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Infective Endocarditis-Inflammation,of the inner tissue of the heart,such as its valves -Symptoms & Signs : .fever .malaise .fatigue .heart murmur .roth's spots .osler's nodes .janeway lesions .anemia .nail hemorrhage .septic embolism .wight loss .clubbing .splenomegaly .hematuria .anorexia -Causes : .bacteremia (streptococcus viridans, staphylococcus aureus) -Classifications : .subacute bacterial endocarditis SBE(M.C is streptococcus vinidans) .acute bacterial endocarditis ABE (M.C is staphylococcus aureus) -Diagnosis : +Major criteria include : .positive blood culture .positive echo + vegetation +Minor criteria include : .known cardiac lesion,recreating drug injection .fever >38c .evidence of embolism (arterial emboli,pulmonary infarcts,janeway lesions,conjunctival hemorrhage) .immunological problems (glomerulonephritis,osler`s nodes) -Treatment : .high dose antibiotics (2-6 weeks) +M.C bacteria in prosthetic valve is (staphylococcus epidermidis) +Streptococcus bovis, associated with colon cancer +M.C valveaffected (mitral valve) +The site of endocarditis in drug abusers is Tricuspid valve +The most common organism in infective endocarditis is Streptococcus viridans
Rheumatic Fever -Is an inflammatory disease that can involve the heart, joints, skin, and brain.The disease typically develops two to four weeks after a throat infection (occur post streptococcal infection ‘tonsilitis’) -Cause by antibody cross-reactivity,that can involve the heart,joints,skin and brain / commonly appears in children between the ages of 6-15age -Symptoms & Signs : .two to four weeks after a throat infection fever .multiple painful joints .nvoluntary muscle movements .itchy rash known as erythema marginatum (major) .atrial fibrillation .infection of the valves .abdominal pain .nose bleeds .polyarthritis carditis (major) .sydenham`s chorea(major) .erythema nodosum(minor) .subcutaneous nodules (major) .arthralgia (mainor crieteria) .raised ESR .arthralagia (minor) .arthrities (major) .C-reactive protein,leukocytosis,WBS elevated .ECG (prolonged PR interval) (minor) -Treatment : .high dose antibiotics (pencillin) .NSAID (Aspirin) .erythromycin,prednisone +Lipid lowering agents : .statine .fibrates (gemafibrozil) .bile acid binding .nicotinic acid .fish oil (omega 3)
Syncope -Is defined as a short loss of consciousness and muscle strength, characterized by a fast onset, short duration, and spontaneous recovery -Cardiac Syncope (is sudden without warming and complete recovary / last for 1-2min -Causes of cardiac syncope : .arrhythmia (bradycardia and tachycardia) .obstructive cardiac lesion (Aortic stenosis and mitral stenosis) .acute aortic dissection .pericardial tamponade .pulmonary embolism .pulmonary hypertension. .hypertrophic cardiomayopathy
+Conntraindications of exercise electrocardiography (stress test) : .unstable angina .recent MI (within 10days) .sever hypertrophic cardiomyopathy .sever aortic stenosis .malignant HTN .heart failure
+Causes of sinus tachycardia : .fever .anemia .hear failure .thyrotoxiacosis .drugs (atropin,adrenaline)
+Causes of atrial fibrillation : .ischamic heart diseas (IHD) .rheumatic heart disease .idiopathic .hyperthyroidism .pneumonia .pericarditis .cardiac surgery .alcohol .congenital heart disease
+Wolf parkinson white syndrom WPW : -ECG (delta wave) / usually associated with atrial fibrillation / drug to choice is (amiodarone) +Atrial Flutter : -ECG (saw-tooth appearance) / management like atrial aibrilliation
Pulmonary Edema -Causes : .MI .mitral regurgitation .mitral stenosis .aoratic regurgitation .arrhythmia +Pulmonary edema is caused by : .Fallot Tetralogy .Acute glomerulonephritis .Aspiration of hydrocarbons .Left to right shunt -Sumptoms : .dyspnea .tachycardia .cyanosis .cough with expectoration (pink frothy sputum) .gallorythm .crackless -Diagnosis : .by Chest X-ray -bilateral shadow (butterfly) / Kerley B lines / Effusion -Treatment : .oxygen .ferosamide I.V .morphin .aminophylin
Date: 2016-04-22; view: 676
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