Concept Map Concepts and Prompt: Fernanda Escarra
Concept Map Prompt: Starting with the patient Fernanda Escarra and her presenting information,
create a concept map, which explains the pathophysiological mechanisms underlying her clinical symptoms
and signs of acute congestive heart failure due to acute infective endocarditis. Questions to address in your
concept map:
1. What elements in the patient’s history and physical exam are suggestive of acute congestive heart
failure secondary to acute infective endocarditis?
2. How is Staph aureus introduced into the bloodstream and how does it initiate an inflammatory
response on the mitral valve?
3. How does the inflammatory reaction on the mitral valve lead to the formation of vegetations and
rupture of the chordae tendineae and how does this effect the function of the mitral valve?
4. How does the mitral valve incompetence impact the cardiac cycle to lead to the patient’s symptom of
dyspnea and physical signs of a systolic murmur and bibasilar crackles?
5. Which diagnostic test result is suggestive for a bacterial infection and which ones is confirmatory?
6. Which diagnostic tests are used to evaluate the patient’s cardiopulmonary status and what do the
results indicate? Do they help confirm/establish the diagnosis?
7. What is the rationale for prescribing furosemide and vancomycin for our patient? Please include in
your map the mechanism of action of furosemide and how it helps to relieve the patients feeling of
dyspnea.
Domains of Knowledge
Basic Science
Clinical Practice
Acute inflammation
Afterload
Alveoli
Bacteremia
Cardiac output
Chordae tendineae
Coagulation cascade
Cytokines
DAMPS
Ejection fraction
Endothelial cells
Fibrin
Force of contraction
Hypothalamic temperature set point
Hypoxemia
Left atrial pressure
Left atrial volume
Left atrium
Left ventricular end diastolic volume (LVEDV)
Left ventricular end diastolic pressure
Mechanoreceptors
Mitral valve
Mitral valve vegetations
Neutrophils
Platelets
Pore forming toxins
Preload
Pulmonary venous pressure
Regurgitant blood flow
Staphylococcus aureus (S. aureus)
Stroke volume
Systole
Thrombus
Turbulence
Valvular incompetence
Acute congestive heart failure
Acute infective endocarditis
Antibiotic therapy
Arterial Blood Gas (ABG)
Arterial PO2
Bibasilar crackles
Blood pressure
Blood culture
CBC
CXR
Dyspnea
Echocardiogram
Fever
Furosemide
IV heroin
Methicillin
Mitral valve regurgitation
Neutrophilia
Opioid use disorder
Pulmonary edema
Systolic murmur
Vancomycin
