LP #111 Cardiomyopathies & Infectious Flashcards
- most bacterial or viral
- affect different hear structures
- may cause:
- permanent damage d/t inflammation, exudation & fibrosis
- chronic heart disease & sudden death
Infectious heart disease
- acute, recurring inflammation condition
- mainly in young children
- complications of streptococcal infection
- can result in:
- pericarditis
- myocarditis
- endocarditis
- often associated w/valvular dysfxn
- mitral & aortic valves most commonly affected
Rheumatic fever
Rheumatic fever pathogenesis & tx
Path:
- acute inflammation of valves
- lesion formation on valve leaflets
- fibrosis resulting in dysfxn all valves
Tx: ABX
- inflammation of pericardium
- idiopathic or d/t variety of viruses
- increase capillary permeability in serous pericardium
- result: pericardial effusion
Pericarditis
Compresses bv’s & heart, leads to decrease venous return & CO
Pericardial effusion
Pericarditis Effect on heart fxn depends on
- amount of exudates
- rate of accumulation
- elasticity of pericardium
Pericarditis prognosis
- resolution
- fibrosis & adhesions
Acute s/s pericarditis
- chest pn-radiate to neck, back, abs & sides
- pn worse w/deep breathing, coughing, swallowing & positional changes
- pericardial friction d/t rubbing & friction b/w inflamed pericardial layers
- ABN ECG
-scar tissue forms b/w visceral & parietal layers
Constrictive pericarditis
- acute inflammation of myocardium
- 2nd to viral infection- often a complication of rheumatic fever
- usually self-limiting
- may lead to chronic heart failure or death
- pathogenesis:
- viral infection causes inflammation
- if unresolved- may lead to myocardial necrosis
Myocarditis
Myocarditis s/s: from asymptomatic to sudden death
More common?
- fever
- fatigue
- heart palpitations
- chest pn
- increase WBC count
- dyspnea & tachycardia
- transient (1-2 mos.)
- acute inflammation of endocardium
- d/t bacterial infection
- major concern: damage to heart valves
- at increase risk: people w/pre-existing heart conditions
- infection can lead to:
- inflammation of valves-fibrosis & stenosis
- regurgitant valves
Endocarditis
S/s endocarditis
- fever
- emboli
- cough & dyspnea
- arthralgia or arthritis
- aka coronary heart disease (CHD)
- inability of coronary aa to provide adequate blood supply to myocardium (leads to myocardial ischemia)
Ischemic heart disease (IDH)
Types of IHD
Chronic:
- stable angina pectoris
- variant angina pectoris
- silent ischemia
Acute:
- unstable angina
- myocardial infraction (MI)
- inadequate blood supply to myocardium
- causes:
- atherosclerotic plaques (1*)
- thrombosis
- vasospasm
- associated conditions:
- angina pectoris
- MI
Myocardial ischemia
- caused by transient myocardial ischemia
- result:
- paroxysmal chest pn, or
- feeling of P in chest
- localized to sub sterna l region
- may refer to aw, neck, L shoulder & arm
- forms:
- silent ischemia
- stable
- varient
- unstable
Angina pectoris
- cardiac ischemia w/ no pn
- may cause heart arrhythmia, leading to syncope or sudden death
Chronic IHD ( silent ischemia)
- aka. Classic or exertion all angina
- d/t obstruction in coronary aa- BF does not meet myocardium’s needs
- 1st sign of IHD
- six: acute chest pn- relieved by rest or vasodilation meds
- triggers: exertion, emotional distress & cold
- tx: prevent MI, manage Sx’s & avoid stress
Chronic IHD (stable angina pectoris)
- aka vasospastic angina
- chest pn d/t vasospasm of coronary aa & BF interruption to heart
- d/t coronary stenosis
- pn at rest or w/ min exercise
- nocturnal pn
- caused by overactive SNS response
Chronic IHD (variant angina pectoris)
- caused by injury to atherosclerotic plaques
- platelets aggregate at plaque injury site
- increase bv occlusion d/t thrombus formation
- leads to complete bv occlusion & MI
Acute coronary syndromes (unstable angina pectoris)
- ischemic death of myocardial tissue d/t severe decrease BF
- s/s:
- pn not relieved by rest or meds
- fatigue & weakness (limbs)
- tachycardia, anxiety & restlessness
- cold sweats
- indigestion
- female (classic MI Sx’s): referred pn that radiates to L arm, neck & jaw
- male Sx’s: sudden jaw pn, sleep disturbances, dyspnea * vertigo
- elderly tend to c/o SOB
Acute coronary syndrome (myocardial infarct)
Aka. Coral art artery bypass graft (CABG, pronounced cabbage) surgery, (heart bypass or bypass surgery)
- surgical procedure consisting of diverting a systemic artery
- proximal end of diverted vessel is attached to aorta or one of its major branches
- distal end is attached immediately beyond a partially obstructed coronary artery (target vessel)
- purpose: restore norm blood flow to obstructed coronary artery
- obstruction is due to arteriosclerosis, atherosclerosis or both
Coronary artery bypass surgery
