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33 Cards in this Set
- Front
- Back
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Infective Endocarditis:Def
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infection of the endocardium with formation of vegetative bacterial lesions
*usually staph or strep |
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IE: Pathophysiology
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*damage=>exposed basement membrane =attracts platelets> Thrombus
*bacteria adhesion to endocardium=> vegetative lesions**valve dysfunction |
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IE: portals of entry
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-dental work
95% IV drug use -skin infections |
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IE: S&S familiar
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* fever
* weakness/fatigue * arthralgias (joint pain) * back pain * murmurs * systemic embolizaion in organs (kidney, lungs brain) |
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IE: S&S obscure
*petechiae, splinter hemorrhages, osters nodes, Janeway lesions |
* splinter hemorrhages-lack longitudinal streaks in nails
* petechiae- emboli fragments=> pinpoint hemorrhages (all over-red) * Osters nodes- pea sized lesions on fingertips and toes (purple) * Janeway lesions- flat red spots on hands and feet |
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IE: Diagnostics
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*Blood cultures- find offender
*WBC count- elevated *echocardiogram- visible lesions |
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IE: Treatment
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4-6 weeks of combined antibiotics + hospitalization monitoring valve damage and abcess formation
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Rheumatic fever: Def
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Inflammatory disease can lead to scarring/deformity of cardiac structures
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RF: Pathophysiology
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Starts as strep throat| abnormal immune response membrane antigens bind to receptors in heart=> Damage valves
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RF: Etiology
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caused by delayed infection by group A Beta-hemolytic Strept.
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RF: Incidence
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Low in US more prevalent in elderly and populations w/o access to antibiotics
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RF/RHD: S&S
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*carditis- inflammation =>murmur
*polyarthritis- not permanent *chorea- CNS disorder of weakness and involuntary mvmt *erythema marginatum-flat rash of trunk/arm/thigh |
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RF/RHD: Diagnostic
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*Throat culture
*Anti-streptolysin O titer -made by strep *WBC count- elevated *echocardiogram- assess valve function |
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RF/RHD: Treatment
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antibiotics -penicillin
aspirin- inflammation cardiac drugs surgical repair of valves |
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Valvular disease: Stenosis vs. Regurgitation
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Stenosis- constricted valve opening- chamber must work harder to push through
Regurgitation- valve doesnt close all the way- allows backflow **lead to chamber hypertrophy and dilation |
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Aortic stenosis: Etiology
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*Congenital- diagnosed young adulthood
*complication of RHD |
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AS: Pathophysiology
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Obstructs flow from left ventricle into aorta
LV must work harder- hypertrophy- inc 02 demand |
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AS: S&S
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dec HR (longer duration)
dec SBP dec stroke volume systolic murmur angina (ischemia-02 demand) |
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Aortic regurgitation: Pathophysiology
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incomplete closure allows blood to flow back from aorta into LV. =>hypertrophy/dilation
Back up into pulmonary system and RV=> failure |
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AR: S&S
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inc stroke volume (new load +backflow)
murmur- Sys and dia Heart failure- S&S |
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Mitral stenosis: Etiology
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secondary to endocarditis
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MS: Pathophysiology
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narrowing/fibrosis of valve obstructs flow from L Atria to LV- LA dilation hypertrophy => back up and pulmonary congestion
**Dec CO and stroke volume |
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MS: S&S
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*pulmonary congestion-SOB cough
*palpitations *diastolic murmur *Dec CO-weakness *Arrhythmia |
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Mitral regurgitation: Etiology
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complication of RHD
congenital CAD progression from Mitral valve prolapse |
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MR: PAthophysiology
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Blood flows back into L atria from L ventricle
* L Atria Dilation ** LV Dilation and hypertrophy to maintain CO (eventually failure) |
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MR: S&S
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Fatigue/weakness
palpitations arrhythmia systolic murmur |
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Valvular disease: Treatment
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Digoxin
vasodilators diuretics anticoagulants antiarrythmics |
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Valvular disease diagnostics
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CXR-heart size
valve calcification Echocardiogram- view flow EKG- rhythm/ HR Cardiac catheterization- pressure gradient |
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Valvular disease: surgery
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balloon valvoplasty-stenosis
repair-regurgitation replace- pig valve artificial |
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Mitral Valve Prolapse: etiology
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strong genetic influence
women 8x more likely |
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MVP: PAthophysiology
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Failure of leaflets to fit together
RISK: -lead to MR - Endocarditis risk |
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MVP S&S
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murmur
dysrhythmias |
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MVP: Treatment
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antibiotics prophylactically
(preventative) control palpitaions-meds |
