The pathogenic bacteria directly attack the endocardium, especially the heart valves.
Acute infective endocarditis (AIE) or acute bacterial endocarditis (ABE): mainly invades the mitral and aortic valves, causing septic inflammation. Superfluous organisms form on the involved valves. The warty superfluous organisms are large, brittle, grayish-yellow or light green, and easily broken into bacterial-containing emboli. Components are purulent exudate, thrombus, necrotic tissue, and bacterial piles.
Subacute bacterial endocarditis (SBE): caused by Streptococcus griseus and others. Most often invades mitral and aortic valves and is characterized by the formation of redundant, brittle, easily broken and dislodged valves that are easily deformed and perforated. The components are platelets, fibrin, bacterial mounds, necrotic tissue, and neutrophils. The base has granulation tissue. Emboli generally do not contain bacteria.
It refers to organic lesions of the heart valve caused by various causes of injury or congenital diseases, resulting in stenosis or incomplete closure of the valve orifice, and finally cardiac insufficiency and systemic blood circulation disorders.
Mitral valve stenosis
Mitral valve insufficiency
Aortic stenosis
Aortic valve insufficiency
Etiology
Mostly due to recurrent episodes of rheumatic endocarditis, rarely infectious.
Mostly rheumatic endocarditis, SBE may also be present.
Mainly caused by rheumatic aortitis, a few have congenital.
Mainly caused by rheumatic aortitis, but also infectious, AS, syphilis.
Hemodynamics
mitral stenosis left atrial hypertension, compensatory hypertrophy left atrial decompensation pulmonary stasis
Right ventricular hypertrophy Right heart failure Body vein stasis
Mitral valve closure insufficiency
Left atrial hypertrophy Increased left heart load Left ventricular failure Pulmonary stasis Right ventricular and atrial hypertrophy Right heart failure Stasis of the body circulation
Aortic stenosis Left ventricular ejection obstruction
Left ventricular hypertrophy Left heart failure Pulmonary stasis
Right heart failure Circulatory stasis
Inadequate closure Regurgitation of blood to the left ventricle, left ventricular hypertrophy Left heart failure Pulmonary stasis Right heart hypertrophy Right heart failure Stasis of the body circulation
Cardiac changes
Stenosis of the valve orifice, fish-mouth shape, “pear-shaped heart” on X-ray
X-rays show a “spherical heart”
X-rays show “boot-shaped heart”
Auscultation
Diastolic rumbling murmur in the apical region
Systolic blowing murmur in the apical region
Rough, jet systolic murmur in the aortic valve area
Diastolic murmur in the aortic region