Exam 1: Pericarditis Flashcards
What are the most common viral causes of pericarditis?
Influenza and coxsackievirus
What PE finding is highly specific for pericarditis?
Pericardial friction rub
Best heard over the left sternal border and when the patient is siting up and leaning forward
What is Becks Triad? What is it often seen with?
Hypotension, muffled heart sounds, and JVD
Seen with pericardial tamponade
What is the management of pericarditis?
NSAIDs for the duration of the symptoms
What does failure to improve with NSAIDs within one week suggest in a patient with pericarditis?
That the cause is not idiopathic or viral
When should glucocorticoids be considered for pericarditis?
ONLY if acute pericarditis results in symptoms that are refractory to NSAIDs and colchicine
OR
If the patient has pericarditis due to connective tissue disease, pregnancy, autoimmune, or uremic pericarditis
OR
Patient has significant contraindications to NSAID therapy
What is the treatment for pericardial tamponade?
Drainage, either percutaneous or surgical
What accounts for the majority of cases of healthcare associated infectious endocarditis?
Staphylococci
What are the specific strains of strep that cause infectious endocarditis?
S. Aureus and Viridans strep
What are the cutaneous manifestations of endocarditis?
Petechiae and splinter hemorrhages
What should you be suspicious of if a patient has a fever and heart murmur?
Endocarditis
What are Roth spots?
Seen with endocarditis, retinal hemorrhages with small clear centers from retinal capillary rupture
What is the first diagnostic test for patients with suspected IE?
TTE
What is the most common indication for cardiac surgery in patients with IE?
Heart failure
