ch28 structural, infectious, and inflammatory Cardiac disorders Flashcards
is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium).
Cardiac tamponade
sometimes referred to as “fluid around the heart,” is the abnormal build-up of excess fluid that develops between the pericardium, the lining of the heart, and the heart itself.
Pericardial Effusion
Patients who present with either unstable angina or an acute myocardial infarction.
Develops when ischemia is prolonged and not immediately reversible.
Acute coronary syndrome
Complete occlusion of the artery causing irreversible myocardial cell death
Myocardial infarction
is a series of progressive events associated with cardiac dysfunction
Can lead to heart failure, dysrhythmias, or sudden death
In other words ……. The heart loses its ability to pump the blood
Cardiomyopathy
- increased atrial chamber size
- increased ventricular chamber size
- decreased muscle size
dilated cardiomyopathy
- thickened interventricular septum
- decreased ventricular chamber size
- left ventricular hypertrophy
hypertrophic cardiomyopathy
-left ventricular hypertrophy
restrictive cardiomyopathy
3 cardinal signs of cardiac tamponade: hypotension, muffled heart sounds, JVD
Beck’s triad
Inflammation of the inner lining of the heart and valves
Occurs primarily in patients who have prosthetic heart valves, structural cardiac defects, abuse IV drugs
Possible ports of entry—oral cavity, surgery
Hospital acquired -
endocarditis
Inflammation of the pericardium, the membranous sac that encloses the heart.
- Primary symptom is pain
- Most characteristic sign is a creaky or scratchy friction rub heard most clearly at the left sternal border. also fever, high WBC’s, anemia, elevated ESR or C-reactive protein, nonproductive cough or hiccough.
pericarditis
When valves do not close completely causing blood to flow backwards
regurgitation
when valves do not open completely and bloodflow through the valve is reduced
stenosis
stretching of the valve leaflet into the atrium during systole. It is a deformity that usually produces no symptoms.
- More frequent in women than men.
- These patients are at risk for endocarditis so teach pt. to practice good oral hygiene for prevention.
- should avoid alcohol and caffeine(cough syrup)
mitral valve prolapse
predictable and consistent pain that occurs on exertion and is relieved by rest and/ or NTG
stable angina
also called pre infarction or crescendo angina: symptoms increase in freq. and severity may NOT be relieved with rest and NTG
unstable angina
severe incapacitating chest pain
intractable or refractory angina
also called prinzmetal’s angina: pain at rest with reversible ST-segment elevation; thought to be caused by coronary artery vasospasm
variant angina
objective evidence of ischemia such as ekg changes with a stress test, but patient reports no pain
silent ischemia
involves blood flowing back from the left ventricle into the left atrium during systole.
Mitral regurgitation
the flow of blood back into the left ventricle from the aorta during diastole.
- These pts. are usually on CCB’s and ACE inhibitors
- Need to advise to avoid physical exertion, sports, and isometric exercise.
Aortic regurgitation
the narrowing of the office between the left ventricle and the aorta. Often a result of degenerative calcifications.
- A systolic crescendo-decresendo murmor is heard, it low-pitched rough and rasping.
- If you rest your hand over the base of the heart a vibration may be felt
aortic stenosis
A microbial infection of the endothelial surface of the heart.
- fever and heart murmur are primary symptoms.(may be present)
- other symptoms include petichiae, Osler nodes, Janeway lesions, Roth spots, Splinter hemorrhages, cardiomegaly, HF, tachycardia, or splenomegaly.
infective endocarditis
an inflammatory process involving the myocardium, can cause hurt dilation, thrombi on the heart wall(mural thrombi), infiltration of circulating blood cells around the coronary vessels and between muscle fibers themselves.
CAUTION- these pt’s are sensitive to digoxin
myocarditis
pericarditis that occurs 10 days to 2 months after acute MI
Dressler syndrome
a decrease of 10mm Hg or more in the systolic BP during inspiration( can be a sign of cardiac tamponade)
pulses paradoxus
procedure that punctures the pericardial sac to aspirate pericardial fluid.
- The patient is on continuous ECG and frequent vital signs.
- Head elevated 45-60 degrees.
- Ultrasound used to guide placement of needle.
- Patient will feel immediate relief.
pericardiocentesis
Electrical activity is present but there is ineffective cardiac contraction or circulating volume.
-Can be caused by hypovolemia, hypoxia, hypothermia, hyperkalemia, massive pulmonary embolism, MI, med overdose (BB’s,CCB’s)
PEA pulseless electrical activity
3 meds to avoid for a patient with myocarditis
NSAID’s, Dig, BB’s