Cardio 1B

Question 1

Define acute pericarditis?

Answer 1

Accute inflammation of the pericardium (< 2weeks)

Question 2

What are some common causes of pericarditis?

Answer 2

Viral, bacterial, or fungal infection/ autoimmune diseases RA or SLE/ trauma/ drug toxicity

Question 3

What are the manifestations of pericarditis?

Answer 3

Triad of chest pain (abrupt, precordial, sharp) friction rub (rubbing and friction between the inflamed pericardial surfaces) and ECG changes

Question 4

What are two things the pericardial sac doesn’t tolerate?

Answer 4

Sudden increase in heart size or amount of fluid in pericardial sac

Question 5

What is pericardial effusion?

Answer 5

Accumulation of excess fluid (exudate) in the pericardial sac

Question 6

What characteristics determine the effect pericardial effusion has on cardiac function?

Answer 6

• Amount of fluid
• The rapidity with which the fluid accumulates
• Elasticity of the pericardium

Question 7

What are some of the effect of pericardial effusion?

Answer 7

• Fluid compresses heart wall
• Heart cannot expand to fill
• Backup into the systemic circulation
• Decreased blood flow to the lungs
• Decreased output to body

Question 8

What are the causes of serous pericarditis?

Answer 8

• Systemic lupus
• Rheumatic fever
• Viral infections

Question 9

What is characteristic of serous pericarditis?

Answer 9

Clear, straw-colored, protein rich exudate containing inflammatory cells

Question 10

What is characteristic of fibrinous pericarditis?

Answer 10

Fibrin rich exudate

Question 11

What causes fibrinous pericarditis?

Answer 11

Uremia, myocardial infarction, acute rheumatic fever

Question 12

What is characteristic of purulent pericarditis?

Answer 12

Glossy cloudy exudate (almost always caused by bacterial infection)

Question 13

What is characteristic of hemorrhagic pericarditis?

Answer 13

Bloody exudate usually caused by tumor invasion of the pericardium but can result from TB or bacterial infection

Question 14

What is cardiac tamponade?

Answer 14

An increase in pericardial sac pressure caused by the accumulation of fluid or blood in the pericarduial sac

Question 15

What are the effects of cardiac tamponade?

Answer 15

• Reduced ventricular filling

- Hemodynamic compromise

Question 16

What is used to treat cardiac tamponade?

Answer 16

Pericardiocentesis (subxiphoid approach or parasternal approach)

Question 17

What are the two major forms of myocardial disease?

Answer 17

Myocarditis and primary cardiomyopathies

Question 18

Define Myocarditis?

Answer 18

Inflammation of the heart muscle (and conduction system) without evidence of myocardial infarction

Question 19

How does myocarditis present itself?

Answer 19

Myocardium becomes thick and swollen biventricular heart failure in young persons who don’t have valvular, rheumatic, or congenital disease

Question 20

What are the causes of myocarditis?

Answer 20

• # 1 Viral infection
• Drug toxicity (cocaine)
• Autoimmune diseases

Question 21

What is cardiomyopathy?

Answer 21

-Non inflammatory disease not associated with hypertension, congenital heart disease, valvular disease, or coronary artery disease

Question 22

What is the most common form of cardiomyopathy?

Answer 22

Dilated cardiomyopathy

Question 23

What are the characteristics of dilated cardiomyopathy?

Answer 23

• Progressive hypertrophy
• Dilation
• Impaired pumping in one or both ventricles
• Mural thrombi are common and could lead to thromboemboli

Question 24

What is a thromboemboli?

Answer 24

Mobile blood clot

Question 25

What causes dilated cardiomyopathy?

Answer 25

Idiopathic (unknown), infectious myocarditis, alcohol

Question 26

What is characteristic of hypertrophic cardiomyopathy?

Answer 26

- Ventricular hypertrophy - Impaired diastolic ventricular filling - Often autosomal dominant inheritance

Question 27

What is the least common of then cardiomyopathies?

Answer 27

-Restrictive cardiomyopathy

Question 28

What is characteristic of restrictive cardiomyopathy?

Answer 28

- Restricted ventricular filling | - Excessive rigidity and stiffness of the ventricular wall

Question 29

What is infective endocarditis caused by?

Answer 29

Bacterial infection

Question 30

What are the 2 independent factors normally required to develop infective endocarditis?

Answer 30

- Damaged endocardial surface (valvular disease, prosthetic heart valves, congenital heart defect) - Portal of entry (organism must gain access to vasculature: oral lesion, upper respiratory tract infection, skin lesion, dental procedure) - Can develop in IV drug users

Question 31

What are the characteristics of infective endocarditis?

Answer 31

- Large, soft, friable, easily detached vegetations consisting of fibrin and intermeshed inflammatory cells and bacteria - May cause ulceration, often with perforation, of the valve cusps or rupture of one of the chordae tendineae - Mitral valve is frequently involved

Question 32

Where can embolisms occur?

Answer 32

Anywhere in the body

Question 33

What is the primary antibiotic used to prevent endocarditis?

Answer 33

-Amoxicilin

Question 34

What drugs can be used for patients who are allergic to penicillin?

Answer 34

- Cephalexin - Azithromycin - Clarithromycin