CARDIO Flashcards
MC valve affected by infective endocarditis
Mitral (tricuspid if IVDA)
MC organism to cause acute infective endocarditis
staph aureus (esp IVDA)
MC organism to cause subacute infective endocarditis
streptococcus viridans
MC organism in early prosthetic valve endocarditis
staph epidermidis
Endocarditis in men >50 years old with recent GI or GU procedure, likely caused by this organism
enterococcus
Suspect these organisms in pt with endocarditis and negative bcx
HACEK organisms
Haemophilus aphrophilus
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae
Dx for endocarditis
Modified Duke criteria
Rq. +2 major, +1 major and +3 minor, or +5 minor
–major: pos bcx, pos echo
–minor: predisposing condition (recent procedure, ivda, etc), fever, vascular or embolic phenomena (janeway lesions, septic arterial or pulmonary embolic, etc), immunologic phenomena (Osler’s node, Roth spots, +RF, acute glomerulonephritis), +BCx or +TTE not meeting major criteria
Tx for endocarditis
anti-staphylococcal pcn (nafcillin or oxacillin) and ceftriaxone or gentamicin x4-6 weeks
Tx for prosthetic endocarditis
Vancomycin, gentamicin, and rifampin x4-6 weeks
Endocarditis ppx indications
- predisposing cardiac condition (prosthetic valve, h/o endocarditis, congenital heart disease, cardiac valvulopathy in heart transplant pt) AND 2. Routine dental, respiratory, or skin procedure (includes I&D)
Endocarditis ppx tx
amoxicillin 2g 30 min preop (clinda 600mg if allergic)
2 MC causes of pericarditis
idiopathic and viral (enterovirus, coxsackie virus)
Triad in Dressler syndrome:
post-MI pericarditis, fever, pleural effusion
electrical alternans is seen in this condition
pericardial effusion
(alternating QRS complex amplitude)
Dx of cardiac tamponade:
TTE w/ pericardial effusion and diastolic collapse of chambers
Tx of cardiac tamponade:
immediate pericardiocentesis
Dx for constrictive pericarditis:
TTE w/ pericardial thickening or calcifications (CT scan or MRI more sensitive than TTE)
pericardial knock may be heard in this condition
constrictive pericarditis
Tx for constrictive pericarditis:
sxs: diuretics
definitive mgmt: pericardiectomy
MC valvular disease
aortic stenosis
MC innocent physiologic murmur
still murmur
MC continuous benign murmur
cervical venous hum
Congenital heart disease that can lead to paradoxical embolic or cryptogenic strokes
PFO, ASD