Acquired Cardiac Conditions Flashcards
Acute rheumatic fever is an inflammatory condition causing damage to ______
Connective tissue
Describe the pathophysiology of acute rheumatic fever
Untreated streptococcal pharyngitis causes autoimmune response
What 3 organ systems are primarily affected by acute rheumatic fever?
- Heart
- CNS
- Joints
Acute rheumatic fever can lead to … (2)
- Rheumatic heart disease
- Scarring of mitral valve
What is required for diagnosis of acute rheumatic fever?
Presence of 2 major AND 2 minor criteria
What are the major criteria of acute rheumatic fever? (5)
- Carditis
- Migratory polyarthritis
- Subcutaneous nodules
- Erythema marginatum
- Sydenham chorea
What is migratory polyarthritis?
Movement of pain from one joint to another
What is sydenham chorea?
Neurological disorder causing dance-like movements
What are the minor criteria of acute rheumatic fever? (3)
- Polyarthralgia
- Increased ESR / CRP
- Prolonged PR interval
What is polyarthralgia?
Pain in 5 or more joints
What laboratory findings indicate acute rheumatic fever? (3)
- Elevated ESR / CRP
- Elevated ASO
- Positive throat culture
What is the primary goal of treatment for acute rheumatic fever?
Elimination of hemolytic streptococci
Describe the treatment of acute rheumatic fever (4)
- NSAIDS
- Penicillin
- Corticosteroids
- Bedrest until inflammation has resolved
______ can be used as an alternative for penicillin if the patient is allergic
Erythromycin
How long does prophylactic treatment of acute rheumatic fever last?
5 - 10 years
In the case of mitral / aortic regurgitation …
Activities should be restricted for weeks / months
Describe the risk of morbidity associated with acute rheumatic fever
Progressive mitral stenosis - may need valve replacement in adulthood
Describe the pathophysiology of infective endocarditis
Pathogens / bacteria encounter damaged endothelium
What are the manifestations of infective endocarditis? (5)
- Broken blood vessels in eyes / mouth / chest
- Blanchable lesions on hands / feet
- Red bumps on fingers / toes
- Hemorrhagic lesions
- Petechiae
Hemorrhagic lesions indicate ______
Extracardiac emboli
What laboratory findings indicate infective endocarditis? (2)
- Bacteria growth in blood
- Elevated WBCs
Infective endocarditis requires IV fluids for how long?
4 weeks
What age group has the highest incidence of Kawasaki Syndrome?
Toddlers < 5 years old
Kawasaki Syndrome is also known as ______
Acute systemic vasculitis
Describe the pathophysiology of Kawasaki Syndrome
Autoimmune response causes vasculitis in coronary arteries
What are the possible causes of Kawasaki Syndrome? (3)
- Dust mites
- Rickettsiae
- Rug shampoo / new rugs
Kawasaki Syndrome is uncommon in what age groups? (2)
- Infants < 3 months
- Children > 12 years
When do epidemics of Kawasaki Syndrome occur?
Late winter / early spring
What are the manifestations of Kawasaki Syndrome? (5)
- High fever (lasting > 5 days and unresponsive to antibiotics)
- Bilateral conjunctivitis without exudate
- Polymorphous erythematous
- Fissured lips / strawberry tongue
- Swollen hands / feet
What is required for diagnosis of Kawasaki Syndrome?
4 out of 5 diagnostic criteria
Diagnosis of Kawasaki Syndrome may be made with less criteria if ______ are present
Coronary artery changes
What laboratory findings indicate Kawasaki Syndrome? (3)
- Elevated WBCs
- Elevated ESR / CRP
- Thrombocytosis
______ is the primary tool for initial evaluation and follow-up of children with coronary artery lesions
Echocardiogram
Treatment of Kawasaki Syndrome is most effective if given within the first ______ of illness
10 days
What is the primary method used to treat Kawasaki Syndrome?
IVIG and aspirin
What is the dosage of IVIG for Kawasaki Syndrome?
2 grams / kg over 10 - 12 hours
What is the primary function of IVIG for Kawasaki Syndrome?
Reduces risk of aneurysms
What is the dosage of aspirin for Kawasaki Syndrome?
80 - 100 mg / kg / day
What is the primary function of aspirin for Kawasaki Syndrome?
Reduces fever / inflammation
______ may be used for children with large aneurysms from Kawasaki Syndrome to prevent thrombosis / occlusion
warfarin
Describe the nursing management of Kawasaki Syndrome (2)
- Frequent monitoring for CHF
- Lip balm, lotion, cool cloths, tepid baths
Children with Kawasaki Syndrome at at an increased risk for developing ______ in adulthood
Coronary artery disease
Patients with acquired cardiac conditions should continue to receive prophylactic antibiotics for the remainder of their life prior to what types of procedures? (2)
- Dental procedures
- GI / GU / respiratory surgery
