In what cardiac disorder would we see Janeway lesions. Osler nodes or Roth spots?

Rationale: A. Myocardial infarction is incorrect because an MI results from acute coronary artery occlusion leading to ischemia and necrosis of heart muscle. Its manifestations include chest pain, dyspnea, diaphoresis, and ECG changes, but it does not cause Janeway lesions, Osler nodes, or Roth spots. B. Heart failure is incorrect because heart failure involves the heart’s inability to pump effectively, causing symptoms like edema, dyspnea, fatigue, and pulmonary congestion. It is not associated with peripheral or retinal vascular lesions. C. Pericarditis is incorrect because pericarditis is inflammation of the pericardial sac, presenting with chest pain, pericardial friction rub, and sometimes pericardial effusion, but it does not cause Janeway lesions, Osler nodes, or Roth spots. D. Endocarditis is correct because infective endocarditis can cause vascular and immune-mediated lesions due to septic emboli and immune complex deposition. Janeway lesions are painless, erythematous macules on the palms and soles caused by septic emboli. Osler nodes are painful, tender nodules on the fingers and toes resulting from immune complex deposition. Roth spots are retinal hemorrhages with pale centers seen on fundoscopic exam. These lesions are classic peripheral signs of infective endocarditis, which involves infection of the heart valves or endocardial surface.