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What are the 3 types of inflammatory heart diseases
endocarditis, pericarditis, rheumatic carditis
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Which inflammatory heart disease is uncommon
endocarditis
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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
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SxS of endocarditis
- flu like
- Janeway lesions
- Petichiae
- Osler nodes
- Roths spots
- Splenomegaly
- Splinter hemorrhage (nails)
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What are the 4 complications of endocarditis?
HF, aneurysm, embolism of veg fragments, abscess
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What kind of labs are used in EC?
Blood cultures, creatine, serological immune testing (circulating antigens)
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What is the priority treatment for endocarditis and what do you do before treatment?
- Antibiotics (2-8wks)
- BCx before Abx
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What kind of surgery is done for endocarditis?
- Drain abscesses
- replace/repair valve
- remove vegetations
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Which pts are at risk for pericarditis?
- those that just had a resp viral infection
- men, uremic, and ESRD
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After which 2 events can pericarditis occur?
MI and CABG
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2 main sxs of pericarditis
- abrupt chest pain
- pericardial friction rub
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Describe chest pain of a pericarditis pt
- relieved when leaning forward
- pain w/ deep inspiration and positional change
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3 main complications of pericarditis?
- pericardial effusion
- chronic obstructive pericarditis
- cardiac temponade
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What is cardiac temponade?
a very high pressure due to fluid around the heart
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Sxs of cardiac temponade
- narrowed pulses
- hypotension
- muffled heart sounds
- JVD
- cool mottled skin
- high CVP
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What tx is done for cardiac temponade
pericardiocentesis
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What is EKG change is seen in a pericarditis
ST elevation in ALL leads
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Dx done for pericarditis to r/o what?
- possible MI
- cardiac enzymes
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Meds for pericarditis
NSAIDS, aspirin, Tylenol, corticosteroids
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What 2 surgeries are done for pericarditis
- pericardial window (open hole)
- pericardiectomy
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What causes rheumatic carditis?
abnormal immune response to pharyngeal infections
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What bacteria causes rheumatic carditis
Group A Beta-hemolytic streptococci
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Describe patho of rheumatic carditis
inflammation→small vegetations on valves→deformity
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Sxs of rheumatic carditis
- friction rub
- heart murmur (S3, S4)
- cardiomegaly
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What 3 Dx test are seen in rheumatic carditis
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What med for rheumatic carditis and if allergic
- PCN
- Clindamycin and Erythromycin
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How long are Abx given for rheumatic carditis
5-10 years
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