T4 Inflammatory and Structural Heart Disorders

• What are signs of mitral valve regurgitation?

  Holosystolic "blowing" murmur, volume overload, and left sided heart failure.
• What are signs of mitral valve stenosis?

  Loud S1, atrial fibrillation, exertional dyspnea.
• What is the most common cause of sudden cardiac death in young athletes?

  Hypertrophic cardiomyopathy.
• How long does stable angina last?

  Less than 20 minutes.
• What provides relief for stable angina?

  Nitroglycerin or rest.
• When does unstable angina occur?

  At rest, relieved by nitroglycerin, has a high risk for myocardial infarction.
• What is Prinzmetal angina?

  Episodic chest pain unrelated to exertion caused by coronary artery vasospasm.
• What relieves Prinzmetal angina?

  Nitroglycerin or calcium channel blockers.
• What is the priority goal for someone experiencing a myocardial infarction?

  Percutaneous coronary intervention.
• What is the time a patient should take to get from door to cath lab?

  Less than 90 minutes.
• What is infective endocarditis?

  Infection of the endocardium and heart valves.
• What bacteria is responsible for health care associated infection that causes endocarditis?

  MRSA.
• What are the three stages to endocarditis?

  Bacteremia, adhesion, vegetation.
• What is the process of endocarditis?

  Fibrin, leukocytes, platelets, and microbes stick to the valve or endocardium (embolization) and those emboli can go to different parts of the body.
• What are manifestations of endocarditis that are secondary to septic embolism?

  Osler nodes on fingertips or toes, Janeway's lesions on fingertips, palms, soles of feet, and toes, Roth's spots.
• What is important for those with infective endocarditis?

  Prophylactic antibiotics.
• If someone has an active infection for endocarditis, how long will they be on antibiotics?

  Long term, 4 - 6 weeks.
• What should people with endocarditis know as patient teaching?

  Antibiotic prophylaxis, dental hygiene, regular follow-up, avoid people with infections.
• For pericarditis, what is the normal fluid volume?

  10 - 15 mL.
• What are clinical manifestations for pericarditis?

  Chest pain that worsens with deep inspiration and lying flat, pericardial friction rub in left lower sternum when forward.
• What can pericardial effusion lead to?

  Tamponade.
• What is the best position for comfort for pericarditis?

  HOB 45 degrees and leaning forward.
• What are signs of mitral valve stenosis?

  Dyspnea, orthopnea, hemoptysis, hoarseness, and atrial fibrillation, loud S1.
• What is the most common cause of mitral valve stenosis?

  Rheumatic disease.
• What are symptoms for mitral valve prolapse?

  Normally asymptomatic.
• If symptoms develop for mitral valve prolapse, what can be given?

  Beta blockers.
• What drug should be used carefully with aortic stenosis?

  Nitroglycerin.
• Why should nitroglycerin be used carefully with aortic stenosis?

  Hypotension and can worsen chest pain.
• What are auscultatory findings for aortic valve stenosis?

  Normal to soft S1, Decreased or absent S2, prominent S4.