Infective Endocarditis Overview

<p>major Organ damage depending where its located</p> Signup and view all the answers

<p>bacteria, virus, fungus entering the bloodstream and settling in the endocardium which is the inner lining of the heart and valves</p> Signup and view all the answers

<p>fever, chills, aching muscles, fatigue, dyspnea, cough, hematuria, edema, murmur----Remember FROM JANE</p> Signup and view all the answers

<p>Fever-Roth Spot-Osler nodes-Murmur___Janeway lesions--Anemia--Nail bed hemorrhage--Emboli</p> Signup and view all the answers

<p><strong>Infective Endocarditis</strong></p> Signup and view all the answers

<p>Endocardium</p> Signup and view all the answers

<p>Echocardiogram-Formation of vegetations on the damaged heart valve</p> Signup and view all the answers

<p>Septic emboli</p> Signup and view all the answers

<p>IV antibiotic like vancomycin,ampicillin, sulbactam(unasyn) specific for C&amp;S. Also antipyretics, rest and valve replacement</p> Signup and view all the answers

<p>Elevated WBC and decreased RBC--Blood culture to identify the bacteria--CXR,CT, and MRI to show spread of infection</p> Signup and view all the answers

<p>Infections  Medications  Post MI  Renal disease  After cardiac surgery  Rheumatic disorders (RA, lupus)  Trauma from chest injury</p> Signup and view all the answers

<p>Elevated white blood cell count, ST-T elevation, CRP elevated, Echo showing pericardial effusions, CT and MRI showing thick pericardium/ WBC count over 10,000,, C-reactive protein, BUN and creatinine level and pericardial fluid culture</p> Signup and view all the answers

<p>largely based on cause-Antibiotics, bed rest, NSAIDS, corticosteriods, Bedrest, Pericardiocentesis, Pericardial Window, Pericardiectomy</p> Signup and view all the answers

<p>Cause is often unknown in chronic pericarditis which includes TB, rheumatic disorders, radiation, neoplastic disease chronic is much worse due to thickening</p> Signup and view all the answers

<p>Pericardial effusion(buildip of fluid)----cardiac tamponade(confusion, hypotensions, tachycardia, jvd, tachypnea, distant heart sounds)---leading to pericardiocentesis. If these signs and symtoms worsen to pericardiocentesis use a ultra sound get a physcian and local anesthetic</p> Signup and view all the answers

<p>Amount of muscle damaged determines extent damage to the heart caused by viral infection(bacteria, parasites, fungi), medications, lead toxicity, HIV, Rheumatic fever, Lupus, Pericarditis or IE, Cardia transplant rejection</p> Signup and view all the answers

<p>Asymtomatic, fatigue, fever, pharnygitis, malaise dyspnea, palpitations, GI DISCOMFORT, chest pain, tachycardia, SUDDEN death</p> Signup and view all the answers

<p>Endomyocardial biopsy(samples of myocardium)--CXR(shows enlarged myocardium)--ECHO(excludes alternative diseases)-MRI(signs of inflammation of myocardium)--ECG(sinus tachycardia)--CBC(elevated WBC)--Cardiac Enzymes(creatine kinase and troponins are elevated but nonspecific</p> Signup and view all the answers

<p>Bedrest, avoid alcohol, diuretics, anticougulants, digoxin, heart transplantation</p> Signup and view all the answers

<p>Sudden death</p> Signup and view all the answers

<p>chronic condition-Congestion and decreased venous circulation, damaged or againg valves no longer prevent backflow when blood is returning to heart, which is why blood pools in lower extremties.</p> Signup and view all the answers

<p>Inactivity, smoking history of DVT, family history of chronic venous insuffiency, professions that stand a lot like nurses teachers, hair stylists, pregnancy, obesity</p> Signup and view all the answers

<p>Leg swelling, itching, pain, cramping, darkened discoloration of legs, restless legs, varicose veins, DVT, Venous ulcers</p> Signup and view all the answers

<p>compression stockings, elevation of legs, avoid standing or sitting for long periods of time, move legs, avoid crossing legs, avoid restrcitive tight clothing, UNNA boot, wound care, laser ablation or radiofrequency ablation, vein stripping</p> Signup and view all the answers

