Myopathies, Heart inflammation Flashcards
Describe the pathophysiology of hypertrophic cardiomyopathy?
Very big hearts, usually genetic cause.
Strong contraction, wears itself out.
Who commonly gets hypertrophic myopathy and what happens to them?
Athletes, they randomly drop down dead.
Describe a dilated cardiomyopathy looking heart?
Two to three times bigger than a normal heart, not muscle growth but really big chambers.
They tend to be a bit floppy.
Describe the pathophysiology of a heart that has restrictive myopathy?
It will have problems with filling during diastole due to it being a stiff heart.
Caused by deposition of something into the myocardium, often this can be amyloid (deposition of abnormal proteins).
Describe what happens due to infective endocarditis?
Endothelium in the heart valve becomes infected.
Leads to turbulent blood flow around the valve.
Leads to deposits of fibrin/platelets on the valve.
Bacteria settle on the deposits and vegetate on them.
Vegetation is weak and can break off and embolize elsewhere in the body and abscesses can form on the myocardium.
What is the most common bacteria to cause infective endocarditis?
Staph aureus.
What are the main causes for endocarditis?
Poor dental hygiene (something occuring at the dentist).
Patients that have had some sort of surgery in the heart.
Staph aureus infections coming from IV drug users as Staph aureus is on the skin and travels into the blood that way.
What investigations might you do and why to investigate infective endocarditis?
Three sets of blood cultures an hr apart to determine which bacteria it is so you can administer the correct antibiotics.
ECHO to look for vegetation on the heart valve.
Urinalysis - to look for septic emboli.
What time period does acute infective endocarditis occur?
days to a week.
What time period does subacute infective endocarditis occur.
Weeks to a months.
What is the first step of treatment for suspected infective endocarditis?
Empirical treatment - giving broad spectrum antibiotics.
What antibiotics are given for viridans group strep?
Strep viridans like butter and grans.
Benzylpenicillin (penicillin) and gentamicin (IV).
What is the purpose of the IV gentamicin when treating strep. viridans?
It backs up the penicillin.
What antibiotics would you use for Staph. aureus?
Staph. aureus goes on holiday to florida to take drugs.
Flucloxacillin IV
What antibiotics would you give for MRSA (methicillin resistant stap. aureus)?
MRSA is a virgin and gay.
Vancomycin and Gentamicin IV.
