Endocarditis, Pericarditis, Tamponade Flashcards
infection of the endocardial surface of the heart, most commonly the valves
infective endocarditis
what 2 organisms usually cause infective endocarditis?
staph
strep
what heart structure is most commonly affected by community acquired infective endocarditis?
mitral valve
what heart structure is most commonly affected by infective endocarditis due to IV drug use?
tricuspid valve
a patient presents with fever, murmur, petechiae, osler/janeway lesions, splinter hemorrhages, weight loss, cough, and splenomegaly. what are they likely experiencing?
infective endocarditis
what criteria is used to diagnose infective endocarditis?
modified duke criteria
what would an echo of a patient with infective endocarditis, show? (3)
vegetations
new regurg
abscess
what is the test of choice to diagnose infective endocarditis?
transthoracic echocardiogram
what are the treatment steps for a stable patient suspected of infective endocarditis?
admit
await blood culture before antibiotics
what are the treatment steps for an unstable patient suspected of infective endocarditis?
admit
begin empiric antibiotics after blood culture sample is taken
what antibiotic can be used as empiric therapy for infective endocarditis?
vancomycin
a patient’s blood culture for infective endocarditis comes back as strep positive. what antibiotic therapy should be given?
IV penicillin G
a patient’s blood culture for infective endocarditis comes back as staph positive. what antibiotic therapy should be given? (2)
IV nafcillin
IV cefazolin
a patient’s blood culture for infective endocarditis comes back as resistant staph. what antibiotic therapy should be given?
vancomycin
what are 2 antibiotic alternatives if a patient is allergic to penicillin?
ceftriaxone
vancomycin
when is surgical treatment indicated for infective endocarditis? (2)
mod-severe heart failure
unavailable antimicrobial therapy for specific organism
what medication can be used as prophylaxis for surgical procedures of infective endocarditis?
amoxicillin
what are 3 symptoms to indicate acute pericarditis?
pleuritic chest pain
ECG changes
pericardial friction rub
what position makes pleuritic chest pain worse? better?
laying down
leaning forward
what would an ECG of acute pericarditis show?
diffuse ST elevations
what would a CXR of acute pericarditis show?
large effusion
when should an echo be URGENTLY ordered for acute pericarditis?
if tamponade is suspected
what cardiac enzyme may be elevated in acute pericarditis?
troponin
what is the goal of therapy for acute pericarditis? (2)
pain relief
resolve inflammation