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PathoPharm 2 > ch 36 inflammatory and structural heart disorders > Flashcards

ch 36 inflammatory and structural heart disorders Flashcards

1
Q

three types of cardiomyopathy

A
  • dilated
  • hypertrophic
  • restrictive
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2
Q

what age group/gender is most at risk for dilated cardiomyopathy

A

middle aged women

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3
Q

what happens to the heart in dilated cardiomyopathy

A
  • heart muscles stretch and thin

- affects systolic bp

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4
Q

common causes dilated cardiomyopathy (5)

A
  • infectious myocarditis
  • alcohol
  • cocaine
  • HTN
  • CAD
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5
Q

diagnostics for dilated cardiomyopathy (4)

A
  • chest x-ray (cardiomegaly)
  • ECG
  • BNP levels
  • echocardiogram
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6
Q

how does hypertrophic cardiomyopathy affect the heart

A
  • thickening of muscles
  • decreased space in ventricles
  • affects diastolic bp
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7
Q

cause hypertrophic cardiomyopathy

A

chronic untreated HTN

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8
Q

S+S hypertrophic cardiomyopathy (4)

A
  • fainting
  • dizziness with activity
  • chest pain
  • dysrhythmias
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9
Q

treatment for dilated and hypertrophic cardiomyopathy

A 
implanted defibrillator
(same meds as for HF)
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10
Q

cause of restrictive cardiomyopathy

A

inflammatory diseases causing stiff heart muscles

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11
Q

S+S restrictive cardiomyopathy (4)

A
  • fatigue
  • orthopnea
  • exercise intolerance
  • systemic signs inflammatory disease
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12
Q

S+S dilated cardiomyopathy

A
  • fatigue
  • dyspnea at rest
  • proxysmal nocturnal dyspnea
  • orthopnea
  • S3/S4 heart sounds
  • pulmonary edema symptoms
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13
Q

what type of cardiomyopathy is often diagnosed in young, healthy males

A

hypertrophic

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14
Q

meds for hypertrophic cardiomyopathy (2)

A
  • b blocker

- digoxin

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15
Q

friction between heart and pericardial sac caused by inflammation and immune response

A

pericarditis

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16
Q

S+S pericarditis (6)

A
  • severe angina
  • dyspnea
  • tachycardia
  • distant heart sounds
  • SOB
  • pericardial friction rub
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17
Q

possible complication of pericarditis

A

pericardial effusion (fluid buildup) which can lead to tamponade and cardiac arrest

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18
Q

classic sign of tamponade

A

pulsus paradoxus (decreased Sbp with inhalation)

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19
Q

S+S tamponade (6)

A
  • distant heart sounds
  • increased HR
  • increased RR
  • pulsus paradoxus
  • JVD
  • confusion
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20
Q

diagnostics for pericarditis (3)

A
  • echocardiogram
  • CT/MRI
  • chest x-ray
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21
Q

care for pericarditis (5)

A
  • O2
  • bedrest
  • NSAIDs
  • IV corticosteroids
  • maybe pericardiocentesis
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22
Q

cause of chronic constrictive pericarditis

A

pericardium scarring

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23
Q

treatment for chronic constrictive pericarditis

A

pericardiectomy (window procedure)

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24
Q

causes myocarditis

A
  • viruses/bacteria/fungi
  • radiation therapy
  • autoimmune disorders
  • coxsackie A+B viruses
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25
Q

early S+S myocarditis (8)

A
  • fever
  • fatigue
  • dyspnea
  • N/V
  • lymphadenopathy
  • angina
  • pericardial friction rub
  • pericardial effusion
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26
Q

late S+S myocarditis (6)

A
  • S3 heart sounds
  • crackles
  • JVD
  • fainting
  • peripheral edema
  • angina
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27
Q

diagnostics myocarditis (6)

A
  • ECG
  • ESR
  • troponin
  • endomyocardial biopsy (during first 6 weeks illness)
  • echocardiogram
  • MRI
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28
Q

meds myocarditis

A
  • digoxin
  • ACE inhibitors
  • b blockers
  • diuretics
  • improve CO: nitroprusside, inamrinone, milrinone
  • prednisone, azathioprine, cyclosporine
29
Q

infection (often s. aureus) of the inner layer of the heart that affects cardiac valves

A

endocarditis

30
Q

3 stages to infective endocarditis (IE)

A
  • bacteremia
  • adhesion
  • vegetation
31
Q

risk factors IE (5)

A
  • older age
  • IV drug use
  • prosthetic valve
  • intravascular devices and healthcare associated infection
  • renal dialysis
32
Q

2 complications IE

A
  • heart valve damage

- emboli

33
Q

S+S IE (6)

