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Consequences of valvular vegetations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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An infected valvular vegetation may result in four consequences which together produce the clinical and pathological picture.

  • bacteraemia and/or septicaemia:
    • this may cause fever, malaise, anorexia, weight loss, leucocytosis, anaemia, a raised ESR, a raised CRP, splenomegaly

  • production of circulating immune complexes:
    • these may lead to splinter haemorrhages, Osler's nodes, Janeway lesions or glomerulonephritis

  • local destruction of cardiac tissue:
    • this may lead to valvular incompetence, heart failure, cardiac conduction abnormalities, abscess formation, fistulas between right and left sides of the heart
    • disappearance of the first heart sound may signify aortic incompetence

  • peripheral emboli:
    • these may cause strokes, splenic or renal infarction and mycotic aneurysms

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