Chapter 37 - Inflammatory Heart Disorders

Front 1

An infection of the inner surface of the heart?

Back 1

Infective Endocardidits

Front 2

Two types of IE?

Back 2

Acute
Subacute

Front 3

Chronic IE affecting individuals with preexisting valvular disease?

Back 3

Subacute IE

Front 4

Rapidly progressing IE affecting individuals with healthy valves?

Back 4

Acute IE

Front 5

Most common bacteria causing IE?

Back 5

Staph aureus
Strep viridans

Front 6

Principal cardiac risk factors for IE?

Back 6

Prior IE.
Prosthetic valves
Acquired valvular disease.
Cardiac lesions.
Pacemakers
Rheumatic heart disease.

Front 7

Principal non-cardiac risk factors for IE?

Back 7

IVDA
Nosocomial bacteremia

Front 8

The primary lesions of IE are called? What are the composed of?

Back 8

Vegetations.
Composed of fibrin, leukocytes, platelets, and microbes.

Front 9

A major complication of vegetations is?

Back 9

Embolization.

Front 10

Major causes of IE?

Back 10

Aging (stenosis)
IVDA
Prosthetic Vavles
Nosocomial Infection
Renal dialysis

Front 11

IVDA leads to what sided IE? What is the causitive organism?

Back 11

Right-sided.
Staph. aureus

Front 12

Clinical manifestations of IE?

Back 12

Low-grade fever.
Splinter hemorrhages in nail beds.
Osler nodes, Roth spots, or Janeway lesions.
New murmur (aortic/mitral)
Pain from systemic emboli

Front 13

Diagnostics for IE?

Back 13

2x Blood Cultures (30-min apart)
New murmur.
Echo shows vegetation or mass.

Front 14

Prophylactic tx for what procedures?

Back 14

Oral, respiratory, GI, GU.
Wound drainage, HD, or have shunts.

Front 15

Initial antibiotic txs by what route?

Back 15

IV

Front 16

Surgical tx of IE?

Back 16

Valve replacement

Front 17

What medications have in impact on developing IE?

Back 17

Immunosuppressants.

Front 18

Duration of antibiotic treatment?

Back 18

4-6 weeks.

Front 19

Life-threatening complications of IE?

Back 19

Cerebral emboli
Pulmonary edema
HF

Front 20

Lab tests to monitor during antibiotic tx?

Back 20

Blood culture
Serum antibiotic level
Renal function (Vanco)

Front 21

Inflammation of the outer layer of the heart?

Back 21

Pericarditis

Front 22

Most common agent causing pericarditis?

Back 22

Coxsackievirus B

Front 23

Non-infectious cause of percarditis?

Back 23

MI

Front 24

Characteristic pathological finding of pericardisis?

Back 24

Inflammatory response.

Front 25

Characteristic clinical manifestations of pericarditis?

Back 25

Progressing severe chest pain.
Worse on deep inspiration or lying supine.
Pericardial friction rub.

Front 26

Where to listen for pericardial friction rub?

Back 26

lower left sternal border

Front 27

Two major complications of pericarditis?

Back 27

Pericardial effusion
Cardiac tamponade

Front 28

Accumulation of excess fluid in pericardial sac?

Back 28

Pericardial effusion

Front 29

Compression of the heart due to increased intrapericardial pressure?

Back 29

Cardiac tamponade

Front 30

Tx of pericarditis?

Back 30

Bacterial - Antibiotic
Lupus - Corticosteriods

Front 31

Side effects of corticosteriods?

Back 31

GI bleeds
Na retention
HypoK
Hyperglycemia
Cushings

Front 32

Tx of pain and inflammation with pericarditis?

Back 32

High dose Asprin or NSAIDs.
Sit leaning forward.

Front 33

Condition resulting from the scarring and subsequent loss of elasticity of the pericardial sac?

Back 33

Chronic constrictive pericarditis.

Front 34

Clinical manifestations of chronic constrictive pericarditis?

Back 34

Mimic HF and cor pumonale.
Pericardial knock.

Front 35

Tx for chronic constrictive pericarditis?

Back 35

pericardiectomy

Front 36

A focal or diffuse inflammation of the muscle of the heart?

Back 36

Myocarditis

Front 37

Diagnostic for myocarditis?

Back 37

endomyocardial biopsy (EMB)

Front 38

Supportive therapy for myocarditis?

Back 38

O2
Bed Rest

Front 39

Complication occurring 2-3 weeks after an infection with group A strep.

Back 39

Acute rheumatic fever (ARF)

Front 40

Hallmark sign of ARF?

Back 40

Aschoff bodies.

Front 41

Major criteria of ARF?

Back 41

Carditis
Arthritis
Chorea
Erythema marginatum
Subcutaneous nodules

Front 42

Prevention of ARF?

Back 42

Penicillin during group A strep infection.

Front 43

Primary symptom of mitral vale stenosis?

Back 43

Dsypnea on exertion.

Front 44

Primary symptom of acute mitral valve regurgitation? Chronic?

Back 44

Pulmonary edema, shock.
Weakness/fatigue

Front 45

Primary symptoms of aortic valve stenosis?

Back 45

Angina, syncope, exertional dyspnea.

Front 46

Do you give a patient with angina due to aortic stenosis nitroglycerin?

Back 46

No!

Front 47

Is aortic regurgitation an emergency?

Back 47

Yes.

Front 48

Symptoms of AR?

Back 48

Cardiovascular collapse
Water-hammer pulse

Front 49

Valvular disease diagnostics?

Back 49

Echocardiogram
CXR
ECG
Cardiac cath

Front 50

What is the main complication of mechanical valves?

Back 50

Hemorrhage secondary to anticoag tx.

Front 51

Three types of cardiomyopathy?

Back 51

Dilated
Hypertrophic
Restrictive

Front 52

Dilated cardiomyopathy leads to?

Back 52

HF

Front 53

Drugs for dilated cardiomyopathy?

Back 53

Preload - Nitro, Lasix
Afterload - ACEIs
Rate - BBs
Atrial Fib - Digoxin

Front 54

Acute HF related to dilated cardiomyopathy tx?

Back 54

Continuous Dobutamine
Aggressive diuresis.

Front 55

Four main characteristics of hypertrophic cardiomyopathy?

Back 55

Ventricular hypertrophy
Rapid contraction
Impaired relaxation
Obstructed outflow

Front 56

Drugs for hypertrophic cardiomyopathy?

Back 56

BBs & CCBs

Front 57

Symptoms of restrictive CMP?

Back 57

fatigue
exercise intolerance
dyspnea