A
  • anorexia and weight loss
  • general pain
  • clubbing
  • splinter hemorrhages
  • osler’s nodes
  • janeway’s lesions
34
Q

diagnostics IE (3)

A
  • blood cultures
  • echocardiogram
  • duke criteria
35
Q

what is duke criteria

A

3 blood cultures drawn over 1 hour from 3 different sites

36
Q

major criteria in duke criteria (2)

A
  • positive blood culture

- evidence vegetation on echocardiogram

37
Q

minor criteria in duke criteria (4)

A
  • predisposing heart condition
  • fever
  • vascular phenomena
  • immunologic phenomena
38
Q

treatment IE (3)

A
  • antibiotic prophylaxis
  • antipyretics
  • IV fluids
39
Q

painful, red or purple pea-sized lesions on fingertips or toes (seen in pts with IE)

A

osler’s nodes

40
Q

flat painless small red spots on hands and feet (seen in pts with IE)

A

janeway’s lesions

41
Q

what procedures should you ask if pts have had within last 6 months when evaluating for IE (4)

A
  • dental
  • urologic
  • surgical
  • gynecologic
42
Q

chronic condition affecting all layers of the heart characterized by scarring and deformity of heart valves caused by acute inflammatory disease of heart

A

rheumatic heart disease

43
Q

what age group is primarily affected by rheumatic heart disease

A

young adults

44
Q

what causes rheumatic fever

A

group A strep

45
Q

most common S+S with RF

A

mono/polyarthritis

46
Q

3 signs of carditis with RF

A
  • heart murmur
  • heart enlargement and HF
  • pericarditis
47
Q

major criteria for diagnosing RF (3)

A
  • sydenhams chorea
  • erythema marginatum
  • subcutaneous nodules
48
Q

symptom of RF, characterized by involuntary movements of face and limbs, muscle weakness, and speech + gait problems

A

sydenhams chorea

49
Q

symptom of RF, nonpruritic bright pink lesions on trunk and proximal extremities, intensified by heat

A

erythema marginatum

50
Q

minor criteria for diagnosing RF (3)

A
  • fever
  • polyarthralgia
  • lab tests (increased CRP and WBC)
51
Q

2 diagnostics for RF

A
  • test for group A strep

- echocardiogram

52
Q

meds for RF (3)

A
  • antibiotics (amoxicillin, erythromycin, clindamycin)
  • aspirin
  • corticosteroids
53
Q

narrowing of heart valve that impedes forward flow,

A

stenosis

54
Q

results from stenosis, backward flow of blood caused by incomplete closure of valve leaflets

A

regurgitation

55
Q

does stenosis cause murmur when valve is open or closed

A

open

56
Q

does regurgitation cause murmur when valve is open or closed

A

closed

57
Q

most common cause mitral valve stenosis

A

rheumatic heart disease

58
Q

appearance of stenotic mitral valve due to thickening and shortening of valve structures

A

fish mouth appearance

59
Q

5 main causes mitral valve regurgitation

A
  • MI
  • chronic rheumatic heart disease
  • mitral valve prolapse
  • ischemic papillary muscle dysfunction
  • infective endocarditis
60
Q

serious complications mitral valve prolapse (4)

A
  • mitral valve regurgitation
  • infective endocarditis
  • sudden death
  • cerebral ischemia
61
Q

S+S mitral valve disorder (5)

A
  • exertional dyspnea*
  • progressive fatigue caused by decreased CO
  • heart murmur and palpitations
  • systemic embolization
  • a fib
62
Q

clinical manifestations aortic valve stenosis (5)

A
  • left ventricular hypertrophy
  • decreased CO
  • pulmonary HTN
  • soft S1, diminished/absent S2
  • prominent S4
63
Q

what med is contraindicated in pts with aortic valve stenosis because of likelihood for severe hypotension and decreased preload

A

nitroglycerin

64
Q

3 causes aortic valve regurgitation

A
  • infective endocarditis
  • trauma
  • aorta dissection
65
Q

clinical manifestations aortic valve regurgitation (6)

A
  • fluid volume overload
  • left ventricle dilation and hypertrophy
  • syncope and vertigo
  • nocturnal angina with sweating
  • dysrhythmia (murmur)
  • dyspnea and increasing fatigue
66
Q

diagnostics for valvular disorders (2)

A
  • cardiac cath

- transesophageal echocardiogram

67
Q

treatment options valvular disorders (3)

A
  • low sodium diet
  • percutaneous ballon valvuloplasty
  • surgery for repair or replacement
68
Q

nursing considerations with mechanical valve replacement (3)

A
  • lifelong anticoagulant therapy with warfarin
  • monitor INR: 2.5-3.5
  • bridge therapy with lovenox
69
Q

definite diagnosis of myocarditis

A

biopsy of myocardium

PathoPharm 2 (33 decks)

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