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(J2) CPR II Test 1 (Cardiovascular) > Myocarditis and Pericarditis > Flashcards

Myocarditis and Pericarditis Flashcards

1
Q

What is myocarditis?

A

Inflammation of the myocardium

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2
Q

What is the most common cause of myocarditis?

A

in general, viral infections; specifically coxsackievirus

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3
Q

What are causes of myocarditis?

A

Infectious:

-coxsackievirus (most common)

  • HIV
  • Borrelia (Lyme disease)
  • T. cruzi (Chagas disease)

Immune-mediated:

  • rheumatic fever
  • SLE
  • drug-induced
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4
Q

What drugs are associated with myocarditis?

A
  • sulfonamides
  • doxorubicin/daunorubicin (chemotherapeutics)
  • methyldopa
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5
Q

What is the clinical presentaiton of myocarditis?

A

often asymptomatic and preceeded by flu-like illness

variable symptomatic presentation:

  • CHF
  • CP (mimicing MI)
  • palpitations
  • syncope
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6
Q

What are complications of myocarditis?

A
  • arrhythmia
  • sudden cardiac death
  • AV block
  • dilated cardiomyopathy
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7
Q

What developmental form of T. cruzi is found in the heart?

A

amastigotes

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8
Q

What are the histologic types of myocarditis?

What are the causes of each?

A

Lymphocytic:

  • lymphocytic infiltrate
  • viral, autoimmune, and idiopathic myocarditis

Eosinophilic:

  • eosinophil infiltrate
  • drug reaction and parasitic
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9
Q

What is idiopathic giant cell myocarditis?

A

an aggressive myocarditis characterized by pressence of giant cells

-poor prognosis, typically less than 3 mo

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10
Q

What is myocardial sarcoidosis?

A

myocarditis characterized by non-necrotizing granulomas

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11
Q

What is a pericardial effusion?

A

accumulation of fluid in the pericardial space

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12
Q

What is the normal fluid found in the pericardial space?

What fluids may be found in pericardial effusion?

A

Normal:

-thin, clear, straw-colored

Effusion:

  • serous
  • blood (hemopericardium)
  • pus (purulent pericarditis)
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13
Q

What are causes of pericardial effusion?

A

Serous:

  • idiopathic
  • viral pericarditis
  • autoimmune

Purulent:

-bacterial pericarditits

Hemopericardium:

  • cardiac wall rupture
  • aortic dissection
  • trauma
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14
Q

What is cardiac tamponade?

A

pericardial effusion resulting in enough pressure to compress the heart and restrict heart function

-typically either from rapid accumulation of fluid (may require less fluid) or gradual accumulation of a large amount of fluid

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15
Q

How does pericardial effusion present?

A

typically asymptomatic

may present with:

  • CP
  • orthopnea
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16
Q

How does cardiac tamponade present?

A

Beck triad:

  • hypotension
  • distended neck veins
  • muffled heart sounds

additional:

  • tachycardia
  • pulsus paradoxus (decrease in pulse pressure >10mmHg during inspiration)
  • heart failure (biventricular)
  • shock
17
Q

What is pericarditis?

A

inflammation of the pericardium

18
Q

How does acute pericarditis present?

A

Presentation:

  • pleuritic chest pain; positionally dependent (improves with sitting and leaning forward)
  • fever

Exam:

-pericardial friction rub

19
Q

What EKG changes can be seen with pericarditis?

A
  • ST elevation (concave)
  • PR depression
20
Q

What are the types of pericarditis?

(most common?)

A
  • serous
  • fibrinous/serofibrinous (most common)
  • purulent
  • caseous
  • hemorrhagic
  • constrictive
21
Q

What is serous pericarditis?

(cause)

A

pericarditis resulting in an isolated serous exudate

-lymphocytic inflammatory infiltrate

may be associated with viruses and noninfectious inflammatory conditions however both are more likely to produce serofibrinous exudate

22
Q

What is fibrinous/serofibrinous pericarditis?

(cause)

A

pericarditis resulting in mixed serous and fibrinous exudate

-most common

-inflammatory infiltrate (lymphocytic?)

causes:

  • MI
  • Dressler’s syndrome (post-MI autoimmune condition)
  • uremia
23
Q

What is purulent pericarditis?

(cause)

A

pericarditis resulting in fibropurulent exudate

-neutrophilic infiltrate, with possible bacteria

Causes:

-bacterial infection (surrounding tissues, bacteremia, or post-surgical_

24
Q

What is caseous pericarditis?

(cause)

A

pericarditis resulting in caseous exudate

-necrotizing granuloma

cause:

  • tuberculosis
  • occasionally fungal
25
Q

What is hemorrhagic pericarditis?

(cause)

A

pericarditis resulting in mixed blood and fibrinous exudate

Cause:

  • pericardial metastasis (breast, lung, and esophageal)
  • trauma/surgery
  • bacterial
26
Q

How does chronic pericarditis present?

A

as fluid overload and reduced cardiac output

  • JVD (w/ Kussmaul sign, increased distention with inspiration)
  • peripheral edema
  • hepatomegaly/ascites
  • dyspnea
  • tachycardia
  • pulsus paradoxus
27
Q

What is constrictive pericarditits?

A

chronic pericarditis resulting in a rigid, fibrinous pericardium that restricts cardiac function

-mimics restrictive cardiomyopathy

Cause:

-secondary to acute pericariditis

(J2) CPR II Test 1 (Cardiovascular) (18 decks)

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