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57 Cards in this Set

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An infection of the inner surface of the heart?
Infective Endocardidits
Two types of IE?
Acute
Subacute
Chronic IE affecting individuals with preexisting valvular disease?
Subacute IE
Rapidly progressing IE affecting individuals with healthy valves?
Acute IE
Most common bacteria causing IE?
Staph aureus
Strep viridans
Principal cardiac risk factors for IE?
Prior IE.
Prosthetic valves
Acquired valvular disease.
Cardiac lesions.
Pacemakers
Rheumatic heart disease.
Principal non-cardiac risk factors for IE?
IVDA
Nosocomial bacteremia
The primary lesions of IE are called? What are the composed of?
Vegetations.
Composed of fibrin, leukocytes, platelets, and microbes.
A major complication of vegetations is?
Embolization.
Major causes of IE?
Aging (stenosis)
IVDA
Prosthetic Vavles
Nosocomial Infection
Renal dialysis
IVDA leads to what sided IE? What is the causitive organism?
Right-sided.
Staph. aureus
Clinical manifestations of IE?
Low-grade fever.
Splinter hemorrhages in nail beds.
Osler nodes, Roth spots, or Janeway lesions.
New murmur (aortic/mitral)
Pain from systemic emboli
Diagnostics for IE?
2x Blood Cultures (30-min apart)
New murmur.
Echo shows vegetation or mass.
Prophylactic tx for what procedures?
Oral, respiratory, GI, GU.
Wound drainage, HD, or have shunts.
Initial antibiotic txs by what route?
IV
Surgical tx of IE?
Valve replacement
What medications have in impact on developing IE?
Immunosuppressants.
Duration of antibiotic treatment?
4-6 weeks.
Life-threatening complications of IE?
Cerebral emboli
Pulmonary edema
HF
Lab tests to monitor during antibiotic tx?
Blood culture
Serum antibiotic level
Renal function (Vanco)
Inflammation of the outer layer of the heart?
Pericarditis
Most common agent causing pericarditis?
Coxsackievirus B
Non-infectious cause of percarditis?
MI
Characteristic pathological finding of pericardisis?
Inflammatory response.
Characteristic clinical manifestations of pericarditis?
Progressing severe chest pain.
Worse on deep inspiration or lying supine.
Pericardial friction rub.
Where to listen for pericardial friction rub?
lower left sternal border
Two major complications of pericarditis?
Pericardial effusion
Cardiac tamponade
Accumulation of excess fluid in pericardial sac?
Pericardial effusion
Compression of the heart due to increased intrapericardial pressure?
Cardiac tamponade
Tx of pericarditis?
Bacterial - Antibiotic
Lupus - Corticosteriods
Side effects of corticosteriods?
GI bleeds
Na retention
HypoK
Hyperglycemia
Cushings
Tx of pain and inflammation with pericarditis?
High dose Asprin or NSAIDs.
Sit leaning forward.
Condition resulting from the scarring and subsequent loss of elasticity of the pericardial sac?
Chronic constrictive pericarditis.
Clinical manifestations of chronic constrictive pericarditis?
Mimic HF and cor pumonale.
Pericardial knock.
Tx for chronic constrictive pericarditis?
pericardiectomy
A focal or diffuse inflammation of the muscle of the heart?
Myocarditis
Diagnostic for myocarditis?
endomyocardial biopsy (EMB)
Supportive therapy for myocarditis?
O2
Bed Rest
Complication occurring 2-3 weeks after an infection with group A strep.
Acute rheumatic fever (ARF)
Hallmark sign of ARF?
Aschoff bodies.
Major criteria of ARF?
Carditis
Arthritis
Chorea
Erythema marginatum
Subcutaneous nodules
Prevention of ARF?
Penicillin during group A strep infection.
Primary symptom of mitral vale stenosis?
Dsypnea on exertion.
Primary symptom of acute mitral valve regurgitation? Chronic?
Pulmonary edema, shock.
Weakness/fatigue
Primary symptoms of aortic valve stenosis?
Angina, syncope, exertional dyspnea.
Do you give a patient with angina due to aortic stenosis nitroglycerin?
No!
Is aortic regurgitation an emergency?
Yes.
Symptoms of AR?
Cardiovascular collapse
Water-hammer pulse
Valvular disease diagnostics?
Echocardiogram
CXR
ECG
Cardiac cath
What is the main complication of mechanical valves?
Hemorrhage secondary to anticoag tx.
Three types of cardiomyopathy?
Dilated
Hypertrophic
Restrictive
Dilated cardiomyopathy leads to?
HF
Drugs for dilated cardiomyopathy?
Preload - Nitro, Lasix
Afterload - ACEIs
Rate - BBs
Atrial Fib - Digoxin
Acute HF related to dilated cardiomyopathy tx?
Continuous Dobutamine
Aggressive diuresis.
Four main characteristics of hypertrophic cardiomyopathy?
Ventricular hypertrophy
Rapid contraction
Impaired relaxation
Obstructed outflow
Drugs for hypertrophic cardiomyopathy?
BBs & CCBs
Symptoms of restrictive CMP?
fatigue
exercise intolerance
dyspnea