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Inflammatory Disease of the Heart

PERICARDITISDRESSLER SYNDROMEMYCARDITIS

Causative Factors: MICROORGANISMS

Pericarditis MyocarditisBacterial ViralViral BacterialParasitic / fungal Rheumatic fever MI Immunosuppressive therapy

Rheumatic Fever associated with chemotherapy

Pathophysiology:Invasion of bacteria

PERICARDITIS inflammatory response MYOCARDITIS

Exudates formation

Signs and Symptoms:Accumulation of fluid in the pericardium

1. Cardiac Enlargement*cardiomegaly

Signs and Symptoms:1. Precordial Pain 2. Mild To Moderate S/S

Cause: compression of the heart a. fatigue

Aggravating factors: supine, b. pericardial discomfortsneezing & coughing c. dyspnea

Relieving factor: sitting, leaning forward3. Abnormal Heart Sounds

2. Friction Rub *murmur due to turbulentCause: rubbing of the surfaces blood flowDescription: high pitch sound * friction rub

3. Dyspnea compression of the lungs 4. Flu-Like4. Fever infection 5. Dysrhythmias

Common complications:

1. cardiac tamponade2. pericardial effusion

Diagnostic Tests:

1. Echocardiogram2. Chest X-ray3. WBC

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4. ESR5. Precardiocentesis6. Endomyocardial Biopsy

Medical Management:

Pericarditis Myocarditis

- analgesic: NSAID - for hemolytic streptococci: Penicillin- contraindicated: Aspirin - Nursing Alert !- bacterial: antibiotics Penicillin * Avoid Aspirin & ibuprofen if the- fungal: amphoterecin B if the heart failure develop- if severe pericarditis: corticosteroids * Patient with myocarditis are- alternative therapy: cholchicine sensitive to digitalis monitor

digoxin toxicity

1. Relieve Pain

- rest position- position of comfort setting leaning forward- analgesic for pain- bedside commode- diversional activities

2. Reduce Fever- antipyretic as prescribed- check temperature- antibiotic as prescribed- TSB & dont RUB

3. Maintain Cardiac Output- assess pulse and apical rate- monitor intake and output- elevate head of bed

4. Patient Education- gradual increase of physical activities- limit competitive sports

CARDIAC TAMPONADE (PERICARDIAL TAMPONADE)

- inflammation and infection of the inner lining of the heart (endocardium ) andheart valves

Etiology: direct invasion of the bacteria

dental procedure

Cardiac surgery

Parenteral drug abuse

GI tract surgery

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Pathophysiology

Microorganism circulate thru the blood

Dislodgement in the heart valves

Inflammatory response

Deformities

Lesions formation

BREAK OFF

Common complication embolism

Diagnostic Tests:

1. Blood Analysis2. Echocardiogram

Management:

1. Medications:- antibiotics ( to control infectious process)

2. Maintain Adequate Carbohydrate- evaluate heart rate- monitor urinary output- record daily weight

3. Decrease Body Temperature- monitor temperature- increase fluid intake

- provide blankets

4. Improve nutritional status- increase protein- record caloric intake and weight

5. Health Teachings = goal: prevent reinfection- practice good oral hygiene- proper hand washing

Signs & Symptoms

1. Fever, chills & Diaphoresis

2. Weight loss, Anorexia, Weakness & Fatigue3. Joint Pain, Arthraglia

4. Splenomegaly

Signs & Symptoms

1. Petechiae Conjunctiva

2. Splinter hemorrhages on the nailbeds

3. Janeways lesion4. Oslers Nodes

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- pneumococcal and influenza vaccines- prophylactic antibiotics