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Pathophysiology: Cardiovascular system > Inflammation and Infection of the Heart > Flashcards

Inflammation and Infection of the Heart Flashcards

1
Q

Rheumatic fever and Rheumatic Heart disease: Acute systemic inflammatory condition usually occurs in which age category

A

in children from ages 5-15years old

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2
Q

Rheumatic fever and Rheumatic Heart disease: Acute systemic inflammatory condition can occur after which infection?
How is this infection dealt with that allows for this disease to follow?
Where does this infection manifest itself?
How does the bodies defense system react to the infection? What type of tissue does that react with and where?

A

An untreated infection, usually group A beta-hemolytic Streptococcus.
The infection can be an upper respiratory infection, tonsillitis, pharyngitis, or strep throat
Antibodies to streptococcus develop and react with connective tissue in the skin, joints, brain, and heart

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3
Q

What happens to the heart during the acute stage of rheumatic heart disease?

A

inflammation of the heart

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4
Q

What types of inflammation could the heart undergo during rheumatic heart disease?

A
  • Pericarditis
  • Myocarditis
  • Endocarditis
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5
Q

Define pericarditis

A

inflammation of the pericardium, outer layer surrounding heart

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6
Q

Define myocarditis

A

inflammation of the middle layer of the heart wall

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7
Q

Define endocarditis

A

inflammation of the inner lining of the heart

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8
Q

Which inflammation is the most common in rheumatic heart disease?

A

Endocarditis

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9
Q

Along with endocarditis, how do the heart valves function in rheumatic heart disease?

A

They are incompetent.

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10
Q

Which valve is most commonly affected in rheumatic heart disease?
What happens to it?

A

Mitral valve

It may become stenotic or regurgitant

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11
Q

Define stenotic or stenosis

A

Abnormal narrowing of a passage in the body

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12
Q

What are verrucae?

A

Rows of small vegetations along outer edge of valve cusps

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13
Q

Aside from the heart, where else can inflammation occur when a patient has rheumatic heart disease?

A
  1. Large joints
  2. Erythema marginatum
  3. Non-tender subcutaneous nodules
  4. Basal nuclei damage
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14
Q

Define erythema marginatum

A

a skin rash with red macules/ papules with whites centers

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15
Q

Where are the nontender subcutaneous nodules located?

A

extensor surfaces around joints

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16
Q

When rheumatic heart disease effects the basal nuclei, what happens to the body?

A

Involuntary jerky movements of the face, arms, and legs

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17
Q

What are the 8 clinical manifestations of rheumatic heart disease?

A
  1. Low grade fever
  2. Leukocytosis
  3. malaise
  4. Anorexia
  5. Fatigue
  6. Tachycardia: even at rest
  7. Heart murmurs
  8. Acute heart failure
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18
Q

What is the clinical manifestation of acute heart failure in rheumatic heart disease caused by?

A

Valve problems or dysrhythmia

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19
Q

What diagnostic(3) tests are used to diagnose rheumatic heart disease?

A
  1. Elevated serum antibody levels
  2. Heart function test
  3. ECG
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20
Q

What is the test for elevated serum antibody levels referred to as?

A

The ASO (antistreptolysin) titer

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21
Q

What are the 3 courses of treatment for rheumatic heart disease?

A
  1. Penicillin
  2. Prophylactic antibacterial agents
  3. Anti-inflammatory agents
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22
Q

What is penicillin used for when administered to a patient with rheumatic heart disease?

A

To treat infection

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23
Q

Why are prophylactic antibacterial agents administered to patients with rheumatic heart disease?

A

To prevent recurrance

24
Q

Give two examples of anti-inflammatory agents that could be used to help patients with rheumatic heart disease.

A

ASA and Corticosteroids

25
Q

What are the two types of invasive endocarditis?

A

Sub-acute and acute

26
Q

What is sub-acute invasive endocarditis?

A

defective heart valves are invaded by organisms with low virulence

27
Q

What is a bacteria that could cause subacute endocarditis?

