Upload
dr-jayesh-patidar
View
111
Download
1
Embed Size (px)
DESCRIPTION
Citation preview
INFLAMMATORY
CONDITIONS OF
HEART
Dr. Jayesh Patidarwww.drjayeshpatidar.blogspot.com
LAYERS OF THE HEART
9/15/2014 2www.drjayeshpatidar.blogspot.com
MYOCARDITIS
It is inflammation of heart muscle.
CAUSESCommonest cause a virus. Other infections sarcoidosis, immune disease, pregnancy
9/15/2014 3www.drjayeshpatidar.blogspot.com
PATHOPHYSIOLOGY
Virus invades the muscle local inflammation.
After infection subsides, the body’s immune system continues
to inflict inflammatory damage to the heart muscle.
This immune response prolongs the myocarditis.
9/15/2014 4www.drjayeshpatidar.blogspot.com
MYOCARDITIS
9/15/2014 5www.drjayeshpatidar.blogspot.com
Sign & Symptoms
Mild and cause no noticeable symptoms. Pain in the chest. Serious heart failure SOB, fatigue, fluid accumulation in the
lungs & heart,rhythm irregularities inflammation or
scarring.
Diagnosis
Detect signs of irritation of heart muscle. Blood tests (CPK) EKG, Nuclear heart scan shows.9/15/2014 6www.drjayeshpatidar.blogspot.com
Treatment
Corticosteroids.No proven medications Treatment -Salt restriction, ACE
inhibitors, beta blockers treating as well as monitoring heart rhythm
abnormalities.
9/15/2014 7www.drjayeshpatidar.blogspot.com
Prognosis
After initial phase of myocarditis -complete recovery
Chronic Heart Failure due to injured heart muscle.
Sudden unexpected, potentially fatal heart rhythm abnormalities.
Prevented with implantable defibrillators
9/15/2014 8www.drjayeshpatidar.blogspot.com
ENDOCARDITIS
It is a serious infection of one of the four heart valves.
9/15/2014 9www.drjayeshpatidar.blogspot.com
CausesGrowth of bacteria on one of the heart
valves, leading to an infected mass called a vegetation.
Infection may be bacteria in the blood stream after dental work, colonoscopy, and other similar procedures.
Persons at RiskHeart valves (Aortic stenosis, Mitral
stenosis, Mitral regurgitation etc) undergone valve replacements. etc).
9/15/2014 10www.drjayeshpatidar.blogspot.com
Endocarditis
9/15/2014 11www.drjayeshpatidar.blogspot.com
ENDOCARDITIS
9/15/2014 12www.drjayeshpatidar.blogspot.com
Sign & Symptoms
Fever
Fatigue
Chills
Weakness
Aching joints and muscles
Night sweats
Edema of feet and abdomen
Malaise
Shortness of breath
Occasionally scattered small skin lesions
9/15/2014 13www.drjayeshpatidar.blogspot.com
Diagnosis
Echocardiography.
TEE (Trans Esophageal Echocardiography)
Identification of bacteria by blood culture.
Treatment
Antibiotics given intravenously for 4-6 weeks.
Valve replacement
Prognosis
Response to treatment is indicated by a reduction in fever, negative blood cultures and findings on echocardiography.
9/15/2014 14www.drjayeshpatidar.blogspot.com
PERICARDITIS
Heart sits in the centre of the chest and issurrounded by a sac called thepericardium.
This sac has two layers one that fitstightly onto the heart muscle and anotherlooser layer surrounding the inner layer.
Inflammation of these tissue layerssurrounding the heart is referred to aspericarditis.
9/15/2014 15www.drjayeshpatidar.blogspot.com
9/15/2014 16www.drjayeshpatidar.blogspot.com
9/15/2014 17www.drjayeshpatidar.blogspot.com
Etiology
Idiopathic – cause of illness is not identified
Mechanical injury to the heartHeart attack (MI) and Dressler’s
syndromeHeart surgery and post
pericardiotomy syndromeTrauma
InfectionBacterial, viral, fungal, HIV
9/15/2014 18www.drjayeshpatidar.blogspot.com
Tumors/cancerPrimary (rare)Metastatic
Connective tissue diseaseRheumatoid arthritis, SLE,
Sarcoidosis, Scleroderma
Metabolic diseaseUremia, Hypothyroidism
Medication reactionsSide effects of: phenytoin,
hydralizine and procainamide.9/15/2014 19www.drjayeshpatidar.blogspot.com
Sign & Symptoms
Chest pain
SOB
Fever, chills, muscle aches, malaise
9/15/2014 20www.drjayeshpatidar.blogspot.com
Diagnosis
Physical evaluation
Quality of pain,
Physical finding – pericardial friction rub
EKG
Chest x-ray
Ultrasound of the heart
Blood testing for specific causes (Leukemia, kidney failure, connective tissue disease or thyroid abnormalities).
9/15/2014 21www.drjayeshpatidar.blogspot.com
9/15/2014 22www.drjayeshpatidar.blogspot.com
Treatment Medicines that reduce inflammation
NSAID’s to decrease inflammation and fluid accumulation in the pericardial sac.
Narcotic pain medication for pain
Corticosteroids for immunologically mediated causes.
Pericardiocentesis /pericardotomy9/15/2014 23www.drjayeshpatidar.blogspot.com
Complications
Cardiac tamponade
Constrictive pericarditis
9/15/2014 24www.drjayeshpatidar.blogspot.com
Nursing management
Psychological support
Assess heart sounds for new or worsening murmur.
If pt received surgical treatment, provide postsurgical care.
9/15/2014 25www.drjayeshpatidar.blogspot.com
After surgery, monitor patient’s
temperature; a fever may be present for
weeks.
Assess for signs and symptoms of organ
damage such as stroke, CVA, meningitis,
heart failure, MI etc.
Instruct pt and family about activity
restrictions, medications, and signs and
symptoms of infection.
9/15/2014 26www.drjayeshpatidar.blogspot.com
Nursing management
Reinforce that antibiotic prophylaxis is recommended for patients who have had infective endocarditis and who are undergoing invasive procedures.
Refer to home care nurse to supervise and monitor intravenous antibiotic therapy in the home.
9/15/2014 27www.drjayeshpatidar.blogspot.com
9/15/2014 28www.drjayeshpatidar.blogspot.com