Download Heart Inflammatory Questions Can we go over endocarditis and

Heart Inflammatory Questions
Can we go over endocarditis and pericarditis? We rushed through that in class.
What are the most important s/s associated with endocarditis?
Endocarditis – infection of the valves and inner lining of the heart; organisms
will grow where there is increased turbulence of blood flow (ie. Congenital
defects) or in areas of previous cardiac damage, the organisms create a
characteristic lesion of vegetation, fibrin deposits and collagen; this lesion
can break off and embolize somewhere else; usually caused by a bacteria but
can be fungal or viral, can occur after an invasive procedure (ie. Minor
surgery, dental procedures) – this is why they need prophylactic antibiotics
before dental care and procedures
Signs/symptoms – murmur, symptoms of emboli in spleen (ULQ pain,
splenomegaly), kidney (flank pain, hematuria), brain (hemiplegia, decreased
LOC), or peripherally (splinter hemorrhages in nailbeds, petechiae)
Diagnostic studies – echocardiography, blood cultures
Treatment – IV abx for 4-6 weeks, bed rest if cardiac damage, prophylactic
abx for 3-5 years, may need surgery if there is severe valvular damage
Complications - CHF, systemic emboli
Pericarditis – inflammation of the pericardium; acute may be dry or may
cause fluid accumulation, chronic causes fibrous thickening which inhibits
cardiac filling during diastole; risk factors – infection, myocardial injury,
hypersensitivity, renal failure
Signs/symptoms – precordial pain, pericardial friction rub as the
myocardium rubbing against the inflamed pericardium, pain increases with
respiration (sitting may make the pain better), with chronic CHF symptoms
occur and chest pain is usually not predominant
Diagnostic tests – EKG changes, increased WBCs, CT scan
Complications – pericardial effusion leading to cardiac tamponade
Treatment - bedrest, anti inflammatory meds, pericardiocentesis if effusion
or tamponade occurs
Does rheumatic fever always come from strep throat?
Yes, it is caused by the Group A beta-hemolytic streptococcus bacterium