inflammatory conditions of heart
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TRANSCRIPT
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INFLAMMATORY
CONDITIONS OF
HEART
Dr. Jayesh Patidarwww.drjayeshpatidar.blogspot.com
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LAYERS OF THE HEART
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MYOCARDITIS
It is inflammation of heart muscle.
CAUSESCommonest cause a virus. Other infections sarcoidosis, immune disease, pregnancy
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PATHOPHYSIOLOGY
Virus invades the muscle local inflammation.
After infection subsides, the body’s immune system continues
to inflict inflammatory damage to the heart muscle.
This immune response prolongs the myocarditis.
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MYOCARDITIS
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Sign & Symptoms
Mild and cause no noticeable symptoms. Pain in the chest. Serious heart failure SOB, fatigue, fluid accumulation in the
lungs & heart,rhythm irregularities inflammation or
scarring.
Diagnosis
Detect signs of irritation of heart muscle. Blood tests (CPK) EKG, Nuclear heart scan shows.9/15/2014 6www.drjayeshpatidar.blogspot.com
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Treatment
Corticosteroids.No proven medications Treatment -Salt restriction, ACE
inhibitors, beta blockers treating as well as monitoring heart rhythm
abnormalities.
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Prognosis
After initial phase of myocarditis -complete recovery
Chronic Heart Failure due to injured heart muscle.
Sudden unexpected, potentially fatal heart rhythm abnormalities.
Prevented with implantable defibrillators
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ENDOCARDITIS
It is a serious infection of one of the four heart valves.
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CausesGrowth of bacteria on one of the heart
valves, leading to an infected mass called a vegetation.
Infection may be bacteria in the blood stream after dental work, colonoscopy, and other similar procedures.
Persons at RiskHeart valves (Aortic stenosis, Mitral
stenosis, Mitral regurgitation etc) undergone valve replacements. etc).
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Endocarditis
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ENDOCARDITIS
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Sign & Symptoms
Fever
Fatigue
Chills
Weakness
Aching joints and muscles
Night sweats
Edema of feet and abdomen
Malaise
Shortness of breath
Occasionally scattered small skin lesions
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Diagnosis
Echocardiography.
TEE (Trans Esophageal Echocardiography)
Identification of bacteria by blood culture.
Treatment
Antibiotics given intravenously for 4-6 weeks.
Valve replacement
Prognosis
Response to treatment is indicated by a reduction in fever, negative blood cultures and findings on echocardiography.
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PERICARDITIS
Heart sits in the centre of the chest and issurrounded by a sac called thepericardium.
This sac has two layers one that fitstightly onto the heart muscle and anotherlooser layer surrounding the inner layer.
Inflammation of these tissue layerssurrounding the heart is referred to aspericarditis.
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Etiology
Idiopathic – cause of illness is not identified
Mechanical injury to the heartHeart attack (MI) and Dressler’s
syndromeHeart surgery and post
pericardiotomy syndromeTrauma
InfectionBacterial, viral, fungal, HIV
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Tumors/cancerPrimary (rare)Metastatic
Connective tissue diseaseRheumatoid arthritis, SLE,
Sarcoidosis, Scleroderma
Metabolic diseaseUremia, Hypothyroidism
Medication reactionsSide effects of: phenytoin,
hydralizine and procainamide.9/15/2014 19www.drjayeshpatidar.blogspot.com
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Sign & Symptoms
Chest pain
SOB
Fever, chills, muscle aches, malaise
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Diagnosis
Physical evaluation
Quality of pain,
Physical finding – pericardial friction rub
EKG
Chest x-ray
Ultrasound of the heart
Blood testing for specific causes (Leukemia, kidney failure, connective tissue disease or thyroid abnormalities).
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Treatment Medicines that reduce inflammation
NSAID’s to decrease inflammation and fluid accumulation in the pericardial sac.
Narcotic pain medication for pain
Corticosteroids for immunologically mediated causes.
Pericardiocentesis /pericardotomy9/15/2014 23www.drjayeshpatidar.blogspot.com
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Complications
Cardiac tamponade
Constrictive pericarditis
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Nursing management
Psychological support
Assess heart sounds for new or worsening murmur.
If pt received surgical treatment, provide postsurgical care.
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After surgery, monitor patient’s
temperature; a fever may be present for
weeks.
Assess for signs and symptoms of organ
damage such as stroke, CVA, meningitis,
heart failure, MI etc.
Instruct pt and family about activity
restrictions, medications, and signs and
symptoms of infection.
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Nursing management
Reinforce that antibiotic prophylaxis is recommended for patients who have had infective endocarditis and who are undergoing invasive procedures.
Refer to home care nurse to supervise and monitor intravenous antibiotic therapy in the home.
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