Term
| CP, auditory poericardial friction rub & diffuse ST elevation: |
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Definition
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|
Term
| Etiology for 90% of acute pericarditis: |
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Definition
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|
Term
| of the infectious acute pericarditis, what is the most common etiology? |
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Definition
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|
Term
| pericarditis secondary to injury of the heart: |
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Definition
|
|
Term
| which virus is responsible for the majority of infectious pericarditis? |
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Definition
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|
Term
| 3 major S/Sx of acute pericarditis: |
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Definition
1. Severe, sharp substernal CP
2. Dyspnea, possible fvr,
3. Pericardial friction rub |
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|
Term
| What are the aggrevating/alleviating factors for CP in acute pericarditis? |
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Definition
aggrevating: supine & inspiration
alleviating: sitting upright & leaning forward |
|
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Term
| what is the difference betweem ST elevation in MI and the elevation from acute pericarditis? |
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Definition
| pericarditis is concave originating from the Swave & MI is convex originating from the Rwave |
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Term
| Are there Qwaves with pericarditis? |
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Definition
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Term
| Tx for severe pain and persistent Sx in percarditis: |
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Definition
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|
Term
| medicine for recurrent pericarditis or steroid dependancy: |
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Definition
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|
Term
| what are the indications for percardiectomy? |
|
Definition
restriction of heart
pericarditis won't resolve
continual reoccurance |
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Term
| NSAIDS increase the chance of _______ in acute pericarditis. |
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Definition
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Term
| 6 S/Sx of pericardial effusion: pneumonic |
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Definition
F - dysphagia
L - laryngeal nerve compression (hoarseness)
U - hiccUps
I - Ill (nausea)
D - Dyspnea
S - Strain/pressure in chest |
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Term
| what is Ewart sign and what is it assoc w? |
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Definition
| dullness to percussion, bronchial breath sounds & egophony below the angle of the left scapula in Pericardial Effusion |
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|
Term
| what is the best imaging for the pericardium? |
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Definition
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|
Term
| 5 Dx studies for pericardial effusion: |
|
Definition
1. CXR
2. EKG
3. Echo
4. CT
5. MRI |
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Term
| EKG w Pericardial Effusion: |
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Definition
| "electrical alternans" : EKG can change axis; height of QRS will change w ea beat bc of a "swinging heart" |
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Term
| 5 Tx for pericardial effusion: |
|
Definition
1. if aSx then volume can be observed
2. Tx underlying cause
3. Diuretic
4. pericardiocentesis
5. surgery |
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Term
| when pericardial fluid accumulates, increases pressure and compresses the cardiac chambers: |
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Definition
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|
Term
| 8 Sx of cardiac tamponade:pneumonic |
|
Definition
p - little p (Oligouria)
R - restlessness
E - exhausted
S - SOB
S - Sleepy
U - chest Unpleasantness
R - reduced appetite (anorexia)
E - edginess (agitation) |
|
|
Term
| what is Beck's Triad? what is the significance? |
|
Definition
JVD, muffled heart sounds, Hypotension
10-40% of cardiac tamponade patients presentation |
|
|
Term
| what is the most useful Dx study for cardiac tamponade? |
|
Definition
|
|
Term
| which procedure gives a definitive Dx for cardiac tamponade? |
|
Definition
|
|
Term
| 3 Tx for cardiac tamponade: |
|
Definition
1. centesis
2. pericardial window
3. pericardioectomy |
|
|
Term
| thickened, fibrotic, adherent pericardium resulting in impaired ventricular filling and decreased cardiac output: |
|
Definition
| constrictive pericarditis |
|
|
Term
| 4 etiologies for constrictive pericarditis: |
|
Definition
1. IDIOPATHIC (most cases)
2. Radiation therapy
3. Cardiac surgery
4. viral pericarditis |
|
|
Term
| 6 S/Sx for Constrictive pericarditis: pneumonic |
|
Definition
J- JVD
A - A fib
C - concealed heart sounds (muffled)
K - Kussmal sign
E - edema/ascities
D - Dyspnea/fatigue |
|
|
Term
| what is the best non-invasive test for constrictive pericarditis? |
|
Definition
|
|
Term
|
Definition
| JVD rises with inspiration |
|
|
Term
| Tx for constrictive pericarditis: |
|
Definition
aggressive diuresis
pericardiectomy |
|
|
Term
| infection of the endocardium usually involves the: |
|
Definition
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|
Term
| 4 risk factors for infective endocarditis: |
|
Definition
1. structural heart dz
2. immunosupression
3. IV drug use
4. catheter related bacteremia |
|
|
Term
| 75% of infective endocarditis is due to: |
|
Definition
|
|
Term
| what is the most common structural defect of infective endocarditis? |
|
Definition
|
|
Term
| what is commonly the source of infection of infective endocarditis? |
|
Definition
|
|
Term
| which bacteria is the most common organism in infective endocarditis? |
|
Definition
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|
Term
| What is the most common organism for IV drug users in infective endocarditis? |
|
Definition
|
|
Term
| which is the most commonly infected valve in IV drug users? |
|
Definition
|
|
Term
| what is the most common organism w infections of prosthetic valves |
|
Definition
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|
Term
| S/Sx of infective endocarditis: |
|
Definition
flu like Sx; dry cough, low grade fvr, night sweats, weight loss
may present w generalized rash |
|
|
Term
| what percentage of infective endocarditis does CHF occur? |
|
Definition
|
|
Term
| 3 neurologic complications of infective endocarditis: |
|
Definition
1. cerebral emboli
2. encephalopathy
3. meningitis/abcess |
|
|
Term
| Labs for infective endocarditis |
|
Definition
1. increased WBC
2. NCNC Anemia
3. ESR, CRP >
4. Pos BLD Culture wn 2 days
5. EKG: AV block; MI |
|
|
Term
| 2 major criteria for duke's criteria for infective endocarditis: |
|
Definition
1. 2 Positive Blood cultures with IE indicated organism
2. indications for IE on echocardiogram |
|
|
Term
| 5 minor criteria for Duke's criteria for IE: |
|
Definition
1. valvular heart dz
2. Hx of IV drug use
3. fvr>38C
4. vasculitis
5. skin lesions (rash) |
|
|
Term
| Infective endocarditis Tx: |
|
Definition
beta lactam + aminoglycoside 6wks
surgical debridement in 25% of cases |
|
|
Term
| 5 cardiac complications from infective endocarditis: |
|
Definition
1. CHF (leading cause of death)
2. Abscess
3. conduciton abnormalities
4. Coronary Embolism
5. Systemic embolism |
|
|
Term
| what are the skin lesions assoc w infectious endocarditis? |
|
Definition
1. splinter hemorrhages in fingernails
2. janeway lesions
3. osler's nodes |
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