Cardio

• Pericarditis


  Inflammation of the visceral or parietal pericardium
• Pericardial effusion


  Accumulation of fluid in the pericardial space
• Causes of pericarditis

  • Infection: virus (Coxsackie B, echovirus), bacteria (strep pneumoniae, S. aureus), fungi (histoplasma capsulatum, candida)
  • Non-infectious: Dressler syndrome, uremia
• Signs & Symptoms of pericarditis

  • Pericardial friction rub
  • Pulsus paradoxus
  • Initial ST elevation
  • Pleuritic chest pain
  • Dysphagia
  • Hiccups
  • Dyspnea
  • Fever
• Diagnostic Studies for pericarditis

  • EKG: diffuse ST elevation
  • Lab: ↑ WBC, ESR + CRP (infection), CK-MB, troponin
  • Blood culture
  • Throat culture
  • CXR
  • CT scan
  • Echo
  • Pericardial fluid or biopsy
• Medications for pericarditis

  • NSAID
  • Colchicine
  • Monitor N/V, diarrhea
  • Corticosteroid: Methylprednisolone → prednisone
  • Antibiotics
• Nursing Interventions for pericarditis

  • Monitor heart tones, VS, ABG, EKG
  • Throat culture
  • Administer O2 as needed
  • Assess & manage pain
  • Position client for comfort
  • Administer antipyretic, analgesic, antibiotics
  • Bed rest during acute phase
  • Emotional support
  • Monitor for complications & notify provider
• Infective Endocarditis


  Infection of inner layer of heart + cardiac valves
• Risk Factors for infective endocarditis

  • Age
  • IV drug abuse
  • Prosthetic valves
  • Cardiac & Intravascular devices
  • Invasive procedures
  • Renal dialysis
• Signs & Symptoms of infective endocarditis

  • Nonspecific: Low grade fever, chills, weakness, fatigue, anorexia, malaise
  • Cardiac: Murmur (aortic, mitral valves), tachycardia, heart failure, dysrhythmias
  • Vascular: Roth spots, petechiae, splinter hemorrhages, Osler nodes, Janeway lesions, flat, pinpoint, bruise like markings
  • Manifestations secondary to embolization
• Diagnostic Studies for infective endocarditis

  • Past & recent health history
  • Lab: + blood culture, ↑ WBC, ESR, CRP
  • CXR
  • EKG
  • Echo
  • Cardiac cath
• Nursing Interventions for infective endocarditis

  • Monitor temperature
  • Monitor signs of embolization
  • Refer to home health services if continuing IV antibiotics at home
  • Refer to drug rehab if have history of IV drug abuse
  • Wash hands, avoid crowds to prevent infection
  • Oral hygiene
  • Complete course of antibiotics
  • Take rest periods
  • Monitor for signs of recurrent infection
  • Inform all healthcare providers, dentist about history of endocarditis
• Infective Endocarditis


  Infection of inner layer of heart + cardiac valves
• Risk Factors of Infective Endocarditis

  • Age
  • IV drug abuse
  • Prosthetic valves
  • Cardiac & Intravascular devices
  • Invasive procedures
  • Renal dialysis
• Signs & Symptoms of Infective Endocarditis

  • Nonspecific: Low grade fever, chills, Weakness, fatigue, Anorexia, malaise
  • Cardiac: Murmur (aortic, mitral valves), Tachycardia, HF, dysrhythmias
  • Vascular: Roth spots: white centered retinal hemorrhages, Petechiae, Splinter hemorrhages (nail beds), Osler nodes (fingers, toes), Raised, localized hematomas, Janeway lesions (palms, soles), Flat, pinpoint, bruise like markings
  • Manifestations secondary to embolization
• Diagnostic Studiesof Infective Endocarditis

  • Past & recent health hx
  • Lab: + blood cx, ↑ WBC, ESR, CRP
  • CXR
  • EKG
  • Echo
  • Cardiac cath
• Nursing Interventions of Infective Endocarditis

  • Monitor temp
  • Monitor signs of embolization
  • Refer to home health services if continuing IV antibiotics at home
  • Refer to drug rehab if have history of IV drug abuse
  • Wash hands, avoid crowds to prevent infection
  • Oral hygiene
  • Complete course antibiotics
  • Take rest periods
  • Monitor for sx of recurrent information
  • Inform all HCP, dentist about history of endocarditis
• Cardiomyopathy

  A disease of the heart muscle that affects the pumping mechanism of the heart → decreased CO, oxygen, blood supply to the body
• BNP

  Indicates stretching of the ventricles from fluid overload
• Dilated cardiomyopathy (LT HF)

  • Distended ventricles = thin heart muscle & loose muscle walls unable to contract

  1. Enhance myocardial contractility

  2. Decrease preload/afterload

  • ↓ BP ↑ HR
  • ↓ O2 → syncope, agitation, SOB
  • ↑ BNP
• Digoxin

  Given for dilated cardiomyopathy
• Restrictive Cardiomyopathy

  • Rock hard muscle in ventricles → ventricle can't stretch properly → trouble with diastole & refilling
• Restrictive Cardiomyopathy treatment

  To improve diastolic filling & prevent tachycardia
• Restrictive Cardiomyopathy

  • ↓ O2 → syncope, agitation, SOB
  • Swelling
  • Crackles
• Signs & Symptoms

  • Dyspnea
  • Fatigue
  • Exercise Intolerance
  • Angina, palpitations
  • Orthopnea
  • Syncope
  • Signs of HF
• Nursing Interventions

  • Avoid etoh
  • Pace activities
  • Adhere to anticoagulation therapy
• Hypertrophic cardiomyopathy

  • Hypertrophy or thickening of the left ventricular walls & septum
• Hypertrophic cardiomyopathy

  • Symptoms are asymptomatic
  • Syncope
  • Dizziness
  • SOB
  • Fatigue
  • Death
• Signs & Symptoms

  • Dyspnea
  • Dysrhythmia
  • Angina
  • Fatigue
  • Syncope during exertion
• Collaborative Care

  • Surgical tx
  • AV pacing
  • B-Blocker or Calcium channel blocker
  • Antidysrhythmic
  • Coagulation mod
• Client Teaching


  • Avoid strenuous activity & dehydration
  • Rest & elevate legs for venous return
  • Avoid vasodilators