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55 Cards in this Set
- Front
- Back
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What is endocarditis?
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Inflammation of the endocardium. (inflamation of the inside lining of the heart)
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What is infective endocarditis caused by?
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Caused by microorganisms in the blood that colonize/”vegetate” on the platelet and fibrin strands in endothelium
-Heart Structural defects |
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What are the factors that put pts at risk for endocarditis?
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IV therapy, rhuematic fever, prosthetic valves, valve disease, leisions
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What are the clinical manefestations of pts with endocarditis (both types)?
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+ blood culture
New murmur Heart failure Embolic complications -Roth spots-retinal hemmorrage -Splinter hemmorrages-lines under nails Petiacchhe Oslers nodes-painful SubQ lesions on fingers and toes Janeways lesions-painless leisions on soles and palms |
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Your pt is diagnosed with acute endocarditis, you will see?
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Spike of fever/ and chills
signs of HF WBC increase -Weakness |
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Your pt is diagnosed with subacute endocarditis, you will see?
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Fever of unknown orgin
Cough Dyspnea Malaise NORMAL WBC COUNT Anorexia Anemia Elevatied ESR-erythrocyte sedimentation rate Clubbing |
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Damage to endothelial layer of heart causes heart to be infected by fungi, bacteria, or virus, causing body to make formation of thrombi, causing what potential prolem if it happens on the right side of the heart?
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Throws an emboli to the lungs
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What if the emboli is on the left side of the heart?
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Brain, liver, kidney, limb, spleen
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Pt w/infective endocarditis, what is the therapy and what do we monitor?
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IV antibiotic therapy for 6 weeks
Monitor antibiotic levels BUN or creatine increase could be renal failure |
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Endocarditis pt should look for what s x s for another endocarditis episode and are not allowed to do regular activity for?
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Fever, malaise, anorexia
4-6 weeks |
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What is pericarditis and how do pt with this like to be sitting?
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Inflammation of the pericardium (thin sack surrounding the heart) and like to sit upright and forward.
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If a pt is having pericarditis, how would the pain be?
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SHARP, STABBING, CAN RAIDIATE PAIN.
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Mainly infections (viral)
Post MI (Dressler's) Neoplasm Trauma Uremia Connective tissue diseases Endocrine diseases WOULD ALL CAUSE? |
Acute pericarditis
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Scarring with subsequent loss of elasticity (main culprits are acute pericarditis episode, cardiac surgery, radiation therapy)
Can all cause? |
Chronic pericarditis
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Acute pericarditis pain is similar /exact as angina, like?
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Substernal pain radiating to the neck
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What are other symptoms of acute pericarditis?
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Dyspnea, friction rub (scratchy and high pitched), elevated WBC, fever, malaise, EKG shows ST and T elevations, T inverted when ST returns
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Increasing dyspnea, along with increasing signs of heart failure are s x s of ?
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Chronic pericarditis
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NSAIDS would probably be given to pt with pericarditis b/c?
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Decrease inflammation
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What are the 2 complications of pericarditis?
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Tamponade- increase fluid in pericardium and increased pressure on the heart
Pericardial effusion |
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What are the s x s of TAMPONADE?
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Increased central venous pressure
Increased narrowing pulse pressure Jugular venous distention with clear lungs Decreased cardiac output |
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What is abnormality of the heart muscle called leading to functional changes of the heart?
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Cardiomyopathy
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What is associated with cardiomyopathy (primary causes arent known)?
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Chronic alcohol abuse
viral infections pregnancy |
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Secondary cardiomyopathy is caused by myocardial diseases such as?
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HTN, MI
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Dialated cardiomyopathy (most common) is?
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Enlargement of the 4 chambers of the heart
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Dialated cardiomyopathy causes what leading to what?
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Decreased contractability leading to decreased cardiac output
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Hypertrophic cardiomyopathy is the unexplained progressive?
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Thickening of the muscle mass causing increase pulmonary and venous pressure, leading to decreased cardiac output
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What cardiomyopathy is it when excessive rigid ventricular walls do not stretch during diastole what what does this create?
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Restrictive
creates backfilling and R sided heart failure Reduced stroke volume and low cardiac output |
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Weakness, fatigue, signs of L sided heart failure, and S3 and S4 is S and S of what cardiomyopathy?
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Dialated cardiomyopathy
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What cardiomyopathy with show s and s of dyspnea, signs of R sided heart failure, S3 and S4, and emboli formation?
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Restrictive
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What cardiomyopathy will show s and s of exertional dyspnea, synocpe (fainting), angina, signs of heart failure, S4, and sudden cardiac death?
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Hypertrophy
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Stenosis and regurgitation are the 2 types of ?
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Valvular diseases-defects in structure or function of valves
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Rhumatic fever, rheumatoid arthritis, untreated strep infections, or lupus, can develop?
