12&13 - Cardiac Pathology II Flashcards
carnevale defines HTN
140/90 over three consevutive readings at least one week apart
cause unknown HTN
essential HTN 90-95% cases
malignant HTN
180/120
medical emergency!
stage II HTN
160/100
signs of retinopathy
hard exudate
flame hemorrhage
cotton wool spot
retinopathy due to HTN
what can long term chronic HTN do to CNS? malignant HTN?
chronic –> cerebral infarction (stroke)
malignant HTN –> intracranial hemorrhage
how will the left ventricular hypertrophy develop with HTN
concentrically
failure of valve to open completely =
stenosis
–> pressure overload
failure of valve to close completely =
insufficiency
–> volume overload
calcification of anatomically normal and congenitally bicruspid aortic valves
aortic stenosis
dilation of the ascending aorta, usually related to HTN and aging
aortic insufficiency
rheumatic heart disease –>
mitral stenosis
mitral valve prolapse aka
myxomaous degeneration
this is a mitral insufficiency
most common valvular abnormality
calcific aortic stenosis
“wear and tear” in 90s or younger people with bicuspid aortic valves
how is calcific aortic stenosis different than stenosis caused by rheumatic heart disease?
rheumatic would include fusion of the commissures
calcific: within sinuses of valsalve
why do we need to treat arotic stenosis?
50% of those presenting with angina will die in 5 yr
50% with CHF will die in 2 yr
sclerosis v. stenosis
sclerosis is fibrosis process, not calcification
can lead to stenosis
what causes rheumatic heart disease
group A strep infection with anitgenic mimicry to mprtn epitopes in heart valves
ALSO SEE
- arthritis of joints
- erythema marginatum
- subcutaenous nodules
- chorea
- couple weeks after pharyngitis
what is pancarditis
inital infection of rheumatic heart disease which effects the whole heart
pericarditis is
fibrinous
myocarditis
aschoff bodies
which valve is most involed with rheumatic heart disease
mitral
then aortic, tricuspid, pulmonic
what do catepillar cells indicate
pancarditis
what does fish mouth indicate
rheumatic heart disease
atrial view of mitral valve
key histological change in tissue with mitral valve prolapse
myxomatous degeneration
midsystolic click indicates
mitral valve prolapse
would you rather have an endocardial infection with staph aureus or strep viridian
step viridians because associated with subacute IE and can be treated with antibiotics
staph aureus is associated with acute IE and is destructive, often requiring surgery, high mortality
major criteria for infectious endocarditis
- 2 positive blood cultures
- echocardiogram identification
- new vavlular regurgitation
4 signs of IE
- splinter hemorrhages
- Janeway lesions
- Roth spots
- Osler nodes
infection of the heart muscle itself
myocarditis
most common cause of myocarditis
coxsackieviruses A and B
how can you tell if it is a a primary(myocarditis) or secondary inflammation?
MI- neutroplils, secondary inflammation
myocarditis - virus cause- lymphocytic infection
borrelia and myocarditis
lyme disease
heart with chagas infection
dilated floppy heart
**amastigotes (cause inflammation and destroy heart tissue)
heart disease resulting from an abnormality in myocardium
cardiomyopathy
assymetric thickening of ventricles
hypertrophic cardiomyopathy
ptrns abnormal in muscle cells
looks normal, but muscle rigid and does not expand
restrictive cardiomyopathy
due to amyloid deposits, radiation
very dilate and weak LV and LA
dialted cardiomyopathy
large fibers that are weak and do not contract well
how will muscular dystrophy affect the heart?
hypertrophic cardiomyopathy
how would storage disorders affect the heart>
hypertrophic cardiomyopathy
most common cause of sudden death in young athletes
hypertrophic cardiomyopathy
type of heart failure for dilated cardiomyopathy
systolic dysfunction
type of heart failure with hypertrophic and restrictive cardiomyopathy
diastolic dysfunction
