Endocarditis inflames the heart's inner lining and valves, causing fever, new murmurs, and splinter hemorrhages. Pericarditis inflames the outer sac, producing stabbing chest pain that worsens when lying down or coughing, plus a friction rub. Both can lead to heart failure or tamponade.
In this video, we're breaking down endocarditis and pericarditis. We'll talk about what they are, their symptoms, and what you need to know for them to pass your nursing school exams. Let's dive in. To start, let's talk about what endocarditis and pericarditis are and how you can tell the difference between endocarditis and pericarditis. Both of them have to do with the layers of the tissue of the heart. Endocarditis is inflammation in the endocardium layer of the heart, which is the innermost layer. And pericarditis is inflammation in the pericardial layer of the heart, which is that sac like layer surrounding the heart. Let's go through each of these types of inflammation and how they may impact the heart's function. So, diving a bit deeper, what happens to the heart with endocarditis? Well, the endocardium, that innermost layer of the heart, becomes inflamed. The endocardium lines the valves, the ventricles and the atria of the heart. And endocarditis happens when this endocardium layer becomes inflamed. Endocarditis is most commonly caused by an infection which starts in the bloodstream and then travels to the heart. In other cases, the inflammation can be from trauma or general inflammation or even unknown causes. And even when the inflammation is not initially infective, endocarditis can cause blood clots to form, and these clots can lead to more infections within the body. A serious complication of endocarditis is congestive heart failure, because the heart valves are infected and the heart can no longer function properly to circulate blood flow. Now, in pericarditis, the pericardium, which is the outer lining or the sac that surrounds the heart, it becomes inflamed. The pericardium is made up of two layers, a fibronous layer, which is the outermost layer, and the visceral layer, which is up against the heart. And in between, this is the pericardial cavity. With pericarditis, either of these layers becomes inflamed and infected. Some common causes of pericarditis are bacteria, viruses, trauma, such as a heart attack, and inflammatory disorders such as lupus. So now that we know what happens with endocarditis and pericarditis and more of the pathophysiology behind them, now let's dive into the signs and symptoms that you will want to be looking out for. Some common symptoms of endocarditis are a fever, along with chills and night sweatshirts. The patient may also develop a new or a different heart murmur. Petechiae, which are little reddish or purple spots on the skin, those can develop as well if there's a clot in the endocardium, Then small pieces start falling off and are dispersed throughout the body. Splinter hemorrhages, which look like thin reddish brown lines underneath fingernails. Those can also be seen. This is from damaged or ruptured capillaries under the nail beds. Now, remember, with endocarditis, the valves, the atria, the ventricles are inflamed, and that causes them to not work as efficiently. So the patient will also have a decreased cardiac output and hypotension may be present, as well as tachycardia, since the heart is really working hard to try to increase that cardiac output. Now, pulmonary edema can also happen because the heart is not able to pump as effectively because of that inflamed endocardium layer. And if the heart can't pump full forward to the body, it gets backed up into the lungs, causing pulmonary edema. Now, another thing that can happen is splenomegaly or an enlarged spleen, because the body is working extra hard to try to fight off this infection. Now let's look at the symptoms of pericarditis. With pericarditis, the symptoms will be slightly different because this is inflammation of that pericardial layer, so that outer sac lining of the heart. Some common symptoms of pericarditis are chest pain, substernal neck or back pain from the inflammation and that rubbing together of those two layers of that pericardium. Pericarditis pain is usually felt in the chest as a stabbing pain, but it can also feel dull or achy. The pain can radiate as the heart beats and adds pressure to the inflamed layers, which can worsen the pain. Now, as you think through the symptoms of pericarditis, think about things that are naturally going to increase the pressure on the heart. Heart things like coughing or laying down will increase the pressure on the heart against that pericardial sac and in turn increase the patient's pain. And you may hear a pericardial friction rub or creaking or crackling, scratching or grating sound. Now, this is from those two layers rubbing together. Remember, those pericardial layers are inflamed and they're rubbing against each other. Now, with pericarditis, the heart can be compressed by that inflammation in that pericardial sac, and therefore it cannot keep up with the demands of the body. This can cause blood to back up into the lungs, which causes shortness of breath. The blood can start to back up into the body, causing edema in the extremities such as the legs, the ankles or the feet, and the patient may also have some arrhythmias or an ST elevation because of the extra pressure on the heart. If pericarditis is severe and there's a lot of pressure on the heart, it can lead to cardiac tamponade Now I know there's a lot to remember for the differences between endocardom and pericarditis and other med surg disorders that you need to know about in nursing school, so make sure that you download the full study guide that we have for you inside the nursing SOS Membership community. We break it down super simple, simple for you, step by step so that you can understand it faster and easier. So check that out inside the community. I'll put the link down below in the description with all the details. Now, if you're struggling to learn pathophysiology in nursing school, check out this video here where I walk you through my top tips for how to learn patho faster and easier. And I'd love to hear from you on what videos you want me to make next. I'm here to help you pass nursing school, so let me know what topics you want me to do a video on. Let me know in the comments below. And my friend, go become the nurse that God created only you to be and I will see you over there in that next video.
