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UM - Cardiovascular Conditions > Inflammatory Heart Diseases > Flashcards

Inflammatory Heart Diseases Flashcards

1
Q

Define myocarditis

A

Inflammatory disease of the myocardium w/a wide range of clinical presentations in an otherwise healthy person, ranging from subtle to devistating

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2
Q

T or F: once the infection is over, myocarditis goes away

A

False - it continues to influence the heart long after the infection and may cause chest pain and lead to heart failure or transplant if left untreated

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3
Q

What is the etiology of myocarditis

A

Majority = idiopathic
- viruses
- bacteria
- fungi
- protozoa
- rheumatic fever
- autoimmune disorders

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4
Q

What is the clinical presentation of myocarditis

A
  • flu-like symptoms (arthralgia, malasie, fever)
  • pharyngitis/tonsilitis/upper respiratory tract infection
  • chest pain, sweats, dyspnea, palpitations
  • HF signs
  • cardiogenic shock
  • syncope or sudden death
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5
Q

What medical tests are done for myocarditis?

A
  • Blood work
  • ECG
  • MRI
  • Endomyocardial biopsy

To rule out other causes
- Echo (TTE)
- Coronary angiogram

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6
Q

What is the medical intervention for myocarditis

A
  • Standard HF treatment (Pharm & implanted devices)
  • Avoid physical stress (several months)
  • Immunosuppression if autoimmune cause
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7
Q

What pharmacological interventions are used for myocarditis

A

Standard HF treatment:
Ace inhibitors
Beta Blockers
ARBs
Diuretics
Inotropics

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8
Q

What is the prognosis for myocarditis

A
  • Good if fulminant (unknown cause)
  • if mild symptoms = complete recovery
  • 30% develop dilated cardiomyopathy
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9
Q

What is endocarditis

A

It is induced by an infection of the endocardium or inner lining of the heart resulting in pronounced inflammation

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10
Q

What are pre-disposing factors to developing endocarditis

A
  • prosthetic valves
  • elderly patients w/degenerated valves
  • IV Drug users
  • IV catheters, pacemaker electrodes
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11
Q

What are non-surgical or drug causes of endocarditis

A
  • Rheumatic valvular disease
  • congenital heart disease
  • mitral valve prolapse
  • degenerative heart disease
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12
Q

What are treatments for endocarditis?

A
  • Antibiotics
  • Surgery is serious enough
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13
Q

What one symptom of endocarditis is present 95% of the time?

A

Fever

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14
Q

What are possible clinical presentations of endocarditis?

A
  • sudden weight loss
  • Joint and muscular pain
  • fever and chills
  • visible purple or red spots
  • heart murmurs
  • constant coughing
  • blood in the urine
  • edema
  • fatigue and unusual tiredness
  • night sweats
  • tenderness below the rib cage
  • a pale face or complexion
  • SOB or difficulty breathing
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15
Q

What diagnostic tests do you do for endocarditis

A
  • Blood cultures
  • Echo (TTE = low sensitivity, TEE = high sensitivity)
  • ECG
  • X-ray
  • MRI
  • CT
  • WBC
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16
Q

What is acute pericarditis

A

Inflammation of the pericardium characterized by chest pain, pericardial friction rub, and serial ECG changes

17
Q

What is the main sign of acute pericarditis compared to the other itis’s?

A

Pain!
Pericardially or retrosternal w/referred pain and intensity varies w/it worse during inflammation

18
Q

Etiology of acute pericarditis

A

-Idiopathic (50%)
- Infections
- Inflammatory disorders
- Metabolic conditions
- Cardiovascular disorders
- Iatrogenic
- Neoplasms
- Drugs/irradiation
- trauma
- pneumonia
- pulmonary infarction

19
Q

What is the clinical presentation of pericarditis?

A
  • chest pain
  • intermittent fever
  • dyspnea/tachypnea
  • cough, dysphagia
  • effusion
20
Q

What are the medical tests done for pericarditis?

A
  • stethoscope
  • ECG
  • Echo - TEE
  • MRI
  • Chest x-ray
  • Ultrasound imaging
  • Lab values

Rule out:
- CT

21
Q

Which lab values are tested for pericarditis?

A
  • CBC
  • Inflammatory markers
  • Electrolytes
  • BUN
  • Creatinine
  • Thyroid hormones
  • Cardiac enzyme levels
22
Q

What is the pharmacological management of pericarditis?

A
  • antibiotic if indicated
  • Anti-inflammatory meds such as NSAIDs or corticosteroids
  • morphine // narcotics
23
Q

What is the surgical management of pericarditis?

A
  • pericardiocentesis for large effusions
  • pericardial window
  • pericardiectomy in constrictive pericarditis
24
Q

What pericardial effusion develop into?

A
  • Tamponade where you get decreased ventricular filling leading to a lesser SV, CO and pulse pressure with a higher venous pressure and high heart rate
25
Q

What are the signs and symptoms of pericardial effusion?

A
  • painful
  • dyspnea
  • cough
  • pericardial friction rub
  • tachycardia
  • tachypnea
    -pulses paradoxous
26
Q

What is the most common complication of acute pericarditis?

A
  • Recurrence 15-30%
27
Q

What are the other complications of acute pericarditis?

A
  • (main = recurrence)
  • constrictive pericarditis
  • cardiac tamponade
28
Q

What is Beck’s Triad and what does it signify?

A
  • Hypotension
  • jugular vein distention
  • muffled heart sounds

= Cardiac tamponade

29
Q

What is pulsus alternans?

A

A strong pulse becoming weak at held mid exhalation, signifying cardiac pump failure

30
Q

What is pulsus paradoxus?

A

A strong pulse becoming weak at held mid inspiration, signifying cardiac tamponade and constrictive pericarditis

31
Q

What is Rheumatic Heart Disease

A

An inflammatory disease which may develop after a group a strep infection such as strep throat or scarlet fever leading to scarring and deformity of the heart valves: commonly appears in kids age 5-15

32
Q

What are signs of rheumatic fever

A
  • infectious signs
  • joint point
  • migratory arthralgia
33
Q

What does rheumatic fever do to the joints?

A
  • causes RA
  • cycle through good and pad
  • painful, tender, hot and swollen
34
Q

What does rheumatic fever do to the brain?

A

Causes a reversible rheumatic chorea due to inflammation of the BG

35
Q

What does rheumatic fever do to the skin?

A

Forms subcutaneous nodules over bony prominences

36
Q

What does rheumatic fever do to the arteries?

A

Causes rheumatic arteritis affecting the coronaries, renal, mesenteric and cerebral arteries

37
Q

What is the prognosis rheumatic fever?

A
  • mortality is low
  • valve and heart dysfunction are common
38
Q

What medical tests do you do for rheumatic fever?

A
  • culture for bacteria
  • echo
  • doppler
39
Q

What is medical management of rheumatic fever?

A
  • aspirin
  • corticosteroids for inflammation
  • valve replace later

UM - Cardiovascular Conditions (5 decks)

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