Pricardial effusion associated with Infective Endocarditis : Incidence , mechansim and clinical Implication.

Pericardial effusion is often detected in patients with Infective endocarditis. Incidence can be as high as 25% . Most often it is mild, can be moderate in few. Mechanism Sympathetic effusion in response to endocardial infection. It’s never more than minimal. (Evidence ? it’s only an assumption) IE related cardiac failure (Raised systemic venous pressure to which pericardial veins drain) Local sepsis, Abcess formation tracks to pericardial space through transmural lymphatics Fungal , granulomatous , Tuberculous IE (Rare) Here IE and PE  share the same pathology Part of systemic sepsis activated Immune mechanism (Polyseroists) Renal Involvement of IE-Renal failure Postoperative pericardial effusion in Prosthetic valve IE (Common, often loculated) Clinical Implication If the pericardial effusion is more than mild, it often denotes worse outcome. This implies more extensive infection or a marker of extracardiac causes of effusion like renal dysfunction. Effusion may predispose to local dissemination of infection and ends up as peri-annular abscess is whether it is a cause or effect of effusion remains to be understood.It is often exudate as one would expect, but transudative  effusions also occur and would indicate more benign course. The sterility of pericardial fluid has not been proven. Culture studies are rarely done from effusions associated with IE. Pericardial effusions appear more often seen in IE of right heart valves. They turn out to be  IV drug ab...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cardiology -Therapeutics Cardiology -unresolved questions Infrequently asked questions in cardiology (iFAQs) pericardial disease pericardial effusion Pericardium infective endocarditis pericardial effusion in infective endocarditis Source Type: blogs