INFLAMMATORY

CONDITIONS OF HEART

LAYERS OF THE HEART

 It

MYOCARDITIS

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

bodys 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

complete recovery

Chronic Heart Failure due to injured

heart muscle.

Sudden unexpected, potentially fatal heart

rhythm abnormalities.

of

myocarditis

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 of these tissue layers

surrounding the heart is referred to as
pericarditis.

Etiology
Idiopathic cause of illness is not
identified
Mechanical injury to the heart
Heart attack (MI) and Dresslers
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

NSAIDs 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 patients

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.