Overview of Cardiac Conditions and Treatments

Sep 5, 2024

Lecture Notes: Cardiac Conditions

Valves and Rheumatic Fever

  • Not much focus on valves for the test.
  • Remember: Rheumatic fever affects the mitral valve.

Infective Endocarditis

  • Definition: Microbial infection of the endocardium.
  • Causes:
    • IV drug use
    • Valve replacements
    • Systemic infections
    • Structural cardiac defects
    • Dental procedures
  • Pathophysiology:
    • Formation of platelet and fibrin vegetation on damaged endothelium.
    • Vegetations can become large due to more platelets and fibrin.
  • Symptoms:
    • Temperature over 101.5°F
    • Flu-like symptoms, cough
    • Shortness of breath, joint pain
    • Fatigue, heart murmur
    • Anorexia, abdominal pain
    • Petechiae and enlarged spleen
  • Complications:
    • Emboli (can lead to heart failure, abscess, aneurysm)
    • Without treatment, it is fatal.
  • Treatment:
    • Strong antibiotics
    • Surgery to replace damaged valves and remove vegetation if necessary.

Pericarditis

  • Definition: Inflammation or alteration of the pericardium.
  • Causes:
    • Idiopathic, infective organisms, post-MI
    • Systemic connective tissue diseases, renal failure
    • Can be fibrous, serous, hemorrhagic, purulent, or neoplastic
  • Symptoms:
    • Substernal or precordial pain (grating or harsh)
    • Aggravated by breathing, swallowing, coughing
    • Pain worse in supine position, better when sitting up
  • Diagnosis:
    • Pericardial friction rub
    • Increased central venous pressure (CVP)
    • Widespread ST elevation on EKG
    • CT scan, echocardiogram, and chest x-ray
  • Treatment:
    • NSAIDs, Colchicine
    • Corticosteroids, if needed
    • Antibiotics if indicated
    • Pericardial drainage or pericardial window (surgery)

Cardiac Tamponade

  • Definition: Accumulation of fluid in the pericardial space leading to decreased cardiac output.
  • Symptoms:
    • Beck's Triad: low BP, distended neck veins (JVD), muffled heart tones
    • Decreased urine output, shortness of breath, increased heart rate
  • Causes:
    • Pericarditis, heart surgery, post-MI, trauma
    • Cancer or tumors in the area
  • Treatment:
    • Medical emergency; requires pericardiocentesis
    • Successful procedure: Decreased JVD, increased BP, clearer heart tones

Important Reminders

  • Understand differences in chest pain: angina, unstable angina, MI, cardiac tamponade vs. pericarditis.
  • Know EKG changes associated with each condition.
  • Review signs and symptoms of each condition.