Cardiac Pathologies: -itises Flashcards
What is important to know from the hx exam?
chest pain, SOB, palpitations, fatigue, syncope, dizziness
What is important to know from the chart review?
lab values, ABGs (arterial blood gasses), meds
What are some components of the examination?
vitals, pulses, posture, skin, chest wall motion, EKG, circulation and lymphatic system
What is pericarditis? Causes?
inflammation of the pericardium or pericardial fluid
infection, acute MI, TB, drug use, cancer, trauma
S&S of acute pericarditis
-sharp/stabbing retrosternal chest pain (radiates to back and LT mid trap)
-fever and malaise
-pain w/ cough, deep breathing or in supine
-dyspnea (non-exertional)
-normal EKG
-auscultation > pericardial friction rub
How to dx pericarditis?
Labs - inflammatory markers
-sed rate
-C-reactive protein
-possible elevated troponins
echocardiography
Tx or management
antibiotics or pericardial drainage
self resolves 1-3 wks
What is constrictive pericarditis?
chronic pericarditis or pericardial effusion which thickens and scars the pericardium
S&S of constrictive pericarditis
-dyspnea and fatigue from decreased CO
-LE and abdominal swelling
-dizziness or syncope
-vague retrosternal chest pain
-jugular venous distention**
Dx tools for constrictive pericarditis
chest x-ray, echocardiograph, CT, cardiac catherization
What is pericardial effusion?
overaccumulation of fluid in pericardial space, restricts heart pump
How is pericardial effusion dx? Tx?
-muffled heart and lung sounds
-dullness to percussion of L lung at scapula angle
-chest radiograph (enlarged cardiac silhouette)
-echocardiography
Tx: pericardiocentesis (pericardial draining)
What is cardiac tamponade? How is it dx?
effusion exerts pressure on heart, impairing diastolic function
echocardiography
Cardiac tamponade tx
Drained with cardiac or pericardial window
S&S of cardiac tamponade
decreased CO; dyspnea, fatigue, syncope, dizziness, cough
What is endocarditis? Causes?
infection of endocardium
bacteria or fungi (travels from other part of body), catheters, tattoos, IV drug abuse, rheumatic fever
S&S of endocarditis
Flu like symptoms, pain w/ breathing, SOB, swelling, fever
-mitral valve regurgitation on auscultation
How to dx endocarditis? Tx?
Dx: labs, EKG, echocardiogram/trans esophageal echocardiogram
Tx: high does long term IV abx, valve replacement
Prevention of endocarditis
prophylactic abx before dental work, upper respiratory procedures, GI/GU procedures if infection present
What is myocarditis? Causes?
inflammation of the heart muscle
infection, drug induced, streptococcal, rheumatic fever
Untreated myocarditis can lead to? Why?
-heart failure > decreased pump function
-MI or CVA > poor pump action > pool of blood in ventricles > clots
-arrhythmias > electrical system affected since it’s in myocardium
What are differentiating features of myocardial ischemia (angina)
-retrosternal radiating tightness
-lasts a few mins
-brought on by stress or exertion
-relieved with rest or nitroglycerin
What are differentiating features of pericarditis
-sharp, pleuritic pain that varies w/ position or inspiration
-rub friction on auscultation
-lasts for hours-days
What are differentiating features of GERD
-retrosternal burning caused by certain foods
-worse in supine
-exertion has no effect
-relieved by antacids
What are differentiating features of peptic ulcer
-epigastric burning
-occurs after meals
-exertion has no effect
-relieved by antacids, not nitroglycerin
What are differentiating features of esophageal spasm
-retrosternal pain w/ dysphagia
-caused by meals
-exertion no effect
-may be relieved by nitroglycerin
What are differentiating features of biliary colic/gallbladder
-constant deep pain in URQ
-pain may radiate to mid back or R sh
-occurs after fatty food or alcohol consumption
-exertion no effect
-not relieved by antacids or nitro
What are differentiating features of costochondral syndrome
-eternal pain worsen by chest mvmnt
-costochondral junctions TTP
-relieved by anti-flams, not nitros
What are differentiating features of cervical radiculitis
-constant ache or shooting pain in sh
-myo/derm pattern
-neck mvmnts make it worse
What are differentiating features of acute coronary syndrome
-radiating retrosternal pressure
-more severe and lasts longer than angina
What are differentiating features of pericarditis
-sharp pleuritic pain that worsens w/ inspiration or in supine
-relieved by sitting fwd
-friction rub
What are differentiating features of aortic dissection
-tearing/ripping pain that migrates over time to chest and back
-severe abdominal pain
-dyspnea
-possible assymetries of BP
-widened mediastinum on chest x-ray
-may mimic stroke
What are differentiating features of pulmonary embolism
-localized pleuritic pain
-dyspnea
-pleural friction rub
-predisposing conditions/risk factors of DVT
What are differentiating features of pneumonia
-pleuritic chest pain
-productive cough
-abnormal lung auscultation and percussion
-chest x-rays show infiltrate
What are differentiating features of pneumothorax
-sudden sharp unilateral chest pain
-decreased breath sounds
-chest x-ray absence of pulmonary markings
What are differentiating features of acute cholecystitis
-RUQ or epigastric pain
-nausea, vomiting
-fatty food intolerance or recent fatty meal
