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Pericarditis and Endocarditis
Pericarditis and Endocarditis
Pericarditis is
the inflammation
of the
membranous
sac surrounding
the heart. It may
be manifested as
an acute or
chronic
condition.
ACUTE PERICARDITIS
Infectious forms of acute pericarditis include….
-bacterial
-viral
-fungal
-tubercular
This is an example
of purulent fungal
pericarditis. Note
the yellowish
exudate that has
pooled in the lower
pericardial sac.
Fibrosis of the pericardial sac develops in the chronic form
causing….
This is when a
pericardial effusion is
so large that it
restricts heart
movement and
pumping
An EKG will note changes or dysrhythmias
Who’s at risk?
-rheumatic heart disease
-congestive heart disease
-degenerative heart disease
-street drugs-due to the possibility of bacterium from
contaminated needles
-following intrusive procedures
-dental procedure
-minor surgery
-gynecological exams
-insertion of indwelling urinary catheters
As organisms embed into the tissues, a vegetative (morbid outgrowth, wart-like
projections made of fibrin, RBC’s, and WBC’s) growth perforates the chambers
or valve leaflets. Fibrin and calciferous growths may ulcerate and scar the valves.
If the vegetations break away from the valves they could
cause an embolus, which it turn could cause an infection
or abscess in the organs where they lodge….
Systemic embolization
-occurs from left side heart vegetation that breaks loose and
travels to the peripheral circulation
-progresses to organs
-brain
-kidneys
-spleen
-limb infarction
Lung embolization
-occurs from right side heart vegetation that break off and
travels to the lungs
Some signs and symptoms of endocarditis….
-flu like symptoms -splinter hemorrhages in nailbed
-fatigue -weight loss
-chest pain -rapid pulse
-headaches -onset of a murmur
-joint pain -aortic and mitral valves most
-chills commonly affected
-petechiae
-conjuntiva
-oral mucosa
-neck
-anterior chest
-abdomen
-legs
Roth spots-small
white spots in the
retina close to the
optic disk, often
surrounded by a
systemic infection.
Osler nodes-small,
tender cutaneous
nodes, usually
present in the fingers
and toes. They are
due to infected emboli
from the heart.
DIAGNOSTICS….
-EKG-will show changes
and dysrhythmias
-Chest x-ray
-TEE-transesophageal
echocardiography (An
ultrasonographic
transducer is introduced
into the esophagus. This
test detects cardiac
sources of emboli,
prosthetic heart valve
malfunction, endocarditis,
aortic dissection, cardiac
tumors, and valvular and
congenital heart disease.
Labs would indicate….