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50 Cards in this Set
- Front
- Back
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Most common cause of endocarditis |
Bacteria |
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Low risk for endocarditis |
Coronary artery disease Aortitis Pacemaker ASD |
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High risk for endocarditis |
IV drug abuse Prosthetic valves Patent ductus arteriosus VSD Marfans History of IE Aov coarctation Mitral regurgitation
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With IE which side of the semi lunar valves does organisms attach? |
The Atrial side (flow side or where we see regurge) |
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Which side of the AV valves does organisms attach to? |
Atrial side (flow side or where we see regurgitation) |
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What is 1 showing |
aortic valve veg oscillations seen in the LV |
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2. Anterior mitral valve flutter due to AI caused by veg. 3. LV overload pattern and hyperdynamic LV function due to severe acute AI caused by veg 4. Early closure of the MV caused by increased LV end diastolic pressure |
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Intermediate risk for endocarditis |
Pressure monitoring lines in the RA Non valvular cardiac implants Calcific AS MV prolapse MS TV disease PULM valve disease |
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Early opening of the AOV with acute severe AI due to Vegetation |
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Acute IE |
Staphylococcus aureus, invasion of a normal valve |
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Olsers nodes, petechiae or spots in the whites of the eyes are seen qith |
Infective endocarditis |
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The most serious complication of invective endocarditis |
Abscess. Presents as echo-free cavity in the annulus of the infected valve or echo density in an adjacent structure |
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Veg must be greater than ___ mm to see in a TTE |
2-3mm |
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Higher chance of embolization with vegs greater than |
5 mm |
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Subaccute IE |
Invasion of an abnormal valve, subtle presentation, caused by Streptococcus viridian |
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AOV notching from severe mitral valve regurgitation from a vegetation. And LA enlargement from MR. |
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Veg must be greater than 1mm to be detected by |
TEE |
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perforation, fistula, embolism, abscess, flail leaflet and aneurysm are complications of |
Infective endocarditis |
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Myocarditis can be |
Diffuse or local |
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Negative blood culture |
Does not rule out endocarditis |
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What is needed for diagnosis of myocarditis |
Biopsy |
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The most common cause of myocarditis is |
Viral- coxsasckievirus B |
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Aggressive treatment of myocarditis |
Intra aortic balloon pump, LVAD, heart transplant |
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Most common cause of pericarditis is |
Idiopathic most cases are probably viral |
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Acute pericarditis occurs within |
Two weeks of condition and lasts up to six weeks |
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Chronic pericarditis follows acute and can last up to |
6 months |
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Pericarditis involves what layers of the heart |
Parietal and visceral |
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Which is better? Slow developing large effusion or small, rapid accumulating. |
Slow developing large |
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Constrictive pericarditis does what to the cardiac output and the Stroke volume? |
Decreases (Early termination of diastole) |
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Thickening and scarring, restricted diastolic filling, decreased cardiac output, equalized and elevated end diastolic pressures |
Constrictive pericarditis |
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What is the treatment of choice for constrictive pericarditis? |
Pericardiectomy ( remove the pericardium) |
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Constrictive pericarditis usually surrounds all 4 chambers and has mitral pattern __ respiratory changes |
With |
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Restrictive CMO surrounds ventricles only and has a mitral inflow pattern ___ respiratory changes |
Without |
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Best view for pericardial effusion |
Subcostal |
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Equalization of pressures with constrictive pericarditis is best detected by |
Cath |
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Flat LV wall motion in diastole and septal bulge to the left during inspiration(septal bounce) |
Constrictive pericarditis |
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Causes movement of the IVS toward the LV during inspiration |
Decreased pulm venous pressure |
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Effusive effusion |
No septal bounce Fluid Big E little A ( still has restrictive pattern) No/little change inflow pattern with respiration |
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Tamponade m mode 2. collapse of the RV in diastole 3. Paradoxical septal motion (parallel) - measure effusion - increase sweep speed |
M mode is very helpful to look at tamponade |
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Tamponade PW of MV or TV Decrease sweep speed to 25 4ch
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MV decreases with inspiration increases with expiration TV increases with inspiration decreases with expiration
( goes with Septal shift to the left w/ inspiration) |
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Dresslers syndrome can cause |
Pericardial effusion |
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What else can look like pericardial effusion? |
Fat pad ( loculated anterior space between epi and myocardium, gelatinous) Usually PE is not only located Anterior |
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In LAX you can differentiate Pericardial effusion from Plural |
Pericardial effusion is Anterior to the DAO, no change with respiration Pleural effusion posterior to DAO and respiratory changes |
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Small pericardial effusion is less than |
1 cm, loculated, and in the right heart or LA |
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Large pericardial effusion is greater than |
1 cm and all the way around heart |
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Pericardial effusion usually originates near the |
RA ( lowest pressure of all the chambers) |
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With tamponade when do you see collapse of the RV |
Diastole |
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Becks triad (tamponade) |
Hypotension, muffled hearts sound, elevated venous pressure |
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Pulsus paradoxus (tamponade) |
Exaggerated decrease in systolic BP with inspiration |
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Echo findings of tamponade |
Right atrial late systolic and early diastolic collapse. Right ventricular diastolic collapse Paradoxical septal motion RV and LV volume changes with respiration Swinging heart with large effusion Dialated IVC Increased hepatic flow with I inspiration
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