+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