HEART INFECTIONS

HEART INFECTIONS : 

HEART INFECTIONS Ma. Tosca Cybil A. Torres, RN

Endocarditis : 

Endocarditis inflammation of the inside lining of the heart chambers and heart valves (endocardium). can involve the heart muscle, heart valves, or lining of the heart. Most people who develop endocarditis have heart disease of the valves.

Risk factors : 

Risk factors Injection drug use Permanent central venous access lines Prior valve surgery Recent dental surgery Weakened valves Bacterial infection Fungi

Symptoms : 

Symptoms Chills Fatigue Fever Heart murmur Joint pain Muscle aches and pains Night sweats Nail abnormalities (splinter hemorrhages under the nails) Paleness Red, painless skin spots on the palms and soles (Janeway lesions)

Janeway lesion : 

Janeway lesion

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Red, painful nodes in the pads of the fingers and toes (Osler's nodes) Shortness of breath with activity Swelling of feet, legs, abdomen Weakness Weight loss Note: Endocarditis symptoms can develop slowly (subacute) or suddenly (acute).

Exams and Tests : 

Exams and Tests CBC -anemia Chest x-ray Echocardiogram ECG Erythrocyte sedimentation rate (ESR) Repeated blood culture and sensitivity

Treatment : 

Treatment Long-term antibiotic therapy is needed to get the bacteria out of the heart chambers and valves. usually have therapy for 6 weeks must be specific for the organism blood culture and the sensitivity tests

Surgery to replace the heart valve is usually needed when: : 

Surgery to replace the heart valve is usually needed when: The infection is breaking off in little pieces, resulting in a series of strokes The person develops heart failure as a result of damaged heart valves There is evidence of organ damage

Possible Complications : 

Possible Complications Arrhythmias, such as atrial fibrillation Blood clots or an infected clot from the endocarditis that travels to the brain, kidneys, lungs, or abdomen, causing severe damage to, and infection of, these organs Brain abscess Brain or nervous system changes Congestive heart failure Glomerulonephritis Jaundice Severe heart valve damage Stroke

Prevention : 

Prevention People with certain heart conditions often take preventive antibiotics before dental procedures or surgeries involving the respiratory, urinary, or intestinal tract. Those with a history of endocarditis should have continued medical follow-up.

Myocarditis : 

Myocarditis an inflammation of the heart muscle an uncommon disorder that is usually caused by viral infections such as coxsackie virus, adenovirus, and echovirus

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may also occur during or after various viral, bacterial, or parasitic infections (such as polio, influenza, or rubella). exposure to chemicals or allergic reactions to certain medications associated with autoimmune diseases. muscle becomes inflamed and weakened

Symptoms : 

Symptoms History of preceding viral illness Fever Chest pain that may resemble a heart attack Joint pain or swelling Abnormal heart beats Fatigue Shortness of breath Leg swelling Inability to lie flat *total absence of symptoms is common

Additional symptoms : 

Additional symptoms Fainting, often related to arrhythmias Low urine output Other symptoms consistent with a viral infection -- headache, muscle aches, diarrhea, sore throat, rashes

Exams and Tests : 

Exams and Tests Electrocardiogram (ECG) Chest x-ray Ultrasound of the heart (echocardiogram) -- may show weak heart muscle, an enlarged heart, or fluid surrounding the heart. White blood cell count Red blood cell count Blood cultures for infection Blood tests for antibodies against the heart muscle and the body itself Heart muscle biopsy - rarely performed

Treatment : 

Treatment Antibiotics reduced level of activity low-salt diet. Steroids and other medications may be used to reduce inflammation. Diuretics

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If the heart muscle is very weak, standard medicines to treat heart failure are also used. Abnormal heart rhythm may require the use of additional medications, a pacemaker or even a defibrillator. If a blood clot is present in the heart chamber, blood thinning medicine is given as well.

Possible Complications : 

Possible Complications Heart failure Pericarditis Cardiomyopathy

Prevention : 

Prevention Prompt treatment of causative disorders may reduce the risk of myocarditis.

Pericarditis : 

Pericarditis a disorder caused by inflammation of the pericardium, which is the sac-like covering around the heart.

Causes : 

Causes usually a complication of viral infections, most commonly echovirus or coxsackie virus. less frequently, it is caused by influenza or HIV infection. Infections with bacteria can lead to bacterial pericarditis (also called purulent pericarditis).

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Some fungal infections can also produce pericarditis. can be associated with systemic diseases such as autoimmune disorders, rheumatic fever, tuberculosis, cancer, leukemia, kidney failure, HIV infection, AIDS, and hypothyroidism

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Heart attack and myocarditis radiation therapy to the chest medications that suppress the immune system. injury (including surgery) or trauma to the chest, esophagus, or heart unknown (idiopathic pericarditis)

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most often affects men aged 20-50, usually following respiratory infections In children, it is most commonly caused by adenovirus or coxsackie virus.

Symptoms : 

Symptoms Chest pain, caused by the inflamed pericardium rubbing against the heart relieved by sitting up and leaning forward Pleuritis type: a sharp, stabbing pain radiate to the neck, shoulder, back or abdomen increases with deep breathing and lying flat, and may increase with coughing and swallowing

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Breathing difficulty when lying down Need to bend over or hold the chest while breathing Dry cough Ankle, feet and leg swelling (occasionally) Anxiety Fatigue Fever

Exams and Tests : 

Exams and Tests pericardial rub heart sounds may be muffled or distant signs of fluid in the pericardium (pericardial effusion). If the disorder is severe, there may be crackles in the lungs, decreased breath sounds, or other signs of fluid in the space around the lungs (pleural effusion).

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Chest x-ray Echocardiogram Chest MRI scan Heart MRI or heart CT scan Blood culture CBC, may show increased WBC count Erythrocyte sedimentation rate (ESR) Pericardiocentesis, with chemical analysis and pericardial fluid culture

Treatment : 

Treatment analgesics anti-inflammatory drugs(NSAIDS) such as aspirin and ibuprofen. Corticosteroids Diuretics

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Pericardiocentesis – may be done if the buildup of pericardial fluid makes the heart function poorly or produces cardiac tamponade using an echocardiography-guided needle or surgically in a minor procedure.

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If the pericarditis is chronic, recurrent, or causes constrictive pericarditis, cutting or removing part of the pericardium may be recommended.

Possible Complications : 

Possible Complications Arrhythmias, such as atrial fibrillation Cardiac tamponade

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Constrictive pericarditis, where inflammation of the pericardial sac results in fibrosis and thickening of the pericardium with adhesions (sticky scars) between the pericardium and the heart. The pericardium creates a rigid "case" around the heart, which can severely limit the ability of the heart to fill with blood. Patients with constrictive pericarditis may develop heart failure, which responds poorly to treatment.