other Cardiac issues

  1. Rheumatic fever
    • delayed response to group A beta- hemolytic strep
    • incr risk poor hygiene, crowding, poverty- dec access to healthcare, poor
    • diffused inflammation- heart, joints, SC tissue
    • antibiotic, corticosteriods
    • untx strep- finish meds as prescribed
  2. Endocarditis
    • infection and inflammation of endocardium
    • Us strep; or Gm (-), bacilli, fungi
    • inc risk with prosthetic/defective heart valves, IVDA
    • complication- HF, emboli- septic- bacteria- emboli attach themselves to heart valve
    • inflammation inside of the heart- valves effected
  3. Endocarditis 2 s/s
    • systemic infection- fever, chills, malaise, wt loss, splenomegaly
    • heart murmurs
    • "vegetation"- living on valve- can see on eco
    • splinter hemorrhage (brown streaks on finger nails), Osler's nodes (small raised tender nodules on fingers and toes), Janesway lesion (on palms and soles petechia)
    • systemic or pulmonary emboli
    • impacts heart valves- bacteria is 3d
  4. endocarditis- tx
    • antibiotics- IV x 4-6 weeks (PICC line, VNA, not finish abx rhematic fever)
    • address complications- may need new valve
    • nursing0 teach @ long term abx, prophylactic abx w/dental or surgical procedures, good oral hygiene- pathogens can get into blood stream
  5. Pericarditis
    • inflammation of parietal and visceral pericardium
    • infection, MI, collagen disease, drug reaction, radiation
    • ** CP- inc w/deep inspiration, decr w/leaning forward- to be able to tell the difference between angina and MI
    • pericardial friction rub
    • fever, inc wbc, ESR
  6. pericarditis- tx
    • treat cause
    • rest
    • NSAIDs prn
    • monitor tamponade
  7. Pericardial effusion
    • accumulation of fluid in pericardial sac
    • manifestations:
    • - chest discomfort
    • - edema
    • - fatigue
    • - seen on ECHO
    • treat like pericarditis
    • fluid is trapped in pericardium space
    • push against ventricular
    • heart difficult to squeeze and expand
    • 5-20 ml in this space - norm
  8. pericardial tamponade
    • life threatening**
    • effusion compresses heart, restricting blood
    • manifestations-
    • - *** Beck's triad: hypotension, JVD, muffled heart sounds
    • - ** narrowing pulse pressure (norm pulse pressure is 40)
    • - tachycardia, dyspnea
    • - seen on ECHO
    • Pericardiocentesis
    • - bleed
    • - infection
    • - dysrythmias
  9. Heart sounds
    • 4 valve areas
    • systolic/diastolic
    • Murmurs:
    • - where best heard
    • - timing
    • - intensity
    • - pitch
    • - quality
    • S1- lub systolic- mitral/tricuspid close
    • S2- dub diastolic- aortic/pulmonary close
    • what are you hearing and where.
  10. Valvular Heart disease
    • Stenosis- plaque can build up in valve when blood cant get thru (narrows opening). blood has to fight to get through. it will sound different
    • effects an OPEN valve murmur
    • Regurgitation- blood goes backwards thru the valves
    • - something is wrong with the valve
    • - dx valve problem
    • - murmur of CLOSED valve
    • often from rhematic fever
    • myocardium hypertrophies and dilates to compensate
    • Echo- dx
  11. Mitral Valve prolapse
    • structural deformity, leaflets billow up (born with this)
    • may result in regurgitation
    • generally asymptomatic/benign unless increased demand- ie pregnancy
  12. Mitral stenosis
    • low pitched, rumbling, diastolic murmur**
    • management- tx heart failure, valve replacement

    Lub sounds crazy
  13. Mitral regurgitation
    • blowing, high pitched, systolic murmur (valve should be closed)
    • management- tx HF, valve replacement
  14. Aortic stenosis
    • harsh, med pitch, systolic murmur
    • managemenet- tx HF, valve replacement
    • Open
  15. Aortic regurgitation
    • soft, high pitched, blowing diastolic murmur
    • management- tx hf, valve replacement
    • closed during diastole
  16. Valvular surgery
    • repair or replacement
    • does not cure preexisting cardiac damage
    • repair- no anti coag
  17. Valve replacement
    • Mechanical
    • - chronic anticoag
    • - man made
    • - last forever
    • - foriegn object- body fights it- clots form
    • - INR 2-3 some 3.5
    • Tissue
    • - less durable, shorten valve lifespan
    • - took from another organism
    • - human or animal
    • - no anticoag
  18. Heart transplanation
    • for endstage cardiac disease
    • availability, rejection major concerns
    • artificial hearts- research continues
Author
Prittyrick
ID
329379
Card Set
other Cardiac issues
Description
my heart beats for you
Updated