Myocarditis & Pericarditis (Light-McGroary) Flashcards
True or false: people with myocarditis who present with MI syptoms tend to have a better prognosis than those who present with heart failure/eosinophilia
True. Eosinophilia is indicative of hypersensitivity myocarditis which often causes long-term complications and is difficult to treat.
which findings are consistent with higher mortality and a need for transplant in patients with myocarditis?
left bundle branch block, right ventricular dysfunction and high troponin t levels
what is the most common finding on ECG that points to myocarditis?
non specific t wave abnormality (NSTW)
cardiac MRI evidence of edema in the heart points to _____ myocarditis
acute. another diagnostically helpful finding is the reduction in clearance of contrast from the heart muscle itslef, which points to myocarditis (as opposed to a distribution of that contrast in the coronary vessels, which would be more indicative of CAD)
gold standard for evaluation of myocarditis, the extent of damage, and determining outcome
cardiac MRI
this critera says that if two or three imaging criteria are positive, there is 78% accuracy of a myocarditis diagnosis
lake louise criteria
new onset HF less than 2 weeks duration with normal or dilated LV and hemodynamic compromise is known as _____ myocarditis, and is one of only two indications for a heart biopsy.
fulminant (sudden); the other indication for heart biopsy is when either giant cell or eosinophilia is suspected
new onset HF of at least 2 weeks duration with dilated LV, new ventricular arrhythmias, and a high degree of AV block or failure to respond to usual care within 1-2 weeks is known as _____ myocarditis, and is one of only two indications for a heart biopsy.
giant cell
a vasodilator used to treat severe hypertenision that may cause pericardial disease
hydralazine
which of these is NOT a major clinical presentation of pericarditis?
A. prolonged PR interval
B. sudden retrosternal pain that is worse with inspiration
C. high pitched friction rub at left sternal border
D. new or worsening pericardial effusion
E. widespread ST elevation
A. It is a depressed PR interval that is associated with pericarditis.
which of the following ekg findings is NOT correctly matched with its stage of pericarditis?
A. Stage 1: Diffuse ST depressoin and PR elevation
B. Stage 2: normalization of the ST/PR segment
C. Stage 3: diffuse t wave inversions
D. Stage 4: normalization of ecg or persistent t wave inversion
A. It is a diffuse ST elevation and PR depression.
chronic pericarditis leads to fibrosis and thickening of the pericardium, preventing relaxation of the heart during diastole and contributing to ___ sided venous overload and low cardiac output.
right sided
this is the most common reason for serous and/or fibrous peridcardial effusion, though effusions may also happen as the result of blunt force trauma, congestive heart failure or mediastinal lymphatic obstruction
inflammation
though the pericardium can tolerate up to a L of fluid accumulation slowly over time, as little as 250 mL accumulated fluid can lead to this condition which is often fatal
cardiac tamponade. this is the most feared complication of pericardial effusion
the cassic clinical presentation of cardiac tamponade includes hypotension, JV distension and distant heart sounds, a constellation of symptoms known as what?
Beck’s triad
