4. PERICARDITIS
Definition
Pericarditis refers to an inflammatory process
of the visceral and parietal pericardium as a
result of bacterial, and viral infection
Pericarditis may be acute or chronic in nature
and may spread to the myocardium.
5.
6. CONT…
The cause of pericarditis in most individuals is unknown
but is likely due to viral infection. Pericarditis may be an
associated complication of many diseases or may be due to
trauma .
7. INCIDENT
Pericarditis affects people of all ages, but men 20
to 50 years old are more likely to develop
pericarditis than others.
Among those treated for acute pericarditis, 15 to 30
percent may experience the condition again.
8. TYPES OF PERICARDITIS .
Acute Pericarditis
It may be dry or exudative
The exudative pericarditis may be serous,
purulent or hemorrhagic..
9. CONT.
The accumulated fluid in the pericardium blocks the
ventricular action. It is no diagnosed in time and it
may cause severe reduction of cardiac output
which result in cardiac shock or even death.
10. CONT.
Chronic pericarditis
Pericardium becomes hard due to constrictive
band around the heart, this prevent blood from
filling and emptying the ventricles, resulting in
cardiac failure.
11. ETIOLOGY
Infection of heart structure may be
Bacterial (especially by tuberculosis bacillus )
Viral(especially by Coxsackievirus must
common)
Fungal
12. Or due to complication of systemic disease.
Rheumatoid arthritis
Scleroderma
Systemic lupus erythematosus
Myocardial infarction and
Trauma(pucture resulting inflammation and
infection)
13. CONT.
Side effect of some medication:
• Isoniazid
• Cyclosporine
• Hydralazine .
15. SIGN AND SYMPTOMS
In acute Pericarditis
Severe chest pain(sharp stabbing pain) due to
pericardial friction
Radiating pain over the left shoulder, neck ,back
Dyspnea
High fever
Distended neck vein
Feeble pulse due to cardiac tamponade
16. In acute Pericarditis
Heart sound very muffled
Sitting up and leaning forward tends to ease the
pain, while lying down and breathing deep worsens
it
19. TREATMENT
• corticosteroid therapy (to help reduce inflammation)
• cardiac medications, such as a beta-blocker, ACE
inhibitor
• behavioral changes, such as rest, fluid restriction,
and a low-salt diet
• diuretic therapy to treat fluid overload
• antibiotic therapy
20. SURGICAL MANAGEMENT
Pericardiocentesis. procedure, where sterile needle or a
small tube (catheter) to remove and drain the excess fluid
from the pericardial cavity
Pericardiectomy. This surgery removes the entire
pericardium. It may be done if the sac surrounding heart
has become permanently rigid due to constrictive
pericarditis
22. MYOCARDITIS
Definition
Myocarditis refers to an refers inflammation of
the heart muscle (myocardium)usually caused by
infection, drugs, chemicals, radiation and metabolic
disorder.
The inflammation of the heart muscle causes
degeneration or death of heart muscle cells
This disease is also occur quite often due to
Pericarditis or endocarditis .
23.
24. CAUSES
Viral infection is the most common cause of
myocarditis.
Some organisms that can cause myocarditis
include:
Epstein-Barr virus (EBV)
Cytomegalovirus (CMV)
Hepatitis
26. CONT…
Fungal and parasitic infections can also cause it.
Other causes include certain chemicals or allergic
reactions to medications or toxins like:
Alcohol
Drugs
Lead
.
27. CONT.
An autoimmune disease
Spider bites
Wasp stings
Snakebites
Chemotherapy and radiation therapy
28. LVEDV: left ventrical end diastolic volume
LAP : Left arterial pressure.
29. SIGN AND SYMPTOMS
Myocarditis often has no symptoms. In fact, most
people recover and never even know they had it.
symptoms may include:
Shortness of breath
Abnormal heartbeat, which causes fainting in rare
cases
Light-headedness
30. CONT..
A sharp or stabbing chest pain or pressure, which
may spread to your neck and shoulders
Fatigue
Painful joints
Swollen joint, legs, or neck veins
Small amounts of urine
31. CONT…
Signs of infection, such as
Fever
Muscle aches
Sore throat
Headache
Diarrhea
32. TREATMENT
• Corticosteroid therapy (to help reduce
inflammation)
• Cardiac medications, such as a beta-blocker, ACE
inhibitor, or ARB
• Behavioral changes, such as rest, fluid restriction,
and a low-salt diet
• Diuretic therapy to treat fluid overload
• Antibiotic therapy
33. COMPLICATION
Heart failure
Heart attack or stroke
Rapid or abnormal heart rhythms (arrhythmias).
Sudden cardiac death
Sudden cardiac death
34. NURSING MANAGEMENT
Nursing assessment :
It includes history taking like ;
Subjective Data
Past medical history ; asked for sign of the
disease and the onset of the disease and review
with patients history of risk factor like cardiac failure
, shock
36. CONT..
Objective data
Assess for temperature elevation , heart murmur,
evidence of cough, peripheral edema an embolism,
, auscultate for heart sound dyspnea, restlessness,
and manifestation of heart failure .
37. NURSING DIAGNOSIS
Ineffective breathing pattern related to inflammation
of heart muscles as evidenced by use of accessory
muscle , dyspnea
Impaired gas exchange related to fluid
accumulation in the lungs as evidenced by
shortness of breath
38. Decreased cardiac output related to valvular
dysfunction as evidenced by poor tissue perfusion
Impaired physical mobility related to fatigue
Altered thermoregulation related to infection as
evidenced by increased body temperature
39. Pain and comfort management
Complete bed rest to reduce oxygen demand
Place the patient in upright position to relieve
dyspnea and chest pain.
Provide analgesics to relieve pain and oxygen to
prevent tissue hypoxia.
Assess the patient’s cardiovascular status
frequently.
40. CONT..
Monitor the patient’s pain level and the
effectiveness of analgesics
Limiting activities
Providing calm and quiet environment
Offering support to reduce anxiety
41. Administering medications & IV fluids:
Monitor vitals before and after administering
medications & IV fluids.
Give drugs as indicated (Aspirin, Steroids).
Give antipyretic drug if fever present.
42. CONT..
Administer prescribed medications & fluids
accurately (Follow10 Rights).
Assess IV infusion site for bleeding or any allergic
response.
43. Nutrition
Ensure high protein, high carbohydrate,
Low sodium diet.
Serve attractive meals that stimulate appetite
44. Prevent complication
Check vital sign and record it carefully.
Carefully monitor intake output.
Closely monitor sign for cardiac tamponade
45.
46. CONT..
MandalG.N.,“Text book of adult nursing” Makalu
publication house (P) Ltd, Dili bazar, Kathmandu
R.N. Wilma J. phipps “Shafer’s Medical Surgical
Nursing”B.I. Publications PVT LTD, New Delhi
Datta BN, (1992). “Text book of Pathology” 2nd
edition, Jaypee brothers (p). Ltd, New Delhi
Mosby,( 2009 ),Medical surgical Nursing (5th edition)