Inflammatory heart diseases
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What are the 3 types of inflammatory heart diseases
endocarditis, pericarditis, rheumatic carditis
Which inflammatory heart disease is uncommon
What puts a pt at risk for endocarditis?
- deformed/prosthetic valves
- IV drug use or poor dental
- congenital or HD
- ischemic disease (MI) or heart surgery
SxS of endocarditis
- flu like
- Janeway lesions
- Osler nodes
- Roths spots
- Splinter hemorrhage (nails)
What are the 4 complications of endocarditis?
HF, aneurysm, embolism of veg fragments, abscess
What kind of labs are used in EC?
Blood cultures, creatine, serological immune testing (circulating antigens)
What is the priority treatment for endocarditis and what do you do before treatment?
- Antibiotics (2-8wks)
- BCx before Abx
What kind of surgery is done for endocarditis?
- Drain abscesses
- replace/repair valve
- remove vegetations
Which pts are at risk for pericarditis?
- those that just had a resp viral infection
- men, uremic, and ESRD
After which 2 events can pericarditis occur?
MI and CABG
2 main sxs of pericarditis
- abrupt chest pain
- pericardial friction rub
Describe chest pain of a pericarditis pt
- relieved when leaning forward
- pain w/ deep inspiration and positional change
3 main complications of pericarditis?
- pericardial effusion
- chronic obstructive pericarditis
- cardiac temponade
What is cardiac temponade?
a very high pressure due to fluid around the heart
Sxs of cardiac temponade
- narrowed pulses
- muffled heart sounds
- cool mottled skin
- high CVP
What tx is done for cardiac temponade
What is EKG change is seen in a pericarditis
ST elevation in ALL leads
Dx done for pericarditis to r/o what?
- possible MI
- cardiac enzymes
Meds for pericarditis
NSAIDS, aspirin, Tylenol, corticosteroids
What 2 surgeries are done for pericarditis
- pericardial window (open hole)
What causes rheumatic carditis?
abnormal immune response to pharyngeal infections
What bacteria causes rheumatic carditis
Group A Beta-hemolytic streptococci
Describe patho of rheumatic carditis
inflammation→small vegetations on valves→deformity
Sxs of rheumatic carditis
- friction rub
- heart murmur (S3, S4)
What 3 Dx test are seen in rheumatic carditis
What med for rheumatic carditis and if allergic
- Clindamycin and Erythromycin
How long are Abx given for rheumatic carditis
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