unrecognized for a long time or is not diagnosed at all; the frequency of detection of newly diagnosed infective endocarditis during surgery or autopsy varies from 13.3% to 25%. The modern course of infective endocarditis is characterized by the development of many complications that determine the leading organ pathology.
In typical cases, diagnosing infective endocarditis does not present significant difficulties. Fever, low-grade fever with chills and chills, the appearance of heart murmurs or changes in them, enlarged spleen, changes in the shape of fingers or nails, embolism, changes in urine, as well as anemia and an increase in ESR allow one to suspect this disease. Isolating the causative agent of infective endocarditis is of great importance, allowing not only to confirm the diagnosis, but also to select antimicrobial therapy.
Urine tests reveal microhematuria and proteinuria, despite the absence of clinical manifestations of kidney damage. With the development of glomerulonephritis, severe proteinuria and hematuria occur. Hemoculture. Bacteremia in subacute infective endocarditis is permanent. The number of bacteria in venous blood ranges from 1/ml to 200/ml in the subacute form of the disease. To buy cytotec online bacteremia, it is recommended to take venous blood samples three times in a volume of 16–20 ml with an interval of 1 hour between the first and lastvenipuncture. When identifying a pathogen, it is necessary to determine its sensitivity to antibiotics. ECG. Conduction disturbances (AV block, sinoatrial block) can be detected in 4–16% of patients, resulting from focal myocarditis or myocardial abscess against the background of infective endocarditis. With embolic damage to the coronary arteries, infarct ECG changes can be detected.