Transcript inflammatory conditions of heart - Nursing PowerPoint Presentations
INFLAMMATORY CONDITIONS OF HEART
LAYERS OF THE HEART
MYOCARDITIS
It is inflammation of heart muscle.
CAUSES Commonest cause a virus. Other infections sarcoidosis, immune disease, pregnancy
PATHOPHYSIOLOGY
Virus invades the muscle local inflammation. After infection subsides, the body’s immune system continues to inflict inflammatory damage to the heart muscle. This immune response prolongs the myocarditis.
MYOCARDITIS
Sign & Symptoms
Mild and cause no noticeable symptoms. Pain in the chest. Serious heart failure SOB, fatigue, fluid accumulation in the lungs & heart, rhythm irregularities inflammation or scarring.
Diagnosis
Detect signs of irritation of heart muscle. Blood tests (CPK) EKG, Nuclear heart scan shows.
Treatment
Corticosteroids.
No proven medications Treatment -Salt restriction, ACE inhibitors, beta blockers treating as well as monitoring heart rhythm abnormalities.
Prognosis
After initial phase of myocarditis complete recovery
Chronic Heart Failure due to injured heart muscle.
Sudden unexpected, potentially fatal heart rhythm abnormalities. Prevented with implantable defibrillators
ENDOCARDITIS
It is a serious infection of one of the four heart valves.
Causes Growth of bacteria on one of the heart valves, leading to an infected mass called a vegetation.
Infection may be bacteria in the blood stream after dental work, colonoscopy, and other similar procedures.
Persons at Risk Heart valves (Aortic stenosis, Mitral stenosis, Mitral regurgitation etc) undergone valve replacements. etc).
Endocarditis
ENDOCARDITIS
Sign & Symptoms
Fever Fatigue Chills Weakness Aching joints and muscles Night sweats Edema of feet and abdomen Malaise Shortness of breath Occasionally scattered small skin lesions
Diagnosis
Echocardiography.
TEE (Trans Esophageal Echocardiography) Identification of bacteria by blood culture.
Treatment
Antibiotics given intravenously for 4-6 weeks. Valve replacement
Prognosis
Response to treatment is indicated by a reduction in fever, negative blood cultures and findings on echocardiography.
PERICARDITIS
Heart sits in the centre of the chest and is surrounded by a sac called the pericardium.
This sac has two layers one that fits tightly onto the heart muscle and another looser layer surrounding the inner layer.
Inflammation pericarditis.
of these tissue layers surrounding the heart is referred to as
Etiology Idiopathic – cause of illness is not identified Mechanical injury to the heart Heart attack (MI) and Dressler’s syndrome Heart surgery and post pericardiotomy syndrome Trauma Infection Bacterial, viral, fungal, HIV
Tumors/cancer Primary (rare) Metastatic Connective tissue disease Rheumatoid arthritis, SLE, Sarcoidosis, Scleroderma Metabolic disease Uremia, Hypothyroidism Medication reactions Side effects of: phenytoin, hydralizine and procainamide.
Sign & Symptoms
Chest pain SOB Fever, chills, muscle aches, malaise
Diagnosis
Physical evaluation Quality of pain, Physical finding – pericardial friction rub EKG Chest x-ray Ultrasound of the heart Blood testing for specific causes (Leukemia, kidney failure, connective tissue disease or thyroid abnormalities).
Treatment
Medicines that reduce inflammation
NSAID’s to decrease inflammation and fluid accumulation in the pericardial sac.
Narcotic pain medication for pain
Corticosteroids for immunologically mediated causes.
Pericardiocentesis /pericardotomy
Complications
Cardiac tamponade Constrictive pericarditis
Nursing management
Psychological support
Assess heart sounds for new or worsening murmur.
If pt received surgical treatment, provide postsurgical care.
After surgery, monitor patient’s temperature; a fever may be present for weeks.
Assess for signs and symptoms of organ damage such as stroke, CVA, meningitis, heart failure, MI etc.
Instruct pt and family about activity restrictions, medications, and signs and symptoms of infection.
Nursing management
Reinforce that antibiotic prophylaxis is recommended for patients who have had infective endocarditis and who are undergoing invasive procedures.
Refer to home care nurse to supervise and monitor intravenous antibiotic therapy in the home.