A 42-year-old man with known valvular heart disease develops a fever for 1 week. He appears unwell; findings include a pansystolic murmur at the apex that radiates to the axilla and a soft S1 sound. He has petechiae on his conjunctival sac, linear hemorrhages under a few fingernails, and painful, tender, and erythematous nodules on some of the distal fingertips. Which of the following is the most responsible mechanism for these physical findings?
High-Yield Explanation
Common findings in infective endocarditis include petechiae, Roth's spots, Osler's nodes, Janeway lesions, splinter hemorrhages, stroke, and infarction of viscera, or extremities.Many of the complications are thought to be embolic but may include vasculitis. Autopsy studies reveal that many systemic emboli go unrecognized. Brain, lung, coronary arteries, spleen, extremities, gut, and eyes are common locations for emboli.