Other cardiac Flashcards
endocarditis prophylaxis indications
Prophylaxis recommended with predisposing anomalies undergoing dental procedures, operations involving the respiratory tract, or operations of infected skin or MSK
(unrepaired cyanotic congenital disease, incompletely repaired congenital disease, or if repaired with prosthetics)
meds for endocarditis prophylaxis
Amoxicillin
PCN allergy: cephalexin or azithromycin
IV: ampicillin or cefazolin
How do you treat endocarditis
Consult ID – treat empirically while cultures are pending
Cover: staph, strep, and entero →
IV vancomycin + ceftriaxone
When is surgery indicated for endocarditis
if medication management is unsuccessful in preventing heart failure
Almost always required if fungal is present or unresponsive to treatment 7-10 days
If sinus of Valsalva is involved or septal abscess
Recurrent infection
Continuing embolization
Large vegetation
Embolic stroke
(Valve debridement, repair, or replacement)
T/f: use anticoagulants in endocarditis
false
How do you treat myocarditis?
ACEI + BBs if LVEF<40%
NSAIDS for pain (actually avoid?!)
Treat arrhythmias
How do you treat more severe myocarditis?
Specific antimicrobial therapy when infecting agent has been identified
Exercise limited
Severe: cardiac transplant or ventricular assistive devices
refer!
Treatment of pericarditis
Restriction of activity until symptoms resolve
Aspirin w/ taper
(ibuprofen can be given instead)
Colchicine to prevent recurrence + continued for 3 months, may be given for longer in refractory/recurrent cases
Dressler syndrome = aspirin + colchicine
How do you treat constrictive pericarditis?
Determine underlying etiology and treat accordingly
Aggressive diuresis
Surgical pericardiectomy if unable to control w/ meds
How do you treat pericardial effusion?
Small: careful observation of JVP + pulse, serial echos
Large: drainage
(Avoid vasodilators + diuretics to avoid HOTN)
Refer a pericardial effusion if
Any unexplained effusion
Significant in those with HF or pericarditis
HOTN or paradoxical pulse
Any signs of tamponade
pericardiac tamponade treatment
Urgent pericardiocentesis or cardiac surgery
