C h a p t e r 22

Rheumatic Carditis Results from from a serious complication of rheumatic fever

(beta-hemolytic streptococci infection). All layers of the heart
become inflamed. Pericardial layers are covered with an exudate
and become thickened. Symptoms include tachycardia, heart
murmor, pericardial friction rub, etc. It is prevented by treating
strep infections with antibiotics.
Infective Endocarditis Infection of the endocardium that occurs in males more often
than females. Even with antibiotic treatment, the infection can
be fatal. Bacteria attach to eroded endocardium where they seek
shelter in a coverings made of platelets and fibrin. Related to
dental disease. Symptoms include a fever and a new heart
murmor. It is important to always treat a patient who had
infective endocarditis with antibiotics before / after and surgical
procedure.
Pericarditis Acute or chronic inflammation of the pericardium (sac
surrounding the heart). The inflammation causes problems as
the heart tries to expand and fill, resulting in decreases in cardiac
output and blood pressure. Can be caused by infections, drug
reactions, connective tissue disorders, etc. Symptoms are chest
pain, which is located substernally and over the heart, radiating
elsewhere. Also, pericardial friction rub is present. Usually
resolves within 6 weeks, however chronic constrictive pericarditis
is treated with pericardiectomy (removal of the entire, rough,
calcified pericardium).
Cardiac Tamponade A life threatening compression of the heart by fluid accumulated
in the pericardial sac
Myocarditis Inflammation of the myocardium. The amount of muscle
destruction and necrosis that occurs as a result of myocarditis
determines the extent of damage to the heart. It is a rare
condition that most commonly develops following a viral
infection.
Cardiomyopathy Enlargement of the heart muscle, of which there are three types;
dilated, hypertrophic, and restrictive. Can lead to heart failure,
and there is no cure for it. Symptoms are similar to heart failure.
Dyspnea on exertion, orthopnea, and fatigue.
Dilated The size of the ventricular cavity enlarges with reduced cardiac
Cardiomyopathy output. Most common type of cardiomyopathy
Hypertrophic Enlargment of the cardiac muscle wall, often of the septum and
Cardiomyopathy left ventricle
Restrictive Impairs ventricular stretch and limits ventricular filling. It is the
Cardiomyopathy rarest kind of cardiomyopathy. It may be caused by infiltrative
diseases such as amyloidosis
Thrombophlebitis Formation of a clot and inflammation within a vein. The clot
usually forms first and then the inflammation. It is the common
disorder of veins, with the legs being most often affected.
Usually no symptoms, treated with warm, moist heat.
Myectomy Surgery to remove part of the ventricular septum to allow greater
flow of blood
Deep Vein DVT; The most serious form of thrombophlebitis because
Thrombosis pulmonary emboli can result if the thrombus detaches
Venus Thrombus Made up of plateletes, red blood cells, white blood cells, and
fibrin. Plateletes attach to a vein wall and then a tail froms as
more blood cells and fibrin collect
International INR; It measures the effectiveness of warfarin therapy. It uses a
Normalized Ratio standardized testing reagent. Replaces, or is also known as
prothombin time
Pericardial Friction Rub which is a result of friction from the inflamed pericardial and
Rub epicardial layers rubbing together as the heart fills and contracts.
It may be heard intermittently or continously
Pericardial Effusion It is a build up of fluid in the pericardial space. It is the most
common complication of pericarditis.
Cardiac Tamponade It is a complication of pericarditis, and is life threatening
compression of the heart by fluid accumulated in the pericardial
sac. Cardiac output drops, as heart rate increases to
compensate. Requires immediate treatment by way of a 16
gauge needle injected into the pericardium to remove the fluid.
Cardiac Trauma Two types can occur; nonpenetrating and penetrating.
Nonpenetrating occur from blunt trauma such as car wrecks,
while penetrating occur from things that go in you like a knife or
gunshot.
Homans' Sign Pain in the calf with sharp dorsiflexion of the foot, is present in
less than 50% of those with thrombophlebitis and is not specific
to DVT(deep vein thrombophlebitis).