Infective and inflammatory conditions and arrhythmia Flashcards
(44 cards)
What can cause infective/inflammatory conditions of the heart
- Bacteria
- Viruses
- Autoummune conditions (esp. rheumatic fever, rhumatoid arthritis, SLE)
- Drug reactions
- In the immunosuppressed may also be caused by fungus (ESP. candida)
Endocarditis
inflammation of the endocardium
Endocardial lining of the heart is a continuation of the
Intimal layer of the BV and also lines the heart valves (tricupsid, aortic, mitral)
What is a complications of endocarditis
Vegetations
Vegetations are
lesions or clusters of the infecting organism or localization of autoimmune activity, often develops inside the cusp of the valves, they can be stable pr unstable
Vegetations of ___ or ____ origin are susceptible to breaking away the wall/valve under the hemodynamic pressure of the heart. They can create dangerous emboli
Bacterial or fungal
Unstable vegetation is referred to as
Friable
Types of endocarditis
Infective endocarditis, bacterial endocarditis, non-effective endocarditis
Infective endocarditis
occurs when microrganisms adhere to the endocardial surface of the heart, most commonlyu bacterial in origin but may also be fungal or viral or seconary to autoimmune disease
Bacterial endocarditis
often caused when bacteria are introduced to the bloodstream during dental surgery or other medical procedures,
Non-infective endocarditis
AKA as non-bacterial thrombotic endocarditis (NBTE)- formation of sterile and fibrin thrombi on previously undamaged cardiac valves and adjacent endocardium in response to trauma, circulating immune complexes, vasculitis or a hypercoagualable state
Acute disease (in endocarditis)
is more severe, associated with fever, systemic toxicity and death from sepsis in several days to weeks
Subacute disease (in endocarditis)
usually occurs in patients with prior valve disease. It is less severe, associated with a low grade fever, vague systemic complaints and various embolic phenomena
Signs and symptoms of Endocarditis
45% have musculoskeltal symptoms- arthalgia (pain in joints), arthritis, low back pain, myalgia
fever, chills, fatigue, sweating
acute valve damage, pulonary, edema SOB
-constant deep achy chest pain
Medical treatment with endocarditis
long term antibiotics, often four-six weeks or more, if valve damage has occured surgical repair or valve replacement may be required
RMT Concerns for endocarditis
- avoid treatment while the condition is active and the risk of embolism is high
- establish if there is a present risk of embolism
- PX nmay be taking anticoagulants which could increase bleeding/bruising
- Assess for CCHF status and adapt treatment accordingly
Myocarditis
an inflammatory condition of a heart muscle that can result from a variety of causes, most cases are viral in nature, but toxins, drug reactions, and autoimmune reactions are also common causes
Types of myocarditis
Acute myocarditis, viral mycarditis
Acute myocarditis
rare inflammatory disease, which may lead to the sudden onsite of cardiac failure and death
Viral myocarditis
is preceded many times by a flu-like illness or gastroenteritis.
Signs and symptoms of myocarditis
viral infections are often asymptomatic, may present as a constant deep pain similar to endocarditis or with fatigue, SOB, fever, and arthralgia, may also appear in the form of heart failure or sudden cardiac death, may disguse itself as ischemic, valvular or hypertensive heart disease
Medical treatment of myocarditis
no medical treatment is necessary with viral infection. Management is through rest and avoidance of physical exertion (to avoid additional stress to the heart), if bacterial infection is the cause (which is rare) antibiotics are introduced
RMT considerations of myocarditis
not considered to be an absolute C/I for massage in the active phases, awarness of CHF concerns if carsiomyopathy/CHF develop
Pericarditis
inflammation or irritation of the pericardium; the outer protective covering of the heart
