Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
Time-critical stabilization
Airway and oxygenation
If respiratory failure or altered mental status, RSI with hemodynamic optimization
If pulmonary edema, noninvasive ventilation and preload reduction when feasible
Circulation and perfusion
If MAP <65 mmHg, initiate vasopressor support after fluid assessment
If cardiogenic shock suspected, early inotrope consideration and bedside echo
Sepsis recognition bundle
If lactate >=2 mmol/L, high-risk sepsis physiology
If lactate >=4 mmol/L or hypotension, septic shock physiology
Early source control planning
If prosthetic valve or cardiac device, early cardiology and CT surgery notification
If abscess concern, urgent TEE pathway
Diagnostic timing targets
Blood cultures before antibiotics when feasible
If unstable, cultures and antibiotics without delay
Empiric antibiotics within 60 minutes for septic shock (ACEP Level B)
Echocardiography within 24 hours for suspected IE with instability (Class I)
Consultation triggers
Infectious diseases early involvement
Class I recommendation for complex bacteremia or suspected IE
Cardiology early involvement
If new murmur, heart failure, conduction abnormality, or prosthetic valve
Cardiac surgery early involvement
If acute severe valve regurgitation or shock
If perivalvular abscess or fistula suspected
If persistent bacteremia despite therapy
Hemodynamic and monitoring
Monitoring strategy
Continuous ECG and pulse oximetry
If PR prolongation or new AV block, perivalvular extension risk
Frequent vital reassessment
If escalating vasopressors, ICU-level care
Arterial line consideration
If on vasoactive infusions or labile pressures
Point-of-care ultrasound integration
Cardiac POCUS
LV function estimate
Valvular regurgitation screening
Pericardial effusion and tamponade physiology
Lung POCUS
B-lines pattern for cardiogenic pulmonary edema support
IVC assessment
Limited accuracy in ventilated patients
Red flags and immediate complications
High-risk features
Hemodynamic instability
Septic shock physiology
Cardiogenic shock physiology
Acute heart failure
New pulmonary edema
New severe regurgitant murmur
Neurologic emergency
Focal deficit suggesting embolic stroke
Severe headache suggesting intracranial hemorrhage
Electrical instability
New AV block suggesting abscess
Anticoagulation and thrombolysis cautions
Thrombolysis generally contraindicated for suspected IE-associated ischemic stroke (Class III harm)
Anticoagulation reassessment in prosthetic valves with CNS hemorrhage risk
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.