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Heart disorders 2 Flashcards

Rheumatic heart disease Infective endocarditis Medications Cardiomyopathies, pericarditis, myocarditis (55 cards)

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1
Q

what is acute rheumatic fever

A

acute immunologically mediated multi inflammatory disease which usually follows a group A beta haemolytic strep infection

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2
Q

what does acute rheumatic fever usually follow

A

a group A

beta haemolytic strep infection

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3
Q

what is acute rheumatic fever characterised by

A 
changes in the heart valves and heart tissue 
Blood vessels 
joints 
subcutaneous tissues 
and CNS
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4
Q

when can we see symptoms of acute rheumatic fever

A

10 days to 6 weeks post infection

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5
Q

what else is included in the pathogenesis of acute rheumatic fever

A

HS reaction combined antibody and T cell response

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6
Q

what are the antibodies against in acute rheumatic fever

A

the m proteins of streptococci but they cross react with the antigens on the heart

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7
Q

what is it called when we suffer from acute rheumatic fever in the heart

A

carditis

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8
Q

what is it called when we suffer from acute rheumatic fever in the pericardium

A

pericarditis

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9
Q

what is it called when we suffer from acute rheumatic fever in the myocardium

A

myocarditis

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10
Q

what is it called when we suffer from acute rheumatic fever in the endocardium

A

valvulitis

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11
Q

what is it called when the aschoff body is seen in all three layers of the heart

A

pancarditis

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12
Q

what is the aschoff body

A

it is a distinct lesion found int he heart which is compromised of macrophages plasma cells and t cells in RHD

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13
Q

when is the aschoff body seen

A

in acute rheumatic heart disease

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14
Q

what are the clinical features of acute rheumatic fever

A 
Migratory polyarthritis of joints 
○ Pancarditis 
○ Subcutaneous nodules 
○ Skin lesions 
Sydenham chorea- involuntary random movements
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15
Q

what is migratory polyarthritis

A

One large joint after another becomes painful and swollen for a period of days and then subsides spontaneously, leaving no residual disability.

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16
Q

how do we diagnose acute rheumatic fever

A

by the JONES CRITERIA

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17
Q

what does the jones criteria state

A

that they have two of the major manifestations
OR
one major and two minor manifestations

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18
Q

what do we definitely need for acute rheumatic fever

A

previous strep A infection

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19
Q

what is the definition of rheumatic heart disease

A

A valvular disease resulting from chronic valve damage as a result of acute rheumatic fever

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20
Q

what can we develop from rheumatic heart disease

A 
Cardiac hypertrophy 
Dilation 
Heart failure 
Arrhythmias 
Thromboembolic complication due to trial dilation 
Infective endocarditis
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21
Q

what is the treatment for rheumatic heart disease

A

Surgical repair or prosthetic replacement of heart valves

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22
Q

what is the pathology for rheumatic heart disease

A

nodules called verrucae in areas of valve damage

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23
Q

what is usually the sole cause of mitral stenosis

Study These Flashcards
A

rheumatic heart disease

24
Q

define endocarditis

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A

inflammation of the endocardium of the heart

25
what are the two main forms of endocarditis
infective endocarditis | non infective endocarditis
26
what does non infective endocarditis involve
nonbacterial thromboembolic endocarditis
27
define infective endocarditis
it is invasion of the heart valves or chamber by a microbe/bacteria/fungi
28
what is the vegetations of infective endocarditis a mixture of
thrombotic debris organisms and they destroy underlying cardiac tissues
29
what is the difference between acute and subacute infective endocarditis
acute infective endocarditis is very nasty and more destructive
30
DESCRIBE ACUTE INFECTIVE endocarditis
can occur with infection of a previously normal heart valve | caused by highly virulent organisms
31
what are the signs and symptoms of acute infective endocarditis
necrotising ulcerative lesions that perforate through the valve
32
what is the treatment of acute infective endocarditis
difficult to treat with antibiotics but will need surgery
33
describe subacute infective endocarditis
low virulence bacteria than acute | insidious deformed valves
34
treatment for subacute infective endocarditis
antibiotics
35
what is needed for infective endocarditis
organisms present in the blood stream to cause infection OR cardiac vascular abnormality leading to abnormal flow leading to adherence or growth of organisms
36
risk factors for infective endocarditis
pros heart valves IVDU IV drug use younger age group usually males polymicrobial infective endocarditis
37
what in creases the mortality for infective endocarditis
Right sided cardiac involvement in more than 60% of cases | Mortality rate is 4x higher for pure left sided vs pure right sided
38
high risk factors for IE is
prior ep of endocarditis pros heart valve complex congenital heart defects
39
moderate risk of IE
PATENT ductus arteriosus septal defects hypertrophic cardiomyopathy
40
how does bacteria get into the blood
``` IVDU wounds strep viridans in the mouth strep aureus on the skin coagulase negative staphylocci- Heart valves ```
41
which group of bacteria can be a cause of infective endocarditis
the HACEK GROUP
42
what bacteria are part of the HACEK group
``` haemophilus aggribacteur cardiobacterium eikenella kingella ```
43
what can also be a cause of IE in 5-10% of cases
culture negative IE
44
which organisms fail to grow in nromal blood cultures
coxiella chlamydia bartonella legionella
45
what are clinical features of infective endocarditis
``` fever chills weakness loss of weight/flu like new heart murmur ```
46
how do we diagnose infective endocarditis
duke criteria
47
what are clinical manifestations of infective endocarditis
janeway lesions osler nodes roth spots
48
what do janeway lesions look like
erythymatous spots on hands/soles
49
what to osler nodes look like
subcutaneous nodes in the pulp of digits
50
what do roth spots look like
retinal haemorrhages in the eye
51
what pneumonic can we use to look at clinical manifestations of IE
FROM JANE
52
WHAT does from jane stand for
fever roth spots osler nodes murmurs janeway lesions anaemia nail haemorrhage emboli
53
what is the treatment for infective endocarditis
but of a pain but we can use | broad spectrum antibiotic such as penicillin for 4-6 weeks
54
what are the nice guidelines for infective endocarditis
Antibacterial prophylaxis and chlorhexidine mouthwash are not recommended for the prevention of endocarditis in pt undergoing dental procedures better to have high OH standard
55
who does non infective endocarditis affect
occurs in debilitated patients | can be a part of trousseau syndrome

Y3- I & W (21 decks)

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