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Systems > Infective and inflammatory conditions and arrhythmia > Flashcards

Infective and inflammatory conditions and arrhythmia Flashcards

1
Q

What can cause infective/inflammatory conditions of the heart

A
  • Bacteria
  • Viruses
  • Autoummune conditions (esp. rheumatic fever, rhumatoid arthritis, SLE)
  • Drug reactions
  • In the immunosuppressed may also be caused by fungus (ESP. candida)
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2
Q

Endocarditis

A

inflammation of the endocardium

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3
Q

Endocardial lining of the heart is a continuation of the

A

Intimal layer of the BV and also lines the heart valves (tricupsid, aortic, mitral)

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4
Q

What is a complications of endocarditis

A

Vegetations

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5
Q

Vegetations are

A

lesions or clusters of the infecting organism or localization of autoimmune activity, often develops inside the cusp of the valves, they can be stable pr unstable

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6
Q

Vegetations of ___ or ____ origin are susceptible to breaking away the wall/valve under the hemodynamic pressure of the heart. They can create dangerous emboli

A

Bacterial or fungal

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7
Q

Unstable vegetation is referred to as

A

Friable

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8
Q

Types of endocarditis

A

Infective endocarditis, bacterial endocarditis, non-effective endocarditis

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9
Q

Infective endocarditis

A

occurs when microrganisms adhere to the endocardial surface of the heart, most commonlyu bacterial in origin but may also be fungal or viral or seconary to autoimmune disease

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10
Q

Bacterial endocarditis

A

often caused when bacteria are introduced to the bloodstream during dental surgery or other medical procedures,

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11
Q

Non-infective endocarditis

A

AKA as non-bacterial thrombotic endocarditis (NBTE)- formation of sterile and fibrin thrombi on previously undamaged cardiac valves and adjacent endocardium in response to trauma, circulating immune complexes, vasculitis or a hypercoagualable state

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12
Q

Acute disease (in endocarditis)

A

is more severe, associated with fever, systemic toxicity and death from sepsis in several days to weeks

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13
Q

Subacute disease (in endocarditis)

A

usually occurs in patients with prior valve disease. It is less severe, associated with a low grade fever, vague systemic complaints and various embolic phenomena

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14
Q

Signs and symptoms of Endocarditis

A

45% have musculoskeltal symptoms- arthalgia (pain in joints), arthritis, low back pain, myalgia
fever, chills, fatigue, sweating
acute valve damage, pulonary, edema SOB
-constant deep achy chest pain

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15
Q

Medical treatment with endocarditis

A

long term antibiotics, often four-six weeks or more, if valve damage has occured surgical repair or valve replacement may be required

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16
Q

RMT Concerns for endocarditis

A
  1. avoid treatment while the condition is active and the risk of embolism is high
  2. establish if there is a present risk of embolism
  3. PX nmay be taking anticoagulants which could increase bleeding/bruising
  4. Assess for CCHF status and adapt treatment accordingly
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17
Q

Myocarditis

A

an inflammatory condition of a heart muscle that can result from a variety of causes, most cases are viral in nature, but toxins, drug reactions, and autoimmune reactions are also common causes

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18
Q

Types of myocarditis

A

Acute myocarditis, viral mycarditis

19
Q

Acute myocarditis

A

rare inflammatory disease, which may lead to the sudden onsite of cardiac failure and death

20
Q

Viral myocarditis

A

is preceded many times by a flu-like illness or gastroenteritis.

21
Q

Signs and symptoms of myocarditis

A

viral infections are often asymptomatic, may present as a constant deep pain similar to endocarditis or with fatigue, SOB, fever, and arthralgia, may also appear in the form of heart failure or sudden cardiac death, may disguse itself as ischemic, valvular or hypertensive heart disease

22
Q

Medical treatment of myocarditis

A

no medical treatment is necessary with viral infection. Management is through rest and avoidance of physical exertion (to avoid additional stress to the heart), if bacterial infection is the cause (which is rare) antibiotics are introduced

23
Q

RMT considerations of myocarditis

A

not considered to be an absolute C/I for massage in the active phases, awarness of CHF concerns if carsiomyopathy/CHF develop

24
Q

Pericarditis

A

inflammation or irritation of the pericardium; the outer protective covering of the heart

25
Q

The function of pericardium is

A

helps anchor the heart in place preventing excessive movement of the heart in the chest cavity with changes in body position, helps to protect the heart from infections and envading tumors

26
Q

An increase in pericardial fluid is called an

A

effusion

27
Q

Causes of pericarditis

A
  • trauma or infection from heart surgery
  • post myocardial infarction (MI) pericardial irritation (esp. if there is a slow bleed through a mural (wall) defect
  • Autoimmune disease (rhumatoid arthritis or lupus)
  • Cancer
  • Kidney failure (irritation due to toxicity of the blood)
  • Drug reactions
  • radiation therapy
28
Q

Cardiac tamponade

A

life threatening condition due to slow or rapid pericardial accumulation of fluid with subsequent compression of the heart

29
Q

exudate in the ____ can result in _____ between the visceral and parietal layers. Friction during heart beats can cause pain and usually results in reinforcement of the continuously micro damaged adhesion

A

pericardium, adhesions

30
Q

Signs and symptoms of Cardiac tamponade

A
  • systemic symptoms of the original cause may be present
  • irritability
  • constant extreme chest pain
  • Pain is generally felt below the sternum or below the ribd in the left side of the chest
31
Q

What is considered to be the most painful heart condition

A

Cardiac tamponade

32
Q

Pericardiocentisis

A

draining the effusion with a needle to relieve pressure on the heart

33
Q

Concerns for the RMT with individuals who have cardiac tamponade

A

This condition is not worsened by massage, avoid increasing venous return, heart rate, painful stimuli

34
Q

Arrhythmia/ Dysrhyhmia

A

disorders of the heart rate and rhythm caused by disturbances in the conduction systems, can lead to hypotension, heart failure and shock because of the big changes in circulatory dynamics

35
Q

Bradycardia

A

slowness of the heart rate

36
Q

What is the purpose of the SA node

A

aka cardiac pacemaker initiates and paces the heartbeat

37
Q

Ventricular fibrillation

A

is a potentially lethal arrhythmia that can occur with one MI or to a heart that has been damaged by coronary artery disease (CAD)

38
Q

Defibrillation

A

the ventricles quiver uselessly, instead of pumping blood requires resuscitation and emergency electrical counter shock

39
Q

Atrial fibrillation (AF)

A

is the most common cause of dysryhmia, usually not lethal immediately but may increase the risk of heart failure and stroke. It is a total organization of atrial activity without effective contraction, which means that the upper chambers will quiver instead of contract and allow blood to pool and clots to form leading to possible embolism and stroke

40
Q

Signs and symptoms of atrial fibrillation

A
  • some people will report feelings of palpitations when they feel irregular heart actions
  • dizziness, chest pain, fainting
  • SOB during exercise and fluid accumulation in the feet and legs
41
Q

Sinus Tachycardia

A

abnormally rapid heart beat, more than 100bpm, normal physiological response to stressers such as fever, hypotension, thyroxicosis (excessive thyroid hormone), anemia, anxiety

42
Q

Sinus bradycardia

A

abnormally low heart rate, the sinus node discharges at a rate less than 60bpm,

43
Q

sinus bradycardia is considered normal in

A

athletes or young adults

44
Q

signs and symptoms of sinus bradycardia

A

syncope, sudden onset of weakness, sweating, nausea, pallor, vomiting, distortion of vision, moving a person into a horizontal position can help to quickly stop these symptoms

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