patho endterm

Pericarditis

Inflammation of the pericardium, the sac surrounding the heart

Pericardial Effusion

Build up of fluid in the pericardial cavity

Cardiac Tamponade

Fluid buildup compressing the heart, leading to decreased cardiac output

Serous Fluid

Fluid due to heart failure

Purulent Fluid

Fluid due to infection

Hemorrhagic Fluid

Fluid due to aneurysm, capillaries or arteries are cut-off

Causes of Pericarditis

Viral infections, bacterial infections, thoracic trauma, myocardial infarction, autoimmune diseases

Pericardial Friction Rub

Grating sound when breath is held

Sharp Chest Pain

Worsens with deep inspiration and relieved by sitting up and leaning forward

Dyspnea

Difficulty breathing

Tachycardia

Increased heart rate

Palpitations

Irregular heartbeat

Edema

Swelling

Flu-like symptoms

Fever, chills, myalgia

Antibiotics

For patients when the underlying cause is infection

NSAID

To reduce inflammation

Analgesic

To manage pain and fever

Bedrest

To reduce the metabolic need and cardiac loads

Infective Endocarditis

Infection of the endocardium or heart valves; Involves endothelial damage

Bacteria causes of Infective Endocarditis

Streptococcus Viridans, Streptococcus aureus, Streptococcus enterococcus

Streptococcus Viridans

Most common bacteria that causes infective endocarditis; 50% to ill; Normal residents in the mouth, throat, and upper respiratory tract

Risk Factors

Intravenous drug use, prosthetic heart valves, congenital heart defects, valvular disorders, rheumatic heart disease

Embolization

Stroke, pulmonary embolism, splenic infarction

Osler’s nodes

Tender lesions on fingers/toes

Treatment for Endocarditis

Given anti-infective therapy 4 weeks

Myocarditis

Inflammation of the myocardium (heart muscle)

Viral causes myocarditis

Influenza virus, Coxsackie virus, Cytomegalovirus, Adenovirus, Parvovirus

Bacterial causes myocarditis

Lyme disease, Chlamydia, Streptococcus

Fungal causes myocarditis

Candida, Cryptococcus, Aspergillus

Antipyretic

for flu and fever

Immunosuppressant

for underlying condition

Valvular Disorders

Disruption of normal blood flow through the heart; Distinguished one valve and type of alteration.

Stenosis

Narrowing of a heart valve, restricting blood flow

Atresia

Lack of valve opening that allows the blood flow, no valve opening

Regurgitation

Valve does not fully close, leading to backflow of blood and increased cardiac workload

Causes Valvular Disorders

Congenital defects, infective endocarditis, rheumatic fever, hypertension, myocardial infarction, cardiomyopathy, heart failure

Treatment Valvular Alterations

Diuretics, Antidysrhythmic, Vasodilator nitrates, Beta blockers drugs end in olol, Anticoagulants, ACE inhibitors drugs end in pril, Valve repair or replacement surgery

Diuretics

Potassium-Sparing, Antidysrhythmic, Vasodilator (Nitrates)

Beta-adrenergic blockers

Drugs end with “olol” (e.g. bisoprolol, propranolol)

ACE Inhibitors

Drugs end with “pril” (e.g. captopril, enalapril)

Cardiomyopathy

Group of condition weakened and enlarged of myocardium; It can be acquired or inherited

Dilated Cardiomyopathy

Ventricles become enlarged and weakened; Starts with left ventricles which eventually affect the right ventricles.

Causes Dilated cardiomyopathy

Genetic, Chemotherapy doxorubicin, Alcohol abuse, Cocaine, Pregnancy, Infections, Diabetes mellitus, Thyroid disorders

Hypertrophic Cardiomyopathy

Common with sedentary lifestyle and appears to have autosomal dominant genetic face; Affect the systolic and diastolic function; Thickening of the heart muscle, reducing ventricular chamber size.

Risk Factors Hypertrophic

Sedentary lifestyle, Thyroid diseases, Genetic predisposition, Hypertension

Restrictive Cardiomyopathy

Stiffened heart walls leading to impaired diastolic dysfunction

Heart Failure

Heart’s inability to pump sufficient blood to meet metabolic needs

Systolic dysfunction

Decreased cardiac output due to contractility

Diastolic dysfunction

Decrease in ventricular filling from abnormal myocardial relaxation

Left sided heart failure

Left ventricular infarction, hypertension, aortic or mitral stenosis

Right sided heart failure

Right ventricular dysfunction leading to blood pooling

Diagnosis HF

History, physical exam, X-ray, ABGs, EKG, echocardiogram, BNP

Clinical manifestations HF

Murmur, dyspnea, tachypnea, cyanosis, fatigue, chest pain

Septal defects

Hole in the septal separating heart chambers

Patent ductus arteriosus

Ductus arteriosus does not close after birth

Coarctation of aorta

Narrowing of the aorta

Transposition of great arteries

Exchange of aorta and pulmonary artery

Dyslipidemia

Elevated blood lipids in the blood

LDL

Low density lipoprotein

HDL

High density lipoprotein

Atherosclerosis

Chronic inflammatory characterized by arterial wall thickening and hardening with fat buildup

Statins

HMG CoA reductase inhibitors

Fibrates

Stimulates lipoprotein lipase decreasing LDL

Ezetimibe

Cholesterol absorption inhibitor

Peripheral vascular disease

Narrowing of peripheral vessels

Buerger’s disease

Arterial inflammation

Raynaud’s disease

Vasospasm of arteries especially hands

Coronary artery disease

Lack of oxygen due to narrowed arteries

Angina pectoris

Severe chest pain radiating to left shoulder or arm

Myocardial ischemia

Reduced oxygen supply to myocardium

Myocardial infarction

Death of myocardial tissue

Stable angina

Chest pain when moving

Unstable angina

Chest pain at rest

Prinzmetal angina

Vasospasm of coronary artery

MI treatment MONAT

Morphine Oxygen Nitrates Aspirin Thrombolytics

Hypertension

Chronic elevation in blood pressure

Shock

Inadequate tissue perfusion due to low blood volume or stagnation

Distributive shock

Vasodilation induced hypovolemia neurogenic septic anaphylactic

Cardiogenic shock

Inadequate cardiac output due to LV failure

Hypovolemic shock

Blood volume loss leads to decreased venous return

Hypopituitarism

Pituitary gland does not produce sufficient hormones

Dwarfism

Short stature due to deficient growth hormone

Diabetes insipidus

Excessive fluid excretion due to low ADH

Hyperpituitarism

Excessive secretion of pituitary hormones

Gigantism

Excess growth hormone before puberty

Acromegaly

Excess growth hormone in adulthood

Diabetes mellitus

Hyperglycemia due to insulin problem

Type 1 diabetes

Autoimmune destruction of beta cells

Type 2 diabetes

Insulin resistance

Gestational diabetes

Occurs during pregnancy

DKA

PH imbalance with ketones