Valve Disease and Endocarditis Flashcards
what are the heart valves
tricuspid
pulmonary
mitral
aortic
what are the av valves
atrioventricular
tricuspid and mitral
what are the semi lunar valves
semilunar valves
pulmonary and aortic
which valves are open during diastole
AV valves
- they close during systole
which valves are closed during diastole
semilunar valves
- they open when the heart contracts (systole)
what happens during diastole
when the muscles of the heart relax and fill with blood
what happens during systole
when the muscles of the heart contract and pump blood into the arteries
what are valve abnormalities
wear and tear
calcification
pannus
endocarditis
thrombus
what are the two major problems caused by valve abnormalities
stenosis: very tight and hard for blood to get through
regurgitation: very loose and blood flows backwards with inc pressure
what happens to myocardium when there are valve abnormalities
development of hypertrophic muscles bc inc workload
what is the aortic stenosis triad
SAD:
syncope–> not enough blood being pumped to brain
angina –> coronary vessels are not getting enough blood
dyspnea –> blood is getting back up causing pulmonary edema
what is mitral reguritation
mitral valve: btw LA and LV
- doesn’t close properly causing fatigue and SOB bc not enough blood being pushed out and there is a back up of blood in the lungs
what is infective endocarditis
inflammation/growth of vegetation of the valve and inner lining of the heart
- growth on the valve that causes can get dislodged then travel as a septic clot to a capillary and spread infection
risk factors for infective endocarditis
prosthetic valve
pacemaker associated
IV drug use
which area of the heart is most frequently infected
tricuspid
what are the causative organisms of IV drug use endocarditis
S. viridans
S. aureus
S. epidermis
symptoms of infective endocarditis
fever, chills
anorexia, wt loss
myalgia: pain in muscles
arthralgia: joint pain
heart murmur
signs of ischemia or infarction of the extremities, spleen, kidney, bowel, brain
septic emboli
what are septic emboli
- microorgs travel to the heart and adhere to the damaged endothelial tissue which attracks WBCs, platelets–> release of cytokines and coag factors
- stimulation of coag cascade results in fibrin deposition and development of vegetation
- vegetation can emobolize into circulation and be carried throughout the blood stream and can initiate infection or ischemia in remote tissues
manifestations of infective endocarditis
many are cause by septic emboli
- petechiae
- splinter hemorrhages: linear streaks in the nailbeds
- janeway lesions: erythematous, non-tender lesions on the palms and soles
- Osler’s nodes: sub q nodules in the pulp of the fingertips
- roth spots: oval retinal hemorrhage with pale centers
infective endocarditis in drug abusers
- viens are portals of entry for the orgs
- s. aureus: found on skin and most common cause of bacteremia
- travels from peripheral vein to inferior vena cava into R side of the heart
- can become emboli and affect enter pulm artery and cause PE
what is the criteria of infective endocarditis
meet either two major criteria
one major and three minor
five minor criteria
what are major criterias for infective endocarditis
+ blood culture x2 12 hrs apart
echocardiogram showing vegetation, abscesses, valve perforation
new regurgitant murmur
what are minor criteria for infective endocarditis
predisposing heart condition
temp greater than 100.4
presence of embolic disease or hemorrhage
presence of immunological phenomena (glomerulonephritis, oslers nodes, roths spots, rheumatoid factor)
+ blood culture or echocardiogram
what is the pharm for infective endocarditis
confirm with + blood culture and get right abx
4-6 weeks abx –> lengthy hospital stay
