Myocarditis and Pericarditis Flashcards

Question

When is alcohol heart disease potentially reversible?

Answer 1

In early stages with immediate and complete abstinence

Answer 2

Involvement of the heart in an inflammatory process, usually caused by an infective agent

Answer 3

``` Toxins Drugs Allergic reactions Vasculitic disorders Viral Ricketsia Bacteria Fungi Protozoa Metazoan Spirochaetes ```

Answer 4

Usually a self-limiting sub-clinical condition during the course of a viral infection Can develop into acute and fulminating heart failure

Answer 5

Acute pericarditis Pericardial effusion Constrictive pericarditis

Answer 6

Acute inflammation of the pericardium

Answer 7

``` MI Infective Neoplastic Myxoedema Autoimmune Radiation Viral Bacterial - tuberculosis Rheumatoid arthritis Systemic lupus Scleroderma Dressler's syndrome ```

Answer 8

Direct infiltration - lung, breast, Hodgkin's disease | Radiation pericarditis - delayed onset, 4 months to 20 years

Answer 9

Chest pain - eased by leaning forward | Friction rub

Answer 10

Chronic relapsing pericarditis Pericardial effusion Pericardial tamponade Pericardial constriction

Answer 11

Collection of fluid in the cavity which lies between the two layers of pericardium

Answer 12

Muffled heart sounds Abnormal JVP Well tolerated if small

Answer 13

Large pericardial effusion

Answer 14

``` Cardiac compression, especially of the right ventricle Reduction in cardiac output Medical emergency Tachycardia Hypotension Oliguria Elevated JVP Pulsus paradoxus Kussmaul sign ```

Answer 15

Demands urgent drainage - pericardiocentesis, percutaneous balloon pericardiotomy, pericardial resection

Answer 16

Heavy fibrosis and calcification of the pericardium - becomes a rigid, non-compliant casing for the heart

Answer 17

``` Early filling of heart is normal Later filling is abruptly halted when the heart comes up against the rigid pericardium Venous congestion Oedema Ascites Liver congestion Kussmaul sign JVP rises on inspiration ```

Answer 18

Restrictive cardiomyopathy

Answer 19

Pericardial resection

Answer 20

``` Most are asymptomatic Syncope and sudden death Dyspnoea Angina Palpitations ```

Answer 21

Competitive sport, usually due to ventricular fibrillation

Answer 22

May be no findings Notched pulse pattern Irregular pulse pattern if in AF or ectopy Double pulse over apex Thrills and murmurs LVOT murmur will increase with Valsalva manoeuvre and decrease with squatting

Answer 23

``` ECG Echo CMRI Sudden cardiac death risk assessment ETT FH ```

Answer 24

``` Progressive, slow onset Fatigue Dyspnoea Orthopnoea Ankle swelling Weight gain due to fluid overload Cough Cardiac failure ```

Answer 25

``` Poor superficial perfusion Thread pulse Dyspnoea at rest JVP elevated Displaced apex Pulmonary oedema Pleural effusions Ascites Hepatomegaly ```

Answer 26

``` Repeated ECG CXR for oedema/effusions Brain natriuretic peptide FBC U&Es Echo CMRI Coronary angiogram Biopsy ```

Answer 27

``` Repeated ECG CXR FBC U&Es Autoantibodies for sclerotic disease Plasma alpha galactosidase A activity for Fabry disease ```

Answer 28

``` Mild symptoms Chest pain Fever Sweats Chills Dyspnoea ``` Adults may present with heart failure years after an initial index event of myocarditis

Answer 29

History of recent (within 1-2 weeks) flu-like syndrome of fevers, arthralgia and malaise or History of pharyngitis, tonsillitis or upper respiratory tract infection

Answer 30

Palpitations Syncope Sudden cardiac death

Answer 31

``` ECG - usually abnormal Biomarkers - often elevated Echo CMRI Viral DNA PCR Auto-antibodies Strep antibodies Lyme B Burgdorferi HIV ```

Answer 32

``` Usually 1-2 week duration Chest pain with pleuritic and postural features Relieved by sitting forwards and exacerbated by lying back Fever High temperature Pericardial rub JVP raised Hypotension ```

Answer 33

ECG Echo Troponin

Answer 34

``` Haemodynamic abnormalities Fatigue Dyspnoea Dizziness Chest pain Pulsus paradoxus JVP raised Pulmonary oedema (rare) ```

Answer 35

Echo | CXR

Answer 36

Reduce risk of sudden death with screening Family history - syncope, ventricular tachycardia, exercise hypotension ICD for high risk cases Symptomatic treatments - drugs, surgical resection, septal ablation

Answer 37

``` Avoid heavy exercise Avoid dehydration Explore FH and first degree relatives ECG/echo Consider genetic testing ```

Answer 38

Drugs to enhance relaxation - beta blockers, verapamil, disopyramide Anticoagulation if in atrial fibrillation Surgical septal ablation ICD if required/indicated

Answer 39

Cause is usually unknown so specific treatment is unavailable Medical treatment can be given for heart failure and arrhythmia if present Thrombi-Embolism prophylaxis Device management with implantable defibrillator or cardiac resynchronisation therapy

Answer 40

``` Correct any anaemia Remove any exacerbating drugs e.g. NSAIDs Correct endocrine disturbances Reduce salt and fluid intake Manage weight ```

Answer 41

``` ACEIs ATII blockers Diuretics Beta-blockers Spironolactone Anticoagulants as required SCD risk assessment Cardiac transplant ```

Answer 42

Generally poor and often influenced by the cause

Answer 43

``` Limited diuretic use as low filling pressures will cause problems Beta-blockers Limited ACEI use Anticoagulants SCD risk assessment Transplant ```

Answer 44

Supportive treatment of heart failure and support for brady/tachy-cardia arrhythmias Immunotherapy if indicated by specific diagnosis Stop possible causative drugs or toxic agent exposure

Answer 45

30% full recover 20% mortality at 1 year 56% mortality at 4 years

Answer 46

Viral - conservative management Idiopathic - colchicine and limited NSAID use Bacterial - drainage and antibiotics, high death rate, treat aggressively

Answer 47

Drainage Send for MCS, neoplastic cells, protein and LDH Surgical pericardial window if persistent effusion

Myocarditis and Pericarditis Flashcards

(72 cards)