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Mitral valve stenosis
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What are the clinical manifestations of a pt with mitral value stenosis?
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**Dyspnea**
Palpitations from A fib Fatigue Accentuated 1st heart sound (S1) Low pitched rumbling diastolic murmur Hoarseness Chest pain Seizures stroke Takes 10-14 years to develop |
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What are the majoirty of mitral value regurgiation contributed to?
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MI
Chronic rhumatic heart disease Mitral valve prolapse Ischmic papillary muscle dysfunction infective endocarditis |
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We dont know a pt have mitral valve regurgitation until pt develops?
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Some degree of left ventricular failure
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Acute mitral valuve regurgitation presents itself with with signs and symptoms?
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Thready peripheral pulses
cool and clammy extremities |
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What are these s and s of?
Weakness Fatigue Palpitations Dyspnea that gradually progresses to orthopnea, paroxysmal nocturnal dyspnea, and peripheral edema Brisk carotid pulses Auscultatory findings of accentuated left ventricular filling leading to audible S3 Murmur is loud pansystolic or holosystolic at apex radiating to left axilla |
Mitral valve regurgitation
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Abnormality of mitral valve leaflets and the papillary muscle or chordae
Allows the leaflets to prolapse back into the left atrium during systole Unknown etiology |
Mitral valve prolapse
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Although mitral valve prolapse is usually benign, what complications can arise?
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Cerebral ischemia
Sudden death infective endocarditis Mitral valve regurgitation |
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What are these S x S of?
Clinical manifestations Most patients asymptomatic for life Murmur from insufficiency that gets more intense through systole Late or holosystolic murmur Clicks mid to late systole that may be constant or vary beat to beat Dysrhythmias Paroxysmal supraventricular tachycardia Ventricular tachycardia Palpitations Lightheadedness Dizziness |
Mitral valve prolapse
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Aortic valve stenosis is almost always caught in childhood/adolencence and results in?
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Obstruction of flow from L ventricle to aorta during systole
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Effect is left ventricular hypertrophy and ↑ myocardial oxygen consumption
Because of ↑ myocardial mass Leads to ↓ CO and pulmonary hypertension Effects of what valvular disoder? |
Aortic valve stenosis
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Angina
Syncope Exertional dyspnea This triad reflects left ventricular failure These are signs and symptoms of what valve disorder? |
Aortic valve stenosis
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What do we not perscribe in pt with aortic valve stenosis and why?
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Nitroglycerin- b/c it reduces preload
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Auscultatory findings
Normal to soft first heart sound Diminished or absent second heart sound Systolic crescendo–decrescendo murmur that ends before second heart sound Prominent fourth sound These are found with what valve disoder? |
Aortic valve stenosis
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Retrograde blood flow from ascending aorta to left ventricle
Results in volume overload Initially, left ventricle compensates by dilation and hypertrophy Myocardial contractility eventually declines Pulmonary hypertension and right ventricular failure to develop This describes? |
Aortic valve regurgitation
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STENOSIS IS WHEN VALVE DOESNT?
REGURG IS WHEN VALVE DOESNT? |
STENOIS DOESNT OPEN FULLY, THEN CLOSES
REGURE IS WHEN IT OPENS, THEN DOESNT CLOSE FULLY |
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Acute: Sudden manifestations of cardiovascular collapse
Left ventricle exposed to aortic pressure during diastole Weakness Severe dyspnea Chest pain Hypotension Constitutes a medical emergency Chronic: Remains asymptomatic for years Exertional dyspnea Orthopnea Paroxysmal nocturnal dyspnea This is? |
Aortic valve regurgitation
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Auscultatory findings
Soft or absent S1 Presence of S3 and S4 Soft, high-pitched diastolic murmur Systolic ejection click Austin-Flint murmur (low frequency diastolic murmur) This is? |
Aortic valve regurgitation
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Occurs almost exclusively in patients
With rheumatic mitral stenosis Who are IV drug abusers Treated with a dopamine agonist Causes what? |
Tricuspid valve stenosis
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Tricuspid valve stenosis causes what to be obstructed?
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Right atrial output is obstructed
Results in right atrial enlargement and elevated systemic venous pressure Usually the result of pulmonary hypertension or right ventricular dysfunction |
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Peripheral edema
Ascites Hepatomegaly Murmur is presystolic or midsystolic Pansystolic murmur may be heard during regurgitation Manifest what valve disorder? |
Tricuspid valve stenosis
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Almost always congenital
Results in backward flow of blood from right ventricle Causes right ventricle hypertension and hypertrophy Clinical manifestations Fatigue Loud midsystolic murmur Describe? |
Pulmonic valve stenosis
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Main focus of prevention for pts with valve disoders?
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Prevent rheumatic fever and infective endocarditis
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What does digitalis do ?(same as digoxin)
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Strengthens the contractions of heart, slows HR, and helps eliminate fluids. Used for valve disodered pts.
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