Ncm 101 Report
Transcript of Ncm 101 Report
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MYOCARDITISMYOCARDITIS
-Inflammation of the muscular walls
of the heart
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Causes
Myocarditis is an uncommon disorderthat is usually caused by viral, bacterial, or
fungal infections that reach the heart.
Viral infections:
-Coxsackie
-Cytomegalovirus
-Hepatitis C
-Herpes
-HIV
-Parvovirus
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Bacterial infections:
-Chlamydia-Mycoplasma
-Streptococcus
-Treponema
Fungal infections:
-Aspergillus
-Candida
-Coccidioides
-Cryptococcus-Histoplasma
-Schistosomiasis
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Symptoms
Symptoms depend on the type ofinfection. Most symptoms may be similar to the
flu. If symptoms occur, they may include:
-Abnormal heartbeat-Chest pain that may resemble a heart attack
-Fatigue
-Fever and other signs of infection including headache, muscle
aches, sore throat, diarrhea, or rashes
-Joint pain or swelling-Leg swelling
-Shortness of breath
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Other symptoms that may occur with this
disease:
-Fainting, often related to irregular heart rhythms-Low urine output
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Exams and Tests
A physical examination may show no
abnormalities, or may reveal the following:
-Abnormal heartbeat or heart sounds (murmurs, extra heart sounds)
-Fever
-Fluid in the lungs
-Rapid heartbeat (tachycardia)
-Swelling (edema) in the legs
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Tests used to diagnosis myocarditis
include:
-Blood cultures for infection
-Blood tests for antibodies against the heart muscle and the body
itself
-Chest x-ray-Electrocardiogram (ECG)
-Heart muscle biopsy (endomyocardial biopsy)
-Red blood cell count
-Ultrasound of the heart (echocardiogram)
-White blood cell count
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Treatment
Treatment is aimed at the cause of the
problem, and may involve:
-Antibiotics-Anti-inflammatorymedicines to reduce swelling
-Diuretics to remove excess water from the body
-Low-salt diet
-Reduced activity
Abnormal heart rhythms may require the use of additional
medications, a pacemaker, or an implantable cardioverter-defibrillator.
If a blood clot is in the heart chamber, you will also receive blood
thinning medicine.
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Prevention
Appropriate immunization (eg. Influenza, hepatitis)
early treatment appears to be important in decreasing the
incidence of myocarditis.
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PERICARDITISPERICARDITIS
Inflammation of the pericardium-
the membranous sac around the heart
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Pathophysiology and etiology
1. Acute idiopathic pericarditis is most common and typical
form; etiology unknown
2. Other causes include:
a. Infection
i. viral (influenza, coxsakievirus)
ii. Bacterial ( staphylococcus, meningococcus,
streptococcus, pnuemonococcus, gonococcus,
mycobacterium tuberculosisiii. Fungal
iv. Parasitic
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b. Connective tissue disorder ( lupus erythematosus,
periteritis nodosa)
c. Myocardial infarction; early, 24 to 72 hours; late, 1 week
to 2 weeks afterMI (Dresslers syndrome)
d. Malignant disease; thoracic irradiation
e. chest trauma, heart surgery, including pacemakerimplantation
f. Drug induced ( procainamide [pronastyl] ); phenitoin
[dilantin] )
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Clinical manefestations
1. Pain in anterior chest, aggraviated by thoracic
motion
2. Pericardial friction rub
3. Dyspnea
4. Fever, sweating, chill
5. Dysrhythmia
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Management
1. Bacterial pericarditis- penicillin or other antimicrobial agent
2. Rheumatic fever- penicillin G or other antimicrobial agent
3. Tuberculosis- antituberculosis chemotherapy
4. Fungal pericarditis- Amphotericin B and fluconazole
5. Systemic lupus erythomatosus- steroid
6. Renal pericarditis- dialysis, indomethacin (indocin)
biochemical control of end stage renal disease
7. Neoplastic pericarditis- intrapericardial instillation of
chemotherapy; radiotherapy
8. Postmyocardial infarction syndrome- bedrest, aspirin,
prednisone
9. Postpericardiotomy syndrome- (after open heart surgery)-
treat symptomatically
10. Emergency pericardiocentesis if cardiac tamponade develops
11. Partial pericardiectomy ( pericardial windows) or total
pericadiectomy for recurrent constrictive pericarditis