Valvular Heart
Cardiomyopathy
Pericarditis
Endocarditis
Kawasaki
100

Name the 4 main heart valves and where they are located. 

Tricuspid- between the right atria and right ventricle

Pulmonic-Between the right ventricle and the pulmonary artery

Mitral/bicuspid- between the left atrium and left ventricle

Aortic - between the left ventricle and the aorta 

100

Type of cardiomyopathy with high incidence of sudden cardiac death. Explain why. 

Hypertrophic cardiomyopathy. It can cause sudden cardiac death when the septal wall becomes so thick it obstructs the aorta/aortic valve so no output is going out to the body. May happen quickly with overexertion. 

100

Acute pericarditis is most commonly associated with which 4 things? Name at least 3/4. 

Infective organisms

Post-Myocardial infarction syndrome aka Dresssler Syndrome

Postpericardiotomy syndrome

Acute exacerbation of systemic connective tissue disorders

100

Antibiotics used for endocarditis- Name 4

Penicillin

Ampicillin

Vancomycin

Gentamycin

Ceftriaxone

Cefazolin

Rifampin

100

Criteria to diagnose Kawasaki

Fever for 5+ days,

Plus 4/5 of the following: 

-cervical lymphadenopathy

-rash w/ diffuse erythroderma

-Changes in oral mucosa- erythema, cracking, oropharyngeal reddening, strawberry tongue

-Bilateral conjunctival injection w/o exudate

-Changes in the extremities- edema/erythema on palms and soles, periungual desquamation o the hands and feet 


CRASH and Burn

200

Describe the difference between stenosis, prolapse, and insufficiency/regurgitation. 

Stenosis is the stiffening/thickening/fusing of the valve to reduce its ability to open all the way which reduces flow through it.

Prolapse is when the valve falls back into the atrium or prior cavity.

Insufficiency/regurgitation is when the vales do not close all the way causing a back flow of blood. 

200

Medications used for Dilated cardiomyopathy- name the class and give an example of them. 

ABCDD- meds 

Ace inhibitors- lisinopril

Beta-blockers - atenolol, metoprolol, carvedilol

Calcium channel blockers- nifedipine, verapimil, diltiazem

Diuretics- furosemidee

Digoxin- 

Statins- simvastatin

Aldosterone antagonists- spironolactone 


200

Pneumonic to remember symptoms with the symptoms

FRICTION

Friction rub, fever

Radiating substernal pain to left shoulder, neck, back

Increased pain in supine

Chest pain, stabbing

Trouble breathing when lying down

Inspiration or coughing causes pain

Overall feeling sick

Noticeable ST-segment elevation

200

Complications of endocarditis (name 3)

Valvular dysfunction

Embolism

Heart Failure

Systemic Complications ie renal failure, neurological defects, etc

200

Long-term complication of Kawasaki Disease

Development of coronary artery aneurysms. 

300

Post-op education for valve replacement (name 5 separate things) 

Prophylactic antibiotics

Warfarin for mechanical valves- many associated education points here

return to normal activity after 6 weeks, no heavy physical activity for 3-6 months.

No invasive dental procedures for 6 months

No using MRI 

Medical alert bracelet/ card for valve info

When to call the provider

300

NEVER give these medications for hypertrophic cardiomyopathy. 

The 3 D's- Digoxin, diuretics, dilators (vasodilators) 

300

Medications used to treat Pericarditis and what they are used for. 

Aspirin or NSAIDs- help with pain and inflammation

Colchicine- help reduce inflammation, and reduce risk of recurrence (what to remember about this?)

Corticosteroids like prednisone, reduce inflammation and immunosuppress

300

How to diagnose Endocarditis (name 3) 

Positive blood cultures

low H&H

Echocardiography- shows evidence of endocardial involvement

Transesophageal echocardiography (TEE)- Allows visualization of cardiac structures that are difficult to see with the TTE 

New Murmur

300

Treatment for Kawasaki Disease

IVIG w/ salicylate therapy

Aspirin

Antithrombotic meds- for children with aneurysms 

400

Procedural and surgical treatments for Valvular Heart disease: Name 2 of each. 

Procedural: Valvuloplasty, Transcatheter aortic valve replacement (TAVR), Transcatheter Mitral Valve Repair- Mitra clip.

Surgical: Valve replacement, Valve Annuloplasty, Commisurotomy, Valve-sparing aortic root replacement, Ross procedure 

400

The 3 main types of cardiomyopathy and basic description of each. 

Dilated- the heart is stretched out/distended.

Hypertrophic- left ventricular hypertrophy obstructing output

Restricted- ventricular walls are stiff, restricting output

400

Signs of cardiac tamponade (5) 

JVD

Paradocical pulse aka pulsus paradoxus

Tachycardia

Muffled Heart Sounds

Hypotension 


Treatment: Pericardiocentesis 


400

Describe symptoms when emboli travels to 3/6 of these locations: Spleen, Kidneys, MEsenteric, Central Nervous System, Lungs, systemic/extremities 

Spleen: sudden abdominal pain and radiation to left shoulder  w/ abdominal rebound tendarness

Kidneys:flank pain radiating to groin, hematuria, pyuria

Mesenteric: diffuse abdominal pain, esp. after eating, abdominal distention

CNS: TIA/Stroke symptoms, confusion, reduced concentration, aphasia, dysphasia etc

Lungs: Pleuritic chest pain, dyspnea, cough, anxiety, agitation, restlessness, Rapid HR

Systemic/Extremities: petechiae, Janeway lesions, Osler's nodes, splinter hemorrhages, roth spots 

400

Nursing scope of practice interventions to assist with symptom relief of Kawasaki Disease (Name 5)

Cool cloths

unscented lotions

soft, loose clothing

mouth care

lubricating ointment for lips

Clear liquids/soft foods 

Quiet environment

500

What are the 4 types of valves that can be used for replacement- explain what they are, which lasts the longest and why? 

Xenograft- another species (ie bovine etc)

Allograft- Cadaver

Autograph-Self

Mechanical- Man-made 

500

What are 4 relative contraindications for a heart transplant? 

Severe obesity

Psychological impairment

Hx of non-adherence to medications

Active substance abuse

Irreversible liver or kidney disease

Uncontrolled diabetes

Lack of social support

Unrealistic expectations

500

Treatments for chronic/recurring pericardial effusion

Pericardial window creation- small portion of pericardium is removed to permit excess fluid to drain into the pleural space

Pericardectomy - removal of the toughened encasing of the pericardium 

500

Pneumonic to remember Endocarditis symptoms. Give the actual symptoms

PATHOGENS


Petechiae

Anorexia

Tired/weak

High fever, heart failure

Osler's nodes

FinGer nail changes (splinter hemorrages)

Embolic events + Janeway lesions

Night sweats , New Murmur

Splenomegaly, Roth Spots 



500

Discharge Education for Kawasaki Disease (list 4) 

Irritability may last 2 months

Periungual desquamation begins 2nd or 3rd week, painless peeling but new skin may be tender

Temporary arthritis

No live immunizations for 11 months

Daily temps for 1-2 weeks 

Heart-healthy lifestyle 


More specific education for children with aneurysms