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34 Cards in this Set
- Front
- Back
What valve is usually involved in endocarditis?
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Mitral
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What valve indicated drug use if it is involved?
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Tricuspid
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Can endocarditis be non-bacterial?
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Yes. It can be secondary to metastasis, renal failure (maranctic or thrombotic), fungal
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What type of endocarditis does s. Aureus cause?
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rapid onset, high virulence, tends to occur secondary to infection elsewhere
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What do the vegetations look like
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Large.
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What type of endocarditis does s. viridians cause?
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subacute. Tends to have smaller vegetations.
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What predisposes you to s.viridins endocarditis?
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tends to occur on previously damaged valves, so rheumatic fever. It is commonly seen after dental work.
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What are the 8 sings of endocarditis?
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JR=NO FAME Janeway lesions, Roth's spots, Nail-bed hemorrhages, Osler's nodes, Fever, Anemia, Murmur (new), Emboli
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What do Janeway Lesions look like?
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multiple small flat erythematous lesions on palms and soles
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What are roth spots?
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round white spots on the retina surrounded by hemorrhage.
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What are osler's nodes?
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Tender raised lesions on the fingers and toes.
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What is the etiology of these olser's nodes, roth spots, and janeway lesions?
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Bacterial vegetations flipping off the heart valve and lodging in the periphery.
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What type of bacteria causes rheumatic fever?
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Group A beta-hemolytic strep
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when does it occur?
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Children 5-15 years, four weeks after a bacterial infection
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Is the bacteria responsible for the symptoms?
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No. RF is an autoimmune reaction of a cross-reactive protein that is found in the initial bacterial infection.
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What are the non cardiac clinical signs of rheumatic fever?
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FEVERSS - Fever, Erythema marginatum, valve damage, Elevated ESR, Red-hot joints (migratory polyarthritis), Subcutaneous nodules, and St. Vitus dance (chorea)
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What hear valves are effected?
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Mitral (most frequent), Aortic, Tricuspid (5%) - high pressure valves mainly.
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What is an Aschoff body?
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classic histological sign of RF, found in the myocardium, contained fibrinoid material, fragmented collages, surrounded by giant cells.
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What are the cardiac signs of RF?
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Verrucious vegetations on the valve, pancarditis, possible pericardial effusions and myocarditis (most common cause of death)
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Name four causes of serous pericarditis.
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RAIL - Rheumatic Arthritis, Infection, Lupus, and Uremia
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What is serous pericarditis?
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straw colored, protein rich exudates - non-purulent, and acute
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What are three causes of fibirnous exudates?
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MI, Rheumatic fever, and Uremia
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Cloudy pericardial exudates indicated what?
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Bacterial infection
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What are two causes of Hemorrhagic pericarditis?
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malignancy and TB
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What is hemorrhagic pericarditis?
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Bloody and inflammatory exudates
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What are the clinical signs of pericardial exudates?
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pericardial pain, friction rub, decreased heart sounds, ST elevation throughout, and pulses paradoxes (like cardiac tamponade)
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What are the long term sequela of pericarditis?
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chronic adhesive or constrictive pericarditis
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What is constiricit pericadritis
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Fibrous scarring in the pericardium obliterates the space and constrict the right side of the heart (because it is less able to withstand the pressure)
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What types of pericaditis lead to constrictive pericarditis
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TB and pyrogenic staph infections
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Syphilitic Heart Disease: What part of the heart does syphilis damage?
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The vaso vasorum of the aorta
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Syphilitic Heart Disease: What does this lead to?
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Dilation of the aorta and valve ring
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Syphilitic Heart Disease: What clinical results does this have?
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it can cause an aortic aneurysm or valvular incompetence
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Syphilitic Heart Disease: What parts of the aorta are effected
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ascending and arch
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Syphilitic Heart Disease: What is the appearance or the aorta?
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Called a "tree-bark" appearance.
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