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2 Path Unit > 10/28-Myocardial Diseases > Flashcards

10/28-Myocardial Diseases Flashcards

1
Q

What is pressure hypertrophy and what is it caused by?

A
  • hypertrophy without dilatation

- caused by hypertension or aortic stenosis

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2
Q

What is volume hypertrophy and what is it caused by?

A
  • hypertrophy with dilatation

- caused by Aortic and mitral regurgitation or L=>R shunts

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3
Q

3 Consequences of hypertrophy?

A
  • angina (decreased perfusion to thickened myocardium)
  • arrhythmias (sudden death)
  • heart failure
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4
Q

Right ventricle hypertrophy is usually a combination of hypertrophy then dilation with either pressure or volume overload, what are three possible causes of this?

A
  • pulmonary hypertension
  • pulmonary stenosis
  • tricuspid regurgitation
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5
Q

T/F- physiologic hypertrophy can lead to extra heart sounds and murmurs

A

true

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6
Q

T/F- left ventricular failure leads to an increase in LV end-diastolic volume and backup of blood into lungs

A

true

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7
Q

4 causes of systolic dysfunction?

A

-ischemic heart disease
-dilated cardiomyopathy
-hemochromatosis
-myocarditis
=>ejection fraction low

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8
Q

4 causes of diastolic dysfunction?

A

-hypertension
-hypertrophic cardiomyopathy
-restrictive cardiomyopathy
-other infiltrative disorders (amyloidosis, fibrosis)
=>ejection fraction normal to increased

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9
Q

4 causes of right ventricular failure?

A
  • MOST COMMON cause is Left sided heart failure
  • pulmonary HTN
  • RV infarction
  • tricuspid regurgitation
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10
Q

What is dilated cardiomyopathy?

A

Systolic disorder with hypertrophy, dilatation, and dysfunction

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11
Q

What is the etiology of primary dilated cardiomyopathy?

A
  • idiopathic (most common)

- familial (genetic cases most commonly autosomal dominant), affecting cytoskeletal proteins and sarcomeric proteins

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12
Q

Etiology of secondary dilated cardiomyopathy?

A
  • Alcoholism (20%)
  • Myocarditis (10%)
  • Peripartum (5%)
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13
Q

Pathological findings of primary dilated cardiomyopathy?

A
  • hypertrophy
  • fibrosis
  • no other findings
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14
Q

Findings associated with secondary dilated cardiomyopathy?

A

myocarditis, hemochromatosis, other disorders

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15
Q

T/F- 90% of cases of arrhythmogenic right ventricular cardiomyopathy are inherited

A

False, only 25% (majority autosomal dominant)

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16
Q

T/F- pathologic changes in arrhythmogenic RV cardiomyopathy progress in the reverse direction (i.e. subepicardial=> subendocardial) of ischemic changes

A

true

17
Q

Is the left ventricular ejection fraction decreased or increased in hypertrophic cardiomyopathy?

A

often normal or increased

18
Q

What are causes of mortality with hypertrophic cardiomyopathy?

A

arrythmias
heart failure
thrombo-embolic phenomenon

19
Q

T/F- hypertrophic cardiomyopathy is caused in most cases by mutations in genes that encode sarcomeric proteins (beta-myosin heavy chains)

A

true

20
Q

Is primary or secondary restrictive cardiomyopathy more common?

A 
Secondary is more common
-amyloidosis (50%)
-Eosinophilic myocarditis (35%)
Primary
-familial (<1%)
-Idiopathic (10%)
21
Q

Eosinophilic myocarditis is usually referred to as what?

A

Loeffler endomyocarditis

22
Q

Gross appearance of primary restrictive cardiomyopathy?

A
  • heart is normal size or enlarged
  • ventricles normal to enlarged
  • atria are dilated
23
Q

Microscopic appearance of primary restrictice cardiomyopathy?

A

interstitial fibrosis

myocyte hypertrophy

24
Q

T/F- isolated amyloid in heart is often related to senile cardiac amyloidosis and deposition of transthyretin

A

true

25
Q

What do eosinophils release that causes myocyte necrosis in eosinophilic restrictive cardiomyopathy?

A

major basic protein

26
Q

What are symptoms of myocarditis?

A

fatigue, dyspnea, palpitations, chest pain, fever (or may be asymptomatic)

27
Q

What is the most common cause of myocarditis in the US?

A

viruses specifically Coxackie virus (molecular mimicry) most common. Other enteroviruses, influenza, CMV, HIV can also cause this.

28
Q

T/F- bacteria such as C. diptheriae and Borrelia burdorferi as well as Fungi (candida), helminths (trichinosis), and trypanosome cruzi (chugs disease) can cause myocarditis as well

A

true

29
Q

T/F- myocarditis can be caused by hypersensitivity rxns to drugs, autoimmune disorders (SLE, rheumatic fever, polymyositis), Sarcoidosis, and transplant rejection

A

true

30
Q

What are the 3 common types of chronic pericarditis?

A
  1. fibrous plaques or delicate adhesions (no clinical significance)
  2. Adhesive mediastinopericarditis (obliteration of pericardial sac, strain on heart)
  3. Constrictive pericarditis (restrictive physiology)
31
Q

What are 5 types of Acute pericarditis?

A
  • Serous
  • Fibrinous and serofibrinous
  • Suppurative
  • Caseous
  • Hemorrhagic

2 Path Unit (14 decks)

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