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Cardiovascular > Endocarditis, Myocarditis and Pericarditis > Flashcards

Endocarditis, Myocarditis and Pericarditis Flashcards

1
Q

What is endocarditis infection of?

A

Heart endothelium

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2
Q

What is a big factor in the bad prognosis of endocarditis?

A

Commonly diagnosed late

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3
Q

What are the two types of presentations of endocarditis?

A

Acute or subacute

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4
Q

What can it cause if bacteria gets in the bloodstream?

A

Septic shock and death

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5
Q

What colour will a negative blood culture bottle be?

A

Blue

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6
Q

What colour will a positive blood culture bottle be?

A

Yellow

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7
Q

How many sets of blood cultures should you take?

A

3

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8
Q

Heart valve abnormality is the main predisposing factor to endocarditis. How does this differ in the old and young?

A

Young- bicuspid valve

Old- calcification

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9
Q

Apart from valve abnormalities, what are other predisposing factors to endocarditis?

A

IV drug user and IV lines

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10
Q

What is the main diagnostic test for endocarditis? What should be done first and second?

A

ECHO- first trans-thoracic ECHO and if a second investigation is needed then use trans-oesophageal ECHO

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11
Q

What is the presentation of acute endocarditis?

A

Overwhelming sepsis and cardiac failure

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12
Q

What are the symptoms of a subacute presentation of endocarditis?

A

Fever, breathless, malaise, weight loss and tiredness

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13
Q

What are signs of endocarditis?

A

New/changed murmur, clubbing, splinter haemorrhages, splenomegaly, Roth spots/Janeway lesions/Oslers nodes, haematuria

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14
Q

Which of Osler’s nodes/Janeway lesions are painful?

A

Osler’s nodes

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15
Q

What is the first stage of the pathogenesis of endocarditis?

A

Heart valve is damaged which causes turbulent blood flow over the roughened endothelium

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16
Q

What happens when there is turbulent blood flow in endocarditis?

A

Platelets and fibrin are deposited

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17
Q

What has to be present for an organism to vegetate in the heart valve?

A

Bacteraemia

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18
Q

What happens when vegetations break off the heart valve?

A

They become lodged in the next capillary bed and cause haemorrhage or abscess

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19
Q

What is the most common cause of endocarditis?

A

Staph. aureus

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20
Q

What is the most common cause of hospital acquired endocarditis?

A

Staph. aureus

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21
Q

Endocarditis following a recent dental procedure is most commonly caused by what?

A

Strep. viridans

22
Q

What does staph. epidermis commonly colonise?

A

IV lines

23
Q

Endocarditis within two months of prosthetic valve surgery is most commonly caused by what?

A

Staph. epidermis

24
Q

What organism is associated with colorectal cancer?

A

Strep. bovis

25
Q

What is another cause of endocarditis which is not a staph or strep organism?

A

Enterococcus

26
Q

Staph aureus is what type of organism?

A

Gram + cocci in clusters

27
Q

Staph epidermis is coagulase what?

A

Negative

28
Q

Strep viridans is the name for a group of organisms. This group are all what type of haemolytic?

A

Alpha

29
Q

What is the prophylaxis for endocarditis?

A

None

30
Q

What is the treatment for all patients with prosthetic valves or negative blood cultures?

A

Vancomycin and gentamycin IV, rifampicin PO 3-5 days later

31
Q

What is the treatment for native valve endocarditis?

A

Amoxicillin and gentamycin IV

32
Q

What is the treatment for PWID with endocarditis?

A

IV flucloxacillin

33
Q

How long are antibiotics for endocarditis given for?

A

4-6 weeks

34
Q

What is the treatment for staph aureus endocarditis?

A

Flucloxacillin IV

35
Q

What is the treatment for strep viridans endocarditis?

A

Benzylpenicillin and gentamycin IV

36
Q

What is the treatment for enterococcus endocarditis?

A

Amoxicillin/vancomycin and gentamycin IV

37
Q

What is the treatment for staph. epidermis endocarditis?

A

Vancomycin and gentamycin IV and rifampicin PO

38
Q

What side does endocarditis usually affect and what valves does this affect?

A

Left side- mitral/aortic valves

39
Q

What side and valve does endocarditis in PWID mostly affect?

A

Right side- tricuspid valve

40
Q

What is myocarditis?

A

Inflammation of the heart muscle

41
Q

Who is myocarditis most common in and what can it sometimes cause?

A

Young people- cause of sudden death

42
Q

What are some symptoms of myocarditis?

A

Fever, chest pain, SOB, palpitations

43
Q

What are signs of myocarditis?

A

Arrhythmias, cardiac failure

44
Q

What are the most common causes of myocarditis?

A

Enteroviruses- Coxsackie A and B, echovirus

45
Q

How is myocarditis diagnosed?

A

Viral PCR, throat swab and stool for enterovirus

46
Q

What is the treatment for myocarditis?

A

Supportive

47
Q

What often occurs with myocarditis?

A

Pericarditis

48
Q

What is the main feature of pericarditis?

A

Chest pain

49
Q

What type of organism usually causes pericarditis?

A

Normally viral, bacterial is less common

50
Q

When is pericarditis common?

A

Post cardio surgery

51
Q

What is the treatment for pericarditis?

A

Antimicrobials and drainage

Cardiovascular (23 decks)

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