cardiovascular , myocarditis, Resumos de Medicina

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myocarditis

intro

• Myocarditis is an inflammatory process involving the myocardium.
• (^) Myocarditis can cause heart dilation, thrombi on the heart wall (mural thrombi), infiltration of circulating blood cells around the coronary vessels and between the muscle fibers, and degeneration of the muscle fibers themselves

patho

• It may begin in one small area and then spread throughout the myocardium. The degree of myocardial involvement determines the degree of hemodynamic effect and resulting signs and symptoms.
• (^) It is theorized that dilated cardiomyopathy is a latent manifestation of myocarditis.

Clinical manifestation

• Chest pain
• (^) Rapid or abnormal heart rhythms (arrhythmias)
• (^) Shortness of breath, at rest or during physical activity
• Fluid retention with swelling of the legs, ankles and feet
• Fatigue
• Other signs and symptoms of a viral infection, such as a headache, body aches, joint pain, fever, a sore throat or diarrhea

dx

Hx and physical exam

• (^) ECG
• (^) Echocariogram
• XRAY

Med mx

• (^) The patient receives specific treatment for the underlying cause if it is known (eg, penicillin for hemolytic streptococci)
• (^) bed rest to decrease the cardiac workload. Bed rest also helps to decrease myocardial damage and the complications of myocarditis.
• (^) Activities, especially sports in young patients with myocarditis, should be limited for a 6-month period or at least until heart size and function have returned to normal.
• (^) Physical activity is increased slowly, and the patient is instructed to report any symptoms that occur with increasing activity, such as a rapidly beating heart.

Nursing mx

• (^) The nurse assesses the patient’s temperature to determine whether the disease is subsiding.
• (^) The cardiovascular assessment focuses on signs and symptoms of heart failure and dysrhythmia.
• (^) The patient experiencing dysrhythmias should receive continuous cardiac monitoring with personnel and equipment readily available to treat life-threatening dysrhythmias.