8: Endocarditis, Myocarditis, Pericarditis Flashcards
other name for non-bacterial verrucous endocarditis
Libman-Sacks endocarditis
Libman Sacks endocarditis
sterile vegetations on cardiac valves, typically seen in SLE
RFs for infective endocarditis
older, male, IVDU, poor dentition, structural heart disease, implantable cardiac device, HIV, hemodialysis
what makes a pt high risk for endocarditis and thus needs prophylaxis?
- Hx infective endocarditis
- prosthetic heart valve or cardiac valve repair
- Hx cardiac transplant
- congenital heart disease
what is endocarditis prophylaxis?
oral Amoxicillin before dental and respiratory tract procedures or procedures involving infected skin/ST
what four imaging modalities are ordered for myocarditis and what they can detect
- CXR: pulm edema, cardiomegaly
- ECG: ischemia, arrhythmias
- Echo: LV/RV dysfunction, valve dysfunction
- CMR (CV MRI): myocardial edema, necrosis
anatomy of the pericardial sac
composed of fibrous outer sac + serous inner double layered sac (parietal+visceral layer)
cardiac tamponade
accumulation of pericardial fluid that compresses the heart -> impairs diastolic filling + decreases CO
most common disorder of the pericardium
acute pericarditis
why do you really not need a definitive caue for acute pericarditis
bc the course is relatively benign
CXR and Echo in acute pericarditis
often normal
ECG changes in acute pericarditis
new widespread ST elevation and/or PR depression
Jugular venous waveforms in cardiac tamponade
absent y descent bc lack of RV filling
pulsus paradoxus
abnormally large decrease in systolic BP during inspiration (>10mmHg)
electrical alterans
alternating amplitue of QRS complex in any lead
