What is the Difference Between Acute and Subacute Endocarditis?

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The main difference between acute and subacute endocarditis lies in the speed of onset and the severity of symptoms. Endocarditis is an infection of the endocardial surfaces of the heart, which includes one or more heart valves. It can be either acute or subacute, with the following distinctions:

  • Acute Endocarditis: This form of endocarditis develops suddenly and may become life-threatening within days. It is characterized by high fevers, fast heart rate, fatigue, and rapid and extensive heart valve damage. Most cases of acute bacterial endocarditis are caused by Staphylococcus aureus.
  • Subacute Endocarditis: This form of endocarditis develops gradually and presents with non-specific symptoms such as fatigue, weight loss, and mild fever over several weeks to months. It is often caused by penicillin-sensitive Streptococcus viridans. Subacute bacterial endocarditis is typically not diagnosed until it has been present for months.

Another difference between the two is the type of bacteria causing the infection. Most cases of subacute endocarditis are caused by penicillin-sensitive Streptococcus viridans, while most cases of acute endocarditis are caused by Staphylococcus aureus. The pneumococcus nearly always produces an acute infection.

In summary, acute endocarditis presents with rapid onset of symptoms and severe complications, while subacute endocarditis has a more gradual onset and presents with non-specific symptoms over an extended period. The types of bacteria causing the infections also differ, with Staphylococcus aureus causing most acute cases and Streptococcus viridans causing most subacute cases.

Comparative Table: Acute vs Subacute Endocarditis

Acute and subacute endocarditis are two forms of infective endocarditis, a microbial infection of the heart valves or the mural endocardium. The key difference between these two forms is the sudden onset of symptoms in acute endocarditis, whereas in subacute endocarditis, the symptoms develop gradually. Here is a table highlighting the differences between acute and subacute endocarditis:

Feature Acute Endocarditis Subacute Endocarditis
Onset of Symptoms Sudden Gradual
Causative Organisms Highly virulent organisms Less virulent organisms
Affected Valves Previously normal cardiac valves Previously damaged cardiac valves
Presentation Fever, fast heart rate, fatigue, and rapid and extensive heart valve damage Fatigue, mild fever, moderately fast heart rate, weight loss

Acute endocarditis is typically caused by highly virulent organisms that infect previously normal cardiac valves. On the other hand, subacute endocarditis is due to the infection of previously damaged cardiac valves by low virulent organisms.