Question

A patient who reports having a sore throat 2 weeks ago now reports chest pain. On physical assessment, the nurse hears a new murmur, pericardial friction rub, and tachycardia. ECG shows a prolonged P-R interval. What condition does the nurse suspect in this patient?

a. Rheumatic carditis
b. Heart failure
c. Cardiomyopathy
d. Aortic stenosis

Answer 1

The nurse suspects rheumatic carditis in the patient, evidenced by symptoms such as chest pain, a new heart murmur, pericardial friction rub, tachycardia, and ECG changes following a recent sore throat, which are characteristic of rheumatic fever sequelae.

Step-by-step explanation:

Given that the patient reports a sore throat from 2 weeks ago and is now experiencing chest pain, a new murmur, a pericardial friction rub, tachycardia, and a prolonged P-R interval on the ECG, the nurse's suspicion may be directed towards rheumatic carditis. This condition follows an untreated or inadequately treated pharyngitis and can cause immune-mediated damage to heart valves. The prolonged P-R interval can indicate damage to the electrical conduction system of the heart, which is a symptom associated with rheumatic fever, and a murmur suggests possible valvular damage. Rheumatic carditis is a serious sequela of rheumatic fever, which is a complication that can arise after an infection with S. pyogenes, typically starting 2-3 weeks after a case of streptococcal pharyngitis.