A

Streptococcus viridans

28
Q

What is acute invasive endocarditis?

A

Normal heart valves are attacked by highly virulent organisms

29
Q

What is a bacteria that could cause acute endocarditis?

A

Staphylococcus aureus

30
Q

What are the basic effects of invasive endocarditis?
Do they change depending on the beast that caused it?
Where does the microorganism attach?
What part of the heart does it invade?
What does it do in that part of the heart?
What might happen to growth that the beasts caused?

A

They are the same regardless of the organism
Microorganisms attach to the endocardium
They invade heart valves causing inflammation and vegetation’s on cusps.
Vegetation’s may break off, forming infective or septic emboli

31
Q

What are vegetation’s?

A

large, fragile masses of fibrin, platelets, other blood cells and microbes

32
Q

What factors that predispose a patient to getting the infection that will cause infective endocarditis?

A
  1. Presence of abnormal heart valves
  2. Bacteremia
  3. Reduced host defenses
33
Q

What are the clinical manifestations of infective endocarditis?

What occurs in severe cases?

A
  1. Low grade fever
  2. Fatigue
  3. Anorexia
  4. Splenomegaly

Congestive Heart Failure in severe cases

34
Q

What are the clinical manifestations of acute endocarditis?
Does it occur quickly or slowly?
What marks the onset?

A

It happens suddenly

Marked by: spiking fever, chills, drowsiness

35
Q

What are the clinical manifestations of sub-acute endocarditis?
Does it occur quickly or slowly?

A

Insidious onset

fatigue increases, anorexia, cough, and dyspnea

36
Q

What diagnostic test is used to ID infective endocarditis?

A

blood culture is used to ID causative agents

37
Q

What is the treatment that is used for infective endocarditis?

A

antimicrobial drugs for several weeks, often IV.

38
Q

Is pericarditis usually a primary or secondary condition?

A

Secondary

39
Q

How is pericarditis classified?

A

By cause or type of exudate

40
Q

What type of inflammation is usually associated with acute pericarditis?

A

Simple inflammation of the pericardium

41
Q

What may acute pericarditis be secondary to? (8)

A
  1. Open Heart Surgery
  2. Myocardial Infarction
  3. Rheumatic Fever
  4. Systemic Lupus Erythematosus
  5. Cancer
  6. Renal Failure
  7. Trauma
  8. Viral Infection
42
Q

What does chronic pericarditis result from?

A

The formation of adhesions between the pericardial membranes

43
Q

In chronic pericarditis, what does the fibrous tissue often result from?

A

Tuberculosis or radiation to the mediastinum

44
Q

How is cardiac output reduced in chronic pericarditis?

A

By limiting the movement of the heart during diastole and systole.

45
Q

Where may inflammation or infection develop during chronic pericarditis other than in the pericardium?

A

In the adjacent structures

46
Q

What symptoms does chronic pericarditis cause?

A

Fatigue, weakness, abdominal discomfort

47
Q

What are the symptoms of chronic pericarditis caused by?

A

Systemic venous congestion

48
Q

Are the clinical manifestations of pericarditis consistent in all cases?

A

No, they are variable depending on the cause.

49
Q

What are the clinical manifestations of pericarditis?

A
  1. Tachycardia
  2. Chest pain
  3. Dyspnea
  4. Cough
  5. Friction Rub
  6. Effusion
50
Q

What is friction rub?

A

a grating sound heard on auscultation

51
Q

Define auscultation

A

the action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis.

52
Q

What is effusion and how does it manifest itself during pericarditis?

A

Large volume of fluid accumulates in pericardial sac

53
Q

What does effusion lead to if it occurs due to pericarditis?

A

Distended neck veins, faint heart sounds, pulsus paradoxus

54
Q

What is pulsus paradoxus?

A

an abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration.
It will drop 10mmHg during inspiration.

55
Q

How does one treat pericarditis?

A

By treating the primary problem.

56
Q

Define Paracentesis?

A

Aspiration of the fluid

Pathophysiology: Cardiovascular system (5 decks)

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