Clinical Presentation & Differentiation
A patient reports sharp chest pain that worsens with inspiration and improves when leaning forward.
What is pericarditis?
Which complication is MOST life-threatening in pericarditis?
What is cardiac tamponade?
This test confirms vegetations (Vegetations are clumps of infectious material that stick to the heart valves) in endocarditis
What is echocardiogram?
Sepsis is defined as this
What is life-threatening organ dysfunction due to infection?
Priority intervention for suspected sepsis
What is initiate IV fluids?
A patient with a recent dental procedure presents with fever and a new murmur.
What is endocarditis?
A patient with endocarditis suddenly develops unilateral weakness. What complication is occurring?
What is embolic stroke?
This must be obtained before starting antibiotics in suspected sepsis
What are blood cultures?
This occurs when vasodilation leads to decreased blood pressure
What is hypotension?
Why are two large-bore IVs necessary in sepsis?
What is rapid fluid resuscitation and medication administration?
A patient had a viral illness 2 weeks ago and now presents with fatigue, dyspnea, and decreased EF.
What is myocarditis?
A patient with myocarditis develops crackles, hypotension, and decreased urine output. What is the priority concern?
What is cardiogenic shock/heart failure?
An elevated lactate indicates this underlying problem
What is tissue hypoperfusion?
A MAP below this value indicates inadequate perfusion
What is ≤ 65 mmHg?
A patient with myocarditis asks to resume exercise. What is the best response?
What is avoid activity until cleared due to risk of worsening cardiac function?
A patient presents with chest pain. What assessment finding would MOST strongly suggest pericarditis rather than myocardial infarction?
What is pain relieved by sitting forward?
A patient with pericardial effusion becomes hypotensive with JVD and muffled heart sounds. What is the priority intervention?
What is prepare for pericardiocentesis?
A patient has elevated CRP/ESR, chest pain relieved by leaning forward, and diffuse ST elevation. What is the diagnosis?
What is pericarditis?
Early septic shock presents with warm, flushed skin due to this
What is vasodilation?
A patient with endocarditis is prescribed IV antibiotics. What is the most important teaching?
What is complete the full course of antibiotics?
A patient presents with fatigue, SOB, and arrhythmias. What additional data would help differentiate myocarditis from sepsis?
What is history of recent viral illness vs systemic infection with hypotension/lactate elevation?
A patient with sepsis becomes hypotensive despite fluids, with elevated lactate and decreased LOC. What stage are they in and what is the next priority?
What is septic shock and initiate vasopressors after fluids?
A patient has decreased EF, arrhythmias, and normal coronary arteries. What condition is most likely?
What is myocarditis?
Late septic shock presents with cold, clammy skin, oliguria, and altered LOC. What is the underlying cause?
What is decreased perfusion and compensatory vasoconstriction?
You have 4 patients. Who do you see FIRST?
A. Pericarditis with chest pain relieved by leaning forward
B. Endocarditis with low-grade fever
C. Myocarditis with fatigue and mild SOB
D. Sepsis with hypotension and elevated lactate
What is D (sepsis with hypotension and elevated lactate)?