Cardiology: hypertension, pericardial diseases, infective endocarditis
General Medicine · MBBS
Study notes
Fever, new murmur, and Janeway lesions — infective endocarditis; blood cultures, then 6 weeks antibiotics. Endocarditis (valve vegetations — Staph/Strep: fever + murmur + embolic phenomena — Janeway (painless), Osler (painful), splinter hemorrhages; Duke criteria): blood cultures BEFORE antibiotics (3 sets), echo (vegetations), 4–6 weeks IV antibiotics; surgery for heart failure, abscess, large vegetations. Pericarditis (pleuritic pain, better leaning forward, diffuse ST elevation + PR depression — NSAIDs/colchicine); tamponade (Beck's — hypotension, JVD, muffled — pulsus paradoxus; echo — pericardiocentesis). Hypertension (≥140/90 — lifestyle + ACE-I/CCB/thiazide; emergency — >180/120 with organ damage: IV nitroprusside/nicardipine). The fever-murmur pair is endocarditis — culture first, always.
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