<p>venous stasis ulcers are the end result of CVI(chronic venous insuffiency) over time congestion and decreased venous circulation leading to changes in lower extremeties--Develop from increased pressure and rupture of small veins can be difficult to treat</p> Signup and view all the answers

<p>Decreased muscle movement( sitting for long periods of time immobole people with sedentary jobs)--venous stasis(CVI)--Reduction of blood flow(shock, MI, HF) Dilated VEins due to age--Faulty valves like stenosis or regurgation___Venous wall injury(trauma, certain IV MEDS, not changing IV in appropriate time)__Increased blood coagulation(oral contraceptives,estrogen, smoking, dehydration, antithrombin deficeincy</p> Signup and view all the answers

<p>Ambulation, SCDS, Leg stretches, compression socks, smoking cessation, decrease weight, avoid sitting for long periods of time USE PROPHYLACTIC MEDS like ASPIRIN LOVENOX HEPARIN SQ</p> Signup and view all the answers

<p>Increased D-dimer 0.5&gt;__compression ultrasonography(may miss large part of vein)__Venous US(can use compression but is a complete study)</p> Signup and view all the answers

<p>superficial veins are warm, moist heat, analgesics, compression stockings, may be started on ASA and given short term anticougulant</p> Signup and view all the answers

<p>Aspirin, Lovenox, Heparin SQ</p> Signup and view all the answers

<p>Vitamin K</p> Signup and view all the answers

<p>inhibits fibrin formation by binding to antithrombin III. Make sure to check PTT levels per protocol if given IV. The antidote is protamine sulfate.</p> Signup and view all the answers

<p>Enoxaparin (Lovenox) SQ</p> Signup and view all the answers

<p>venous insufficiency, varicose veins, recurring DVT, Pulmonary embolism(most serious CP, SOB, Tachypnea, restlessness, anxiety)--Post thrombotic syndrome</p> Signup and view all the answers

<p>Apixaban (Eliquis) Rivaroxaban(xarelto) Edoxaban(savaysa) Enoxaparin(Lovenox)</p> Signup and view all the answers

<p>To regulate the flow of blood in the heart in one direction from tricuspid-pulmonary-aortic-mitral</p> Signup and view all the answers

<p>Echocardiogram- the ultrasouns uses high frequency sound waves to create a picture of the heart, it records moion of heart strucutres including valves and chambers,also looks at heart size, shape, and position, you will alos find ejection fraction</p> Signup and view all the answers

<p>Regurgitation</p> Signup and view all the answers

<p>Chordae tendineae and papillary muscles- structures for mitral and tricuspid valves that ensure tight close  Damage to valves or surrounding structures can result in abnormal valvular functioning</p> Signup and view all the answers

<p>Reduced blood flow through the heart</p> Signup and view all the answers

<p>(Most common heart disease)Mitral Valve Prolapse------mitral valve should be closed during systole--occurs when one flap is too large or defect in chordae tendineae</p> Signup and view all the answers

<p>Hereditary--Ischemic heart disease----Infection damaging the valve---cardiomyopathy</p> Signup and view all the answers

<p>often asymptomatic---murmur--atypical chest pain---dysrhythmias--palpitations--dizziness-syncope--fatigue--dyspnea--anxiety</p> Signup and view all the answers

<p>Emboli--mitral regurgitation--dysrhythmias--HF--IE</p> Signup and view all the answers

<p>EKG, Echocardiogram, CArdiac Cath-------MEDs are beta blockers, antiarrhythmics, aspirin, anticougulants, surgical repair or replacement of valve</p> Signup and view all the answers

<p>Mitral valve doesnt close completely, backflow of blood into left atrium and left ventricle dilates</p> Signup and view all the answers

<p>Beta blockers,calcium chanel blockers, digitalis, anticougulant medications, surgery for severe MR, repair or replacement of acute MR, Vasodilators for those who catnt have surgery</p> Signup and view all the answers

<p>Atrial fibrillation, pulmonary HTN, Heart Failure, Endocarditis</p> Signup and view all the answers

<p>Echo for enlargement of chambers or regurgitation of blood, CXR--hypertrophy of chambers, EKG- A flutter or A-fib</p> Signup and view all the answers

