Other Forms of Heart Disease Flashcards
What is the most common cause of infective endocarditis in IV drug users?
staph aureus (overall it’s staph and strep)
What are the major complications of endocarditis?
emboli (systemic or cerebral) and valvular incompetence leading to CHF
What patients are at high risk of developing infective endocarditis?
cogenital heart disease, rheumatic heart dz, prosthetic valves, degenerative valve dz (calcified aortic valve), previous endocarditis, cardiac transplant pts who develop valvulopathy
What procedures put high risk endocarditis patients at risk for infection?
major dental procedures, invasive procedures involving infected tissue, respiratory procedures (also IV drug use)
What does the presentation for infective endocarditis look like?
fever, dyspnea, myalgias, arthralgias, GI complaints
What are some cutaneous manifestations in infective endocarditis?
petechiae, splinter hemorrhages, osler’s nodes (painful), janeway lesions (not painful)
What should be done to work up infective endocarditis?
blood cultures and echo (especially transesophageal)
What is the initial treatment for infective endocarditis?
penicillin/nafcillin/vancomycin + gentamicin
(vanc + gent is probably best)–eventally might need valve replacement
What is the prophylatic drug for high risk endocarditis pts?
amoxicillin 2 gm or ceftriaxone 1 gm–but because of MRSA prevalance sometimes use vancomycin
What is the major complication of pericarditis?
effusion leading to tamponade
What are the signs and symptoms of acute pericarditis?
sharp, pleuritic chest pain (they usually lean forward because it feels better), friction rub, low fever, tachycardia
What is the primary diagnostic modality for acute pericarditis?
EKG-diffuse ST elevation (concave upwards), depressed PR in the same leads with ST elevation
What should be ordered to evaluate for acute pericarditis with effusion?
echo or CT if there is no echo available
What does EKG with large pericardial effusion causing tamponade look like?
low voltage, tachycardia, electrical alternans (QRS changes in size from beat to beat)
What is Beck’s triad for tamponade?
hypotension, JVD, muffled heart sounds
How do you treat pericarditis?
high dose ASA or NSAIDs for 1-3 weeks (if its infections use antibiotics) also the addition of colchicine helps
What is the treatment for a large pericardial effusion with tamponade?
pericardiocentesis
What kind of murmur is mitral valve prolapse?
mid-systolic click
What does VSD cause?
pulmonary hypertension
What is the treatment for ventricular fibrillation?
immediate cardioversion
What is the most common cause of v fib?
myocardial ischemia
What is sick sinus syndrome?
the SA node goes too fast or too slow (aka tachy-brady sydrome)
What are the symptoms with sick sinus syndrome?
syncope, palpitations, SOB
What is the treatment for sick sinus syndrome?
pacemaker
What does right bundle branch block look like on EKG and is it serious?
rabbit ears –not really serious
What does LBBB look like on EKG and is it serious?
deep S wave in V1 and wide big R wave V6–yes, it’s serious
