pericarditis

Question 1

global ST elevations can indicate

Answer 1

pericarditis

Question 2

causes of acute pericarditis

Answer 2

• viral
• IVDA
• malignancy
• post MI

Question 3

clinical features of acute pericarditis

Answer 3

Chest pain- tends to be pleuritic in nature.
Pain tends to diminish when leaning forward.
Friction rub-

Question 4

ECG findings

Answer 4

1) Global “J” pt. elevations which don’t make sense as far as teammates.
2) Hammock shaped S-T segments (rather than tombstone shaped)
3) P-R slurring

Question 5

how to tx acute pericarditis

Answer 5

• NSAIDs/ASA

- colchicine for chronic

Question 6

Rate of accumulation is important for hemodynamic compromise.

Answer 6

Can hold 2 Liters if fluid slowly accumulates

100 mL can cause tamponade from quick accumulation

Question 7

large volume pericardial effusion (aka tamponade aka restrictive pericarditis) can lead to

Answer 7

• Beck’s triad (hypotension w/narrow pulse pressure, JVD, muffled heart sounds)
• Pulsus Paradoxis (HR decreases as a breath is taken)
• QRS alternans

Question 8

Kussmuals sign: increased JVD with inspiration

is seen with

Answer 8

constrictive pericarditis

Question 9

Dressler’s syndrome

Answer 9

Post MI pericarditis or postmyocardial infarction syndrome pericarditis.
It consists of fever, pleuritic pain, pericarditis and/or a pericardial effusion.
Symptoms begin 2 - 3 weeks after MI
Treat with ASA, Steroids but not 1st month due to delayed healing

Question 10

endocarditis

Answer 10

-Infection of the valvular or endocardial surface of the heart
-Strep viridians favors abnormal heart valves.(Rhueamtic heart fever) Hx. Untreated Strep. Infections as a child
-Staph aureus favors previously normal heart valves
=(infective endocarditis)

Question 11

which valves are most commonly infected from endocarditis?

Answer 11

right side

tricuspid and pumonic

Question 12

MC presenting complaint for endocarditis?

Answer 12

• FEVER
• others will have petechia, splinter hemorrhages, –Janeway lesions ((nontender, erythematous or hemorrhagic macular or nodular lesions on the palms or soles)
• Roth Spots(hemorrhage in the retina with a white center)
• anemia is common

Question 13

how to dx endocarditis?

Answer 13

• blood cultures
• TEE
• history

Question 14

duke major criteria

Answer 14

2  POSITIVE BLOOD CULTURES
Of an organism that typically causes IE
Or, persistent bacteremia
EVIDENCE ON ECHO
DEVELOPMENT OF NEW REGURGE MURMUR

Question 15

duke minor criteria

Answer 15

Fever > 38 C
Predisposition, predisposing heart condition, IV drug use.
Vascular phenomena
Immunologic phenomena
Serologic evidence of an active infection

Question 16

definite IE is confirmed by this dukes criteria

Answer 16

Two Major Criteria
                 Or
One Major Three Minor
                 Or
Five Minor Criteria

Question 17

how to tx IE?

Answer 17

-empiric anbx
vanco for gram +
ceftriaxone

Question 18

should you anticoag IE pts?

Answer 18

no, unless they have afib