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34 Cards in this Set
- Front
- Back
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Most common cause of myocarditis?
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Parvovirus B19 and HHV-6
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What is myocarditis?
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Inflammation may be focal or diffuse and involving any or all cardiac chambers
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Myocarditis can present with?
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Heart failure or chest pain
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Chest pain in myocarditis?
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Can mimic MI especially in younger patients.
Ischemia associated with it may be due to localized inflammation or coronary spasm |
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Can sudden cardiac death occur in myocarditis?
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Yes, it is presumably due to ventricular tachycardia or fibrillation.
In an autopsy series of patients less than 40 who presented with sudden death in absence of unknown heart disease, myocarditis was responsible for 22% of cases less than 30 and 11% in older patients |
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Most frequent arrhythmia in myocarditis?
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Sinus tachycardia
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Commonly felt by patients in myocarditis?
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PVCs are commonly felt by patients
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Signs of myocarditis?
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S3 (Tennessee)
S4 (Kentucky) Fluid overload |
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Signs of right ventricular failure?
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Increased JVP
Hepatomegaly Peripheral edema |
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Signs of left ventricular failure?
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Dyspnea
Orthopnea Pulmonary rales Pulmonary edema |
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Cardiac enzymes in myocarditis?
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Troponin-1 or CK-MB could be elevated
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EKG in myocarditis?
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Diffuse T-wave inversions and/or ST elevations
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Myocarditis should be suspected in?
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A patient, particularly young male, presents with otherwise unexplained cardiac abnormalities of new onset, such as heart failure, MI, arrhythmias, and conduction disturbances
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Recent history (myocarditis)?
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History of recent URI or enteritis may be elicited in majority of cases of viral myocarditis
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Gold standard for diagnosis of myocarditis?
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Cardiac biopsy
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Vaccine and troponins increase?
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Could be a side effect of smallpox vaccine
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What is pericarditis?
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Inflammation of pericardial sac
Can lead to pericardial effusion |
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Pericarditis can compromise?
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Pericarditis can compromise cardiac output via cardiac tamponade or constrictive pericarditis
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Major causes of pericarditis?
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Viral, SLE, drugs
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Pericarditis can occur after?
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May also occur after a MI
Days after or delayed phenomenon |
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Pericarditis of a delayed phenomenon is known as?
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Dressler's syndrome
Symptoms usually occur 4-6 weeks after a MI Fever, pleuritic chest pain, pericardial effusion |
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Pericarditis and chest pain?
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Chest pain tends to worsen in supine position and with inspiration
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Examination in pericarditis?
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May reveal a pericardial friction rub, elevated JVP, and pulsus paradoxus
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What is pulsus paradoxus?
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Decrease in systolic blood pressure greater than 10 on inspiration
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What is a key point with a MI?
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Avoid steroids within a few days after a MI as they can predispose to ventricular wall rupture
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What is cardiac tamponade?
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Excess fluid in pericardial sac, which can lead to compromised ventricular filling and decreased cardiac output
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What are risk factors for cardiac tamponade?
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Pericarditis, malignancy, SLE, TB, trauma (commonly stab wounds medial to left nipple)
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What is Beck's triad and what is it associated with?
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Hypotension (decreased stroke volume)
Distant heart sounds (fluid inside pericardium) Distended neck veins (impaired venous return to heart) Associated with cardiac tamponade |
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Signs of cardiac tamponade?
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Pulsus paradoxus
Kussmaul's sign (JVD on inspiration) Narrow pulse pressure |
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EKG abnormality in cardiac tamponade?
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Electrical alternans is diagnostic
Alternation of QRS complex between beats |
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Treatment of cardiac tamponade?
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Pericardiocentesis
Occurs at 5th intercostal space at left sternal border at cardiac notch of left lung |
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What is commotio cordis?
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Lethal disruption of heart rhythm that occurs as a result of a blow to area directly over heart at a critical time during the cycle of a heart beat causing cardiac arrest
It is a form of ventricular fibrillation |
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Fatality rate of commotio cordis?
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Fatality rate of 65%, and it occurs mostly in boys and young men (avg age of 15), usually during sports
Baseball, hockey, fighting |
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What is metabolic syndrome according to NCEP?
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Waist circumference greater than or equal to 40 in (male) and 35 in (female)
Triglycerides greater than or equal to 150 HDL less than 40 (male) or 50 (female) Blood pressure greater than or equal to 130/85 (or treated for HTN) Fasting plasma glucose greater than or equal to 110 |
