Cardiovascular Infections Flashcards by selcan icli

Describe the direction of blood flow in the heart

Blood flows in from the superior and inferior vena cava to the right atrium
From right atrium to right ventricle
From right ventricle through the pulmonary artery to the lungs
Blood becomes oxygenated in the lung
Blood then flows from the lungs through the pulmonary veins into the the left atrium
From left atrium to the left ventrcile
From left ventricle to the aorta

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What is the name of the valve that is located between the right atrium and right ventricle

Tricuspid valve

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What is the name of the valve that is located between the left ventricle and left atrium

Mitral valve

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What is the name of the valve that is located at the pulmonary artery

Pulmonary valve

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What is the name of the valve at the aorta

Aortic valve

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Which 3 coronary arteries is the heart of heart supplied by

Left anterioir descending coronary artery
Left circumflex artery
Right coronary artery

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What are the 3 distint layers of the heart

Pericardium
Mycordium
Endocardium

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Which layer of the heart is the most outermost layer

Pericardium

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What is the structure of the pericardium

Parietal pericardium
Pericardial cavity
Visceral pericardium

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What is inflammation of the pericardium known as

pericarditis

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What is inflammation of the myocardium known as

myocarditis

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What is inflammation of the endocardium known as

Endocarditis

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What are the causes of pericarditis

Vascular: post myocardial infarction syndrome
Infective
Traumatic: accidental or iatrogenic such as needle
Autoimmune: SLE, RA, sarcoidosis, stills disease or vasculitis
Metabolic: uraemia
Iatrogenic
Neoplastic: malignancy
Amyloidosis

(VITAMIN A)

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What are the common organism that cause infective pericarditis

Virus
Bacteria
TB

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What are the viral causes of pericarditis

Enterovirus
Echovirus
Adenovirus
Mumps
Hepatitis
Varicella zoster virus 
Influenza
HIV
Parvovirus

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What are the bacterial causes of pericarditis

Staphylococcus aureus
Streptococci
Pneumococci
Legionella

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What are the signs and symptoms of pericarditis

Substernal chest pain relieved by sitting forward, wose on inspiration and lying supine
Purulent (bacterial pericarditis): fever, dyspnea, and pain is less common
Tb pericardits: gradual onsent, fever, weight loos and night sweats

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What are the signs of pericarditis

Pericardial rube to the parietal layer rubbing against the visceral layer
Pulses paradoxes
Jugular venous distension

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What are the investigations for pericardtits

Blood: WBC, CRP, troponin
ECG
Echocardiagram
CXR, ct, MRI
Pericardial fluid and tissue biopsy: pericardial fluid is sent for microbiology testing and histology to look for signs 
Microbiology test: serolgy for hiv, mumos, parvovirus, EBV pcr, CMV pcr, respiratory viral swab, ICGRA test, stool for enterovirus 
Vasculitis screen
Renal function test for uraemia 
TSH
Tumour markers

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What are the ECG changes that can occur in pericarditis

Pr elevation
Pr depression
ST depression
St elevation

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What is the diagnostic criteria for pericarditis

In acute pericarditis you need 2/4 of:

Pericarditic chest pain relieved by sitting forward
Pericardial rub
New widespread ST elevation or PR depresion
Pericardial effusion

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What is the incessant pericarditis

Lasting more than 4-6 weeks but less than 3 months

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What is recurrent pericarditis

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Recourring symptoms after symptom free period of 4-6 weeks

What is chronic pericarditis

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Pericarditis lasting more than 3 months

What is the management of viral endocarditis

Symptoms relief by aspirin, NSAIDs, colchicine

What is the management for purulent (bacterial) pericarditis

Antibiotics | Pericardiocentesis (surgical drain) and fluid is sent to the lab to find the exact bug

What is the management for tb pericarditis

RIPE | Pericardiectomy- cutting out little windows

If there is myocarditis what will this affect

Cardiac mucle | Conduction pathway- can lead to cardiac failur or arrhythmia

What are the causes of myocarditis

Viral; adenovirus, enterovirus, SARS cov2 Autoimmune: SLE, gcs, takayasus arteritis Iatrogenic: anthracycline

What is the presentation of myocarditis

Heart attack Heart failure Arrhythmia

What is the management of mycarditis

If viral: supportive | Treat cardiac failure

What is the commnest cause of myocarditis

Chagas disease

What are the other complications of chagas disease

Mega oesophagus Megacolon Myocarditis

What is the management of acute chagas disease

Antiprotozo drugs

What is the management for chronic chagas disease

Supportive

What is the presentation of chagas disease

If the bug bites aroud eye or lips it will cause a swelling

What are the risk factors (cardiac condition) for pericarditis

Congenital heart disease: biscupid valve, ventricular septal defect Valvular heart disease: stenosism regurgitation Prosthetic heart valve Previous infective endocarditis Rheumatic heart disease

What lifestyle puts people at risk for endocarditis

Iv drug use

What are the ways we can classify endocarditis

Acute | Subacute

What is acute endocarditis

``` Affects healthy normal valves Sudden Progressive High mortality Organism is usually staph aureus ```

What is subacute endocarditis

Occurs in pre-existing valve disease Slowly progessive High mortality Organism is usually streptococci (coagulase negaitve e.g strep epidermidis)

What is another way to classify endocardtisi

Native valve endocarditis Prosthetic valve endocardits Intravenoud drug use endocarditis

What are the common organism in native valve endocarditis

S.aureus Streptococci Enterococcus HACEK group

When can prosthetic valve endocarditis occur

Less than 2 months or more than 2 months post op

What is the commonest organism for iv drug use endocarditis

staph. Aureus

What is the pathogenesis of the infective endocarditis

1. There is alteration of the valvular endothelium leading to deposition of platelets and fibrin 2. Bacteria in the blood seed onto it leading to thrombotic vegetation 3. On vegetation there is bacterial growth so more platelets and fibrin deposit 4. This extends to the local structures e,g the chorda tendinae that holds the valves opens leading to endocarditis

What are the complications of endocarditis due to local spreaf

Heart failure Valvular abscess Pericarditis

What are the embolic complications that can occur in endocarditis

Left side can embolise to the rest of body, right side can embolise to the lungs Right side to lungs can cause multiple lung abscess Left side to rest of body can go to spine to cause discitis

What are the symptoms of infective endocarditis

Fever Night sweats Malasie Weight loss

What are the specific symptoms for emboli phenomena in infective endocarditis

Dyspnea with PE Back pain with discitis Fascial from with stroke

What are the signs of endocarditis

``` Fever with new murmur Roth spots Janeway lesions- non painful Osler nodes- painful red nodules Haematuria Splenomegay Splinter haemorrhage ```

What investigations can be done in endocarditis

``` Ecg Urine dip for haematuria Blood: FBC, UE, CRP Blood culture CXR Echocardiogram ```

What criteria is used to diagnose endocarditis

Modified duke criteria

What criteria needs to be met in the modified duke criteria for definite diagnosis if endocarditis

``` 2 major criteria Or 1 major and 3 minor criteria Or 5 minor criteria ```

What is the management of endocarditis

For fever paracetamol Surgery if uncontrolled infection: with large vegetation Give iv antibiotics guided by blood culture result

Cardiovascular Infections Flashcards

(55 cards)