Myocarditis And Pericarditis





Myocarditis And Pericarditis
Myocarditis And Pericarditis


Myocarditis

Myocarditis is an inflammation of the myocardium ( the muscle of the heart), hence its efficiency depends on the health of the individual muscle fibres.

Aetiology:

Bacteria, viruses or parasites, hypersensitivity states as in rheumatic fever or systemic infection.

Signs and symptoms:

- General chest pain.

- Dyspnea.

- Fever and increased pulse.

- Anorexia.

- Fatigue and palpitation.

- The examination may show cardiomegaly, murmur, pericardial friction rub.

Treatment:

1- Cardiotonic drugs ( digitalis).

2- Penicillin for hemolytic streptococci.

3- Bed rest to decrease cardiac work, decrease heart rate, contractility, and decrease pressure.

4- Assess for digitalis toxicity {arrhythmia, nausea, vomiting, anorexia, bradycardia, headache, malaise}.

5- Elastic stockings and active and passive exercise to prevent thrombi formation.


Pericarditis


Pericarditis is an inflammation of the pericardium ( the layer covering the heart muscle).

This covering is composed of two layers:-

The outer layer ( fibrous pericarditis).

The inner layer ( visceral layer).

Aetiology:

1- Idiopathic.

2- Infection: streptococcus or staphylococcus.

3- Disorders of the connective tissues, rheumatic fever and rheumatic arthritis.

4- Hypersensitivity stats – immune reaction or drug reaction.

5- Trauma.

6- Neoplastic disease.


Acute pericarditis:

Signs and symptoms:

1- sharp pain relieved by setting up and leaning forward felt beneath the clavicle in the neck and left the scapular region. pain increase by breath turning in the bed, and twisting the body.

2- friction rub auscultated.

3- signs and symptoms of CHF.

Treatment:

1- Pericardiocentesis.

2- Rest until fever, chest pain disappeared.

3- Analgesics.

4- Antipyretic.

5- Salicylates.

6- Corticosteroids.

7- Penicillin antimicrobial.


Chronic pericarditis:

If chronic, it led to the collection of fluid between the two layers. As result, it prevents the Lt. Ventricle from filling fully which lead to decrease cardiac output.

Signs and symptoms:

1- patient easily tired.

2- Increased heart rate.

3- Signs and symptoms of CHF such as:-

A- Dyspnea.

B- Edema.

4- Distention of superficial veins especially neck veins.



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