T1W1 Flashcards
jones major criteria
J - joints - polyarthritis O - carditis N - subcut nodules E - erythema marginatum S - Sydenham chorea/CNS involvement
jones minor critera
C - CRP increased
A - arthralgia
F - fever
E - elevated ESR
P - prolonged PR interval
A - anamnesis of rheumatism (i.e. PMH of RHD/ARF)
L - leucocytosis
causes of AF
P - pulmonary disease (OSA, COPD, lung ca) I - ischemia/infarct R - RHD and mitral regurgitation A - alcohol/atrial dilation T - thyrotoxicosis/toxins E - electrolytes S - sepsis high BP stress congenital heart defects previous surgeries
diagnosis of RHD
2 major + 1 minor OR
1 major + 2 minor
both with evidence of previous GAS infection - +ve throat culture, +ve antistreptolysin O titre
high risk groups of ARF
those living in communities with high incidence: >30/100,000 5-14yr olds; RHD in total population>2/1000; ATSI in rural and remote and urban areas
etiology of valvular heart disease
MI - myocardial infarction C - cardiomyopathy A - ageing R - RHD E - endocarditis (bacterial)
Diagnosis of infective endocarditis
Dukes criteria
2 major
1 major + 3 minor
5 minor
Dukes major criteria
MAJOR 1 - positive blood culture
2+ve >12hrs apart
3+ve in 3hrs
MAJOR 2 - echocardiogram findings
new onset valvular regurgitation
mass on valve not attributable to anatomic explanation
Dukes minor criteria
- Fever >38deg
- echo findings not major
- blood culture findings not major
- vascular phenomena - major emboli, septic pulmonary infarcts, janeway lesions, subconjunctival hemorrhage, roth spots
- predisposing heart condition
- IVDU
other clinical features of infective endocarditis
splenomegaly
signs of CHF
focal neurological signs secondary to emboli
glomerulonephritis, microscopic hematuria
killip classes - use and what are they
I - no evidence of heart failure
II - mild; crackles <1/3 from base, SBP>90mmHg
III - moderate; crackles >1/3 from base, SBP>90mmHg
IV - severe; crackles >1/3 from base, SBP<90mmHg