Sandbox ID Cardiovascular: Difference between revisions
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===Pericarditis, tuberculous=== | ===Pericarditis, tuberculous=== | ||
:* Preferred regimen: 2 months of [[Isoniazid]] {{and}} [[Rifampicin]] {{and}} [[Pyrazanamide]] {{and}} [[Ethambutol]] followed by 4 months of [[Rifampicin]] {{and}} [[Pyrazanamide]]. [[Prednisolone]] 1–2 mg/kg per day for 5–7 days is also given and is progressively reduced to discontinuation in 6–8 weeks<ref name="pmid15120056">{{cite journal| author=Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y et al.| title=Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. | journal=Eur Heart J | year= 2004 | volume= 25 | issue= 7 | pages= 587-610 | pmid=15120056 | doi=10.1016/j.ehj.2004.02.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15120056 }} </ref> | :* Preferred regimen: 2 months of [[Isoniazid]] 5 mg/kg (300 mg) OD {{and}} [[Rifampicin]] 10 mg/kg (600 mg) OD {{and}} [[Pyrazanamide]] 1,500 mg OD {{and}} [[Ethambutol]] 1,200 OD followed by 4 months of [[Rifampicin]] 10 mg/kg (600 mg) OD {{and}} [[Pyrazanamide]] 1,500 mg OD. [[Prednisolone]] 1–2 mg/kg per day for 5–7 days is also given and is progressively reduced to discontinuation in 6–8 weeks<ref name="pmid12588714">{{cite journal| author=Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN et al.| title=American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. | journal=Am J Respir Crit Care Med | year= 2003 | volume= 167 | issue= 4 | pages= 603-62 | pmid=12588714 | doi=10.1164/rccm.167.4.603 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12588714 }} </ref>. | ||
:: Note: [[Intrapericardial drainage]] is done if needed. If [[constriction]] develops inspite of medical therapy, [[pericardiectomy]] is indicated<ref name="pmid15120056">{{cite journal| author=Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y et al.| title=Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology. | journal=Eur Heart J | year= 2004 | volume= 25 | issue= 7 | pages= 587-610 | pmid=15120056 | doi=10.1016/j.ehj.2004.02.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15120056 }} </ref>. | |||
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Revision as of 14:14, 4 June 2015
Aortitis, infectious
Cardiovascular implantable electronic device infections
Endocarditis, prophylaxis
Mediastinitis, acute
Myocarditis, viral
Pericarditis, fungal
- Fungal Pericarditis[1]
- Empiric therapy : Fluconazole, Ketoconazole, Itraconazole, Amphotericin B, Liposomal amphotericin B or Amphotericin B lipid complex is indicated.
-
- Preferred regimen: Nonsteroidal anti-inflammatory drugs given during 2–12 weeks.
- Note: Corticosteroids and NSAIDs can support the treatment with antifungal drugs. Pericardiocentesis or surgical treatment is indicated for haemodynamic impairment. Pericardiectomy is indicated in fungal constrictive pericarditis.
- Preferred regimen: Sulfonamides are the drugs of choice.
- Note: Corticosteroids and NSAIDs can support the treatment with antifungal drugs. Pericardiocentesis or surgical treatment is indicated for haemodynamic impairment. Pericardiectomy is indicated in fungal constrictive pericarditis.
- Preferred regimen: Combination of three antibiotics including Penicillin.
- Note: Corticosteroids and NSAIDs can support the treatment with antifungal drugs. Pericardiocentesis or surgical treatment is indicated for haemodynamic impairment. Pericardiectomy is indicated in fungal constrictive pericarditis.
Pericarditis, tuberculous
- Preferred regimen: 2 months of Isoniazid 5 mg/kg (300 mg) OD AND Rifampicin 10 mg/kg (600 mg) OD AND Pyrazanamide 1,500 mg OD AND Ethambutol 1,200 OD followed by 4 months of Rifampicin 10 mg/kg (600 mg) OD AND Pyrazanamide 1,500 mg OD. Prednisolone 1–2 mg/kg per day for 5–7 days is also given and is progressively reduced to discontinuation in 6–8 weeks[2].
- Note: Intrapericardial drainage is done if needed. If constriction develops inspite of medical therapy, pericardiectomy is indicated[1].
Pericarditis, viral
- Viral pericarditis[1]
- CMV pericarditis
- Preferred regimen: immunoglobulin 1 time per day 4 ml/kg on day 0, 4, and 8; 2 ml/kg on day 12 and 16.
- Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
- Coxsackie B pericarditis
- Preferred regimen: Interferon alpha or beta 2,5 Mio. IU/m2 surface area s.c. 3×per week.
- Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
- Adenovirus and parvovirus B19 perimyocarditis
- Preferred regimen: Immunoglobulin 10 g intravenously at day 1 and 3 for 6–8 hours
- Note: Symptomatic treatment is given to the patients with viral pericarditis while in large effusions and cardiac tamponade pericardiocentesis is necessary. The use of corticosteroid therapy is contraindicated except in patients with secondary tuberculous pericarditis, as an adjunct to tuberculosis treatment. Drainage, if needed is done.
Rheumatic fever, primary prophylaxis
Rheumatic fever, secondary prophylaxis
Septic pelvic vein thrombophlebitis
- Based on the CT and MRI findings septic pelvic vein thrombophlebitis is classified into following categories for management.[3].
- Right ovarian vein thrombosis
- Preferred regimen: Ertapenem 1 g daily for 7 days AND Enoxaparin (1 mg/Kg) initially AND 3–6 months of Warfarin (INR 2.5) OR Gentamicin 4 mg/kg AND Ampicillin 2 g AND Clindamycin 1200 mg for 7 days AND Enoxaparin (1 mg/Kg) initially AND 3–6 months Warfarin (INR 2.5).
- Note: Repeat CT scan after 3 months. If negative, stop anticoagulation. If still positive for thrombi, anticoagulate for 3 additional months.
- Pelvic branch vein thrombosis
- Preferred regimen: Ertapenem 1 g daily for 7 days AND Enoxaparin (1 mg/Kg) for 2 weeks OR Gentamicin (4 mg/kg) AND Ampicillin 2 g AND Clindamycin 1200 mg for 7 days AND Enoxaparin (1 mg/Kg) for 2 weeks.
- Negative for pelvic thrombi
- Preferred regimen: Ertapenem 1 g daily for 7 days AND Enoxaparin (1 mg/Kg) for 1 weeks OR Gentamicin (4 mg/kg) AND Ampicillin 2 g AND Clindamycin 1200 mg for 7 days AND Enoxaparin (1 mg/Kg) for 1 weeks.
References
- ↑ 1.0 1.1 1.2 Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y; et al. (2004). "Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European society of cardiology". Eur Heart J. 25 (7): 587–610. doi:10.1016/j.ehj.2004.02.002. PMID 15120056.
- ↑ Blumberg HM, Burman WJ, Chaisson RE, Daley CL, Etkind SC, Friedman LN; et al. (2003). "American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis". Am J Respir Crit Care Med. 167 (4): 603–62. doi:10.1164/rccm.167.4.603. PMID 12588714.
- ↑ Javier Garcia, Ramzi Aboujaoude, Joseph Apuzzio & Jesus R. Alvarez (2006). "Septic pelvic thrombophlebitis: diagnosis and management". Infectious diseases in obstetrics and gynecology. 2006: 15614. doi:10.1155/IDOG/2006/15614. PMID 17485796.