Systemic Manifestations of Endocarditis include: Heart valve disease, Pulmonary embolism, Splenomegaly, Retinal hemorrhages, Dermatologic hemorrhagic lesions.
Endocarditis - Neurologic Manifestations
systemic complications
Heart valve disease
- Heart murmur is the most reliable physical exam finding.
Pulmonary embolism
- Common in IV Drug Use with tricuspid valve endocarditis.
Splenomegaly
- In up to 30% of cases.
Retinal hemorrhages (aka Roth Spots)
- Are not specific to endocarditis (found in other immunologic diseases).
Dermatologic hemorrhagic lesions
- Petechiae: Oral/buccal & Extremities
- Osler Nodes: Tender Nodules: Fingers & Toes
- Janeway Lesions: NonTender Hemorrhages: Palms/Soles
Neurologic Complications
Cortical Strokes
- Most common finding (Cortically-based MCA strokes being the most common).
- Hemorrhagic conversion is common and complicates any use of anticoagulants/anti-thrombotics.
Mycotic Aneurysms
- In up to 10% of endocarditis patients
Abscesses, Meningitis, Arteritis
- All are possible but less common than the aforementioned strokes, hemorrhages, and mycotic aneurysms.