<p>Rheumatic heart disease, Endocarditis Rupture, or function of chordae tendineae or ,papillary muscle, MVP ,HTN ,MI ,Cardiomyopathy ,Aging ,Congenital defects</p> Signup and view all the answers

<p>Rheumatic fever, Congenital defects ,Tumor ,Rheumatoid arthritis, Systemic lupus erythematosus, Calcium deposits</p> Signup and view all the answers

<p>Myocardial infarction</p> Signup and view all the answers

<p>Asymptomatic, Murmur  Pulmonary Symptoms  Hemoptysis  Fatigue, Intolerance to activity, dizziness, or syncope  Palpitations and chest pain  Afib or aflutter</p> Signup and view all the answers

<p>Narrowed mitral valve openingEcho <em><strong><em>Enlargement of chambersCXR------ Enlargement of chambers CT <strong>Enlargement of chambers,MRI</strong></em> Narrowed mitral valve opening, Doppler</strong></em>_ A-flutter or a-fibEKG</p> Signup and view all the answers

<p>Atrial fibrillation, emboli, stroke, pulmonary edema, that is treated with anticougulants percutaneous ballon valvuloplasty or surgical valve replacement</p> Signup and view all the answers

<p>thickening of the mitral valve flaps and shortening of the chordae tendineae  Causes a narrowing to the mitral valve opening  Obstructs blood flow from the left atrium into the left ventricle  Left atrium enlarges to hold extra blood  Pressure rises in left atrium and then pulmonary circulation</p> Signup and view all the answers

<p>Increased afterload due to the narrowed aortic valve</p> Signup and view all the answers

<p>All of the above</p> Signup and view all the answers

<p>To increase stroke volume</p> Signup and view all the answers

<p>Aging----Blood from left ventricle into aorta is obstructed through stenosed aortic valve-Left ventricle contracts more forcefully leading to hypertrophy</p> Signup and view all the answers

<p>will have a sytolic murmur--early signs are dizziness, syncope, exertional dyspnea, activity intolerance</p> Signup and view all the answers

<p>Systolic murmur___life threatning V-tach, V-Fib sudden death, endocarditis, heart failure, emboli,__you can treat with aortic valve replacement is the only effective treatment-TAVR-VALVOTOMY-treatment of HF only is symotms present</p> Signup and view all the answers

<p>Narrowed pulse pressure less than 40___late symptoms are angina, heart failure</p> Signup and view all the answers

<p>Increased blood volume in the left ventricle due to backflow from the aorta</p> Signup and view all the answers

<p>Congenital defects, aging, rheumatic heart disease, syphilis, severe HTN, ankylosing spondylitis, endocarditis, aortic dissection</p> Signup and view all the answers

<p>Decreased diastolic blood pressure due to the regurgitation</p> Signup and view all the answers

<p>vasodilators  Digitalis  diuretics  Aortic valve repair or replacement</p> Signup and view all the answers

<p>Improper closing of aortic valve  Results in backflow of blood to left ventricle  Blood volume increases in the left ventricle  Becomes hypertrophied and dilated to maintain CO  Left ventricle eventually fails and CO eventually drops</p> Signup and view all the answers

<p>Aortic valve regurgitation</p> Signup and view all the answers

<p>SX Severe dyspnea Chest pain Fatigue Hypotension Atypical angina Forceful pulse that quickly collapses(Corrigan’s Pulse) Widened pulse pressure (&gt;60) HF symptoms Murmur</p> Signup and view all the answers

<p>pulmonary stenosis is congenital with fatigue and loud murmur</p> Signup and view all the answers

<p>Valvotomy</p> Signup and view all the answers

<p>Prosthetic heart valves</p> Signup and view all the answers

<p>'TAVR' (Transcatheter Aortic Valve Replacement) done for high risk patients</p> Signup and view all the answers

<p>xenograft- porcine or bovine  Allograft- human tissue  Autograft- Self-graft using pulmonary valve then pulmonary valve is replaced  Do not last as long as mechanical valves</p> Signup and view all the answers

<p>caused by RF or IV drug abuse  S/SX: Peripheral edema, ascites, hepatomegaly; diastolic low-pitched murmur with increased intensity during inspiration</p> Signup and view all the answers

<p>Echocardiogram (ECHO)</p> Signup and view all the answers