If a patient has MRSA bacteremia AND new elevated troponins, what should you consider getting?

MRSA bacteremia should raise the possibility of endocarditis in your mind. If a patient’s troponins also increase, you should start an endocarditis workup, since this indicates myocardial damage in the setting of an organism strongly associated with endocarditis.

A corollary question is, if a patient is found to have endocarditis, when can they be managed medically and when can they be managed surgically? Surgery is indicated for endocarditis in cases of MI, conduction delay, CHF, or no response to medical antibiotics.

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