Department of internal medicine 1 with course of cardiovascular pathology Causes Acquired from bacteria viruses trauma Defined as and acute or chronic inflammation of the heart and the heart valves ID: 932153
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INFECTIVE ENDOCARDITIS
Odesa National Medical University
Department of internal medicine 1
with course of cardio-vascular pathology
Slide2Causes Acquired from bacteria, viruses, traumaDefined as and acute or chronic inflammation of the heart, and the heart valves
Includes :
Pericarditis
Endocarditis
Myocarditis
Rheumatic heart disease
Slide3Pericarditis
Causes:
Bacterial, fungal, or viral
Neoplasms form lungs, breasts or other organs
Autoimmune diseases (lupus, RA)
Post cardiac injury
Medications
Aortic aneurysm leakage
Post Mi (Dressler's syndrome)
Description
Inflammation of the pericardium which surrounds the heart
Fluid accumulates in the pericardium
Adhesions may occur
Constriction can cause acute symptoms
Slide4Pericarditis, cont.Subjective symptomsSharp pain over the sternum
, radiating to the back, neck, shoulders and arms
Pain increases with deep inspiration
May be relieved by sitting up
Difficulty breathing
Tachycardia
Feeling of fullness in the chest
Slide5Pericarditis, contObjective symptoms
Dyspnea
Orthopnea
Tachycardia
Substernal chest pain
Pallor, cool, clammy skin
Hypotension
JVD
Pericardial friction rub
Fluid retention, hepatomegaly, ascites (right sided heart failure)
Slide6Pericarditis, contDiagnostic tests
History
WBC
ESR
Cardiac enzymes
Cardiocentesis
EKG may show ST elevation
Atrial fib may occur
CK-MB may be elevated
BUN
Echocardiogram
Slide7Pericarditis, contNursing interventionsAssess pain and give RX
HOB elevated for dyspnea
Bedrest to decrease workload of the heart
O2 as ordered
Monitor Vitals including CVP
May need pericardial window and then follow routine post op care
Slide8Endocarditis Cause
May occur after valve procedure
Or a mitral valve prolapse
Post strep or staph infection
After septic thrombophlebitis
May occur in IV drug uses from infected needles
Description
Acute inflammation of the endocardium, heart valves, or cardiac prosthesis caused by infectious organisms
Usually fatal if not treated
Patients with above problems should receive antibiotics before dental or invasive procedures
Patients may have had recent dental work
Slide9Endocarditis, cont.Subjective symptomsAnorexia, weight loss
Malaise, weakness
Chest pain
chills
Night sweats
Slide10Endocarditis, contObjective symptomsMay have low grade to high grade fever (99-104)
Positive blood cultures
Heart murmurs
Clubbing of fingers
Petechiae
Other organ symptoms R/T emboli reaching other organs (hematuria, pleuritic chest pain, left upper quadrant pain)
Slide11Endocarditis, contDiagnosisUsually hospitalized
Physical assessment and history
Blood cultures
WBC
ESR
Echo
EKG
Cardiac output
Slide12Endocarditis, contNursing interventionsMonitor signs of heart failure
Vitals
Give antibiotics
Monitor renal status
Provide reassurance
Slide13Rheumatic Heart DiseaseDescriptionInflammatory process that may affect the myocardium, pericardium, and endocardium
May produce fatal CHF
Usually results in the scarring and distortion of the valves
Frequent cause of mitral stenosis
Slide14Rheumatic Heart Disease, cont.Objective symptoms
Temperature
Murmurs
Dyspnea
Polyarthritis
Subjective symptoms
History of rheumatic fever
Malaise, fatigue
Pain, may or may not be present
Slide15Rheumatic Heart Disease, cont.Diagnostic tests
History and physical
WBC and ESR
C-reactive protein
Cardiac enzymes
EKG
Chest x-ray
Cardiac cath
Cardiac output
Slide16Rheumatic Heart Disease, cont.Nursing Interventions
Vitals
Provide quiet environment
Provide rest
Administer PCN, dig, and diuretics
Provide nutrition
Monitor I/O
Explain disease process