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20 Cards in this Set
- Front
- Back
Endocardium |
Thin layer of connective tissue that lines the inner surface of the hear and heart valves Heals rapidly Smooth surface helps blood flow easily combines with rapid blood flow it keeps foreign bodies from attaching to the heart |
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Myocardium |
middle layer of the heart thick muscular layer causes the heart to contract |
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Pericardium |
Two layered sac made of fibrous tissue prevents heart from over distending 10-20 mL of serous fluid separate the two layers |
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Endocarditis |
inflammation of the endocardium cause is usually bacterial, but can be viral, fungal or parasitic rheumatic vs infective |
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high risk for endocarditis |
artificial heart valves, cardiac defects, implanted devices (pacemakers), immunosuppressive therapy, any procedure or activiy that can lead to bacteremia i.e dental or other invasive procedures, tattoos, IV drug use. |
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Clinical Manifestations of Endocarditis |
Fever (possibly) New or worsened heart murmur Headache, TIA's, CVA's Fatigue, Achy, Anorexic Petechia **Oslers Nodes (small painful nodules in pads of fingers and toes) |
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Diagnositic Tools for Endocarditis |
WBC Three sets of blood cultures - anaerobic and aerobic - over a 24 hour period erythrocyte sedimentation rate (Sed Rate) C-reactive protein Echocardiogram and or TEE May have a positive RA Factor |
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Medical Management for Endocarditis |
Long term IV antibiotic therapy (2-6 weeks) Continued monitoring of blood cultures Penicillin is usually the drug of choice, sometimes combination therapy. May need valve repair or replacement |
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Rheumatic Endocarditis |
Inflammation of the endocardium caused by streptococcal pharyngitis prompt treatment can prevent rheumatic fever incidence has decreased in developed countries primary antibiotic tx is penicillin |
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Myocarditis |
Inflammation of the heart muscle usually viral but can be bacterial fungal or parasitic autoimmune disease can contribute can be mild or severe, resulting in cardiomyopathy and heart failure |
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clinical manifestations of Myocarditis |
may be asymptomatic may present with flu like symptoms may have chest pain, palpitations, dyspnea may develop CHF or can result in suddent death severity of symptoms depends on the extent of damage to the myocardium |
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Dx tools of Myocarditis |
WBC Erythrocite Sedementation Rate (ESR) Cardiovascular magnetic Resonance (CMR) with contrast EKG - may show ST-T wave changes |
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Treatment of Myocarditis |
Anti-infective Bedrest with gradual increased in physical activity to decrease the cardiac workload Manage symptoms of HF as it develops Treat Arrhythmia |
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Pericarditis |
Inflammation of the pericardium Can lead to cardiac tamponade |
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Two classifications of Pericarditis |
Constrictive - linings adhere restricting ventricular filling OR by what type of fluid accumulates in the pericardial sac - purulent, serous, calcific, fibrinous, sanguinous, or malignant |
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clinical manifestations of pericarditis |
can be asymptomatic if mild constant chest pain that is in the neck or left scapula, may worsen with deep breathing, lying down, or turning in bed pericardial friction rub - heard best at Erbs point Mild fever non productive cough, dyspnea increased heart rate (compensating for decreased cardiac output) |
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Dx for pericarditis |
CT scan - best indicator Echo or TEE Cardiovascular Magnetic Resonance (CMR) EKG |
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Tx of Pericarditis |
bedrest until fever, chest pain, and friction rub have subsided anti-infectives analgesics, corticosteroids, NSIADS pericardiocentesis, or pericardiectomy |
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low blood flow |
absolute hypovolemia - loss of intravscular fluid volume trauma burns hemorrhage GI loss Fistula drainage Diabetes Insipidus Hyperglycemia Diuresis |
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Maldistrubition of blood flow |
some areas of the body will be hyperperfused while others will be underperfused massive peripheral vasodilation - pink warm flushed skin increased intravascular fluid shift to the third spaces leads to increase in blood viscosity with results in the formation of microemboli formation which leads to further decrease in tissue perfusion |