COMPLICATIONS OF INFECTIVE ENDOCARDITIS: THE COMMON TO THE DEVASTATING

Abstract

The initial diagnosis of infective endocarditis can be difficult and challenging to make. A delay in diagnosis can result in potentially life threatening outcomes. Care of the patient with endocarditis must include vigilant assessment for the development of signs and symptoms of embolization and other potential complications. A previously healthy 23-year old male presented to an urgent care centre with general malaise lasting two weeks. CBC, electrolytes, creatinine, chest x-ray, and blood cultures were drawn; the patient was sent home. When the blood cultures were reported positive for streptococcus mitis, the patient was redirected to emergency, and admitted for a full work up for endocarditis. An echocardiogram reported mitral valve (MV) vegetation, perforation, and severe MV regurgitation. Cardiac surgery was consulted and an urgent plan for MV repair or replacement was made. Surgery was delayed as the team was awaiting negative blood cultures. He remained in hospital to await surgery and was started on intravenous antibiotics. During this admission, the patient had complications that will be discussed. Infective endocarditis is a serious, potentially life threatening illness that requires a collaborative approach from the entire health care team. Nursing implications for infective endocarditis include cardiac monitoring for potential lethal arrhythmias, vigilant assessments for re-occurrence of infection, and signs and symptoms of heart failure or embolization.