Circulation: Inflammatory Disorders Flashcards
a microbial infection of the endocardium
infective endocarditis (previously called bacterial endocarditis)
Patients at risk for infective endocarditis:
- abuse IV drugs
- have had valve replacements
- have experienced systemic infection
- have structural cardiac defects
Possible ports of entry for infecting organisms include:
- oral cavity
- skin rashes, lesions, or abscesses
- infections
- surgery or invasive procedures, including IV line placement
If vegetations of infective endocarditis become so large that blood flow through the valve is obstructed, the valve appears stenotic and then is very likely to what?
embolize
S&S of Infective Endocarditis:
- recurrent fevers from 99-103
- murmurs (regurgitant)
- anorexia and weight loss
- development of heart failure
- systemic emboizatoin
- petechiae
- splinter hemorrhages
- Olser’s nodes
- Janeway’s lesions
most common infective organism of Infective Endocarditis is:
- Streptococcus viridans
- staphylococcus aureus
Most common complication of Infective Endocarditis:
- Heart Failure
- Arterial embolization (occurs in half pts)
black longitudinal lines or small red streaks on the distal third of the nail bed
splinter hemorrhages
Prime diagnostic test for Infective Endocarditis:
- positive blood culture
- low H&H
Treatment for Infective Endocarditis:
- Antimicrobials (IV, 5-6wks)
*if ineffective
- surgical removal
Do anticoagulants prevent emolization from vegetations?
No
an inflammation or alteration of the pericardium (the membranous sav that encloses the heart)
Acute pericarditis
S&S of Pericarditis:
- grating pain that is aggravated by breathing (substernal precordial pain that ratiates to Left side of neck, shoulder, or back)
- pain is worse in supine position and may be relieved by sitting up and leaning forward
- high-pitched pericardial friction rub over left lower sternal border
- elevated WBC
- fever
- ST-T spiking
- A. Fib
Treatment of Acute Pericarditis:
- NSAIDs or corticosteroids
- sitting upright, slightly forward
- Pericardial drainage
- Monitor for pericardial effusion
S&S of chronic constrictive pericarditis:
- right sided HF
- elevated systemic venous pressure with jugular distention
- hepatic engorgement
- dependent edema
- exertional fatigue and dyspnea
- thickening of pericardiam (ECHO/CT)
Treatment for uremic pericarditis:
- hemodialysis
Treatment of chronic pericarditis caused by malignant disease:
radiation or chemotherapy
occurs when the space between the parietal and visceral layers of the pericadium fills with fluid
pericardial effusion
may occur when small volumes (20-50mL) of fluid accumulate rapidly in the pericardium and cause a sudden decrease in CO.
Acute Cardiac Tamponade
S&S of cardiac tamponade:
- jugular venous distention
- paradoxical pulse
- decreased heart rate, dyspnea, and fatigue
- muffled heart sounds
- hypotension
systolic blood pressure 10mmHg or more higher on expiration than on inspiration (expiratory pressure-inspiratory pressure = 10 or more)
Paradoxixal pulse (pulsus paradoxus)
what do you do if tamponade is suspected?
alert the physician!
procedure done to remove fluid and relieve the pressure on the heart
pericardiocentesis
a sensitivity response that develops after an upper respiratory tract infection with group A beta-hemolytic streptococci (occurs in almost half of patients with rheumatic fever) inflammation is evident in all layers of the heart
rheumatic carditis
small nodules in the myocardium that are replaced by scar tissue
Aschoff bodies
S&S of rheumatic carditis:
- Aschoff bodies
- tachycardia
- cardiomegaly
- murmur or change in exisitng murmur
- pericadial friction rub
- precodial pain
- ECG changes (prolonged PR)
- indications of HF
- evidence of existing streptococcal infection
indications of streptococcal pharyngitis:
- moderate to high fever
- abrupt onset of a sore throat
- reddened throat with exudate
- enlarged and tender lymph nodes
Treatment for streptococcal pharyngitis & rheumatic fever:
- antibiotic (teach to take for full 10days)
- manage fever (antipyretics &hydration)
- prophylaxis for rest of life
Treatment of chronic constrictive pericarditis may include a _________
pericardectomy
