1B: Pathology of Heart Wall disorders Flashcards
How does Acute pericarditis present (Manifestations?)
- Triad of chest pain (abrupt, precordial, sharp)
- Friction rub (rubbing and friction betwn the inflammed pericardial surfaces)
- ECG changes
What is acute pericarditis?
- Acute inflammation (< 2 weeks) of the pericardium
- Often infectious (bacterial, viral or fungal)
- Can be due to an autoimmune disease (RA, SLE), trauma, drug toxicity
How does this affect the heart?
1) Fluid around the heart compresses heart wall
2) Heart cant expand to fill
3) Backup into systemic circulation
4) Decreased blood flow to the lungs
5) Decreased output to the body
What is pericardial effusion?
-The accumulation of excess fluid (Exudate) in the pericardial
sac–>The amount of fluid, the rapidity with which it accumulates & the elasticity of pericardium determines the effect effusion has on cardiac fxn.
____________ does not tolerate the sudden increase in heart size or the amount of fluid in the pericardial sac.
Pericardial sac
What are the types of pericarditis?
1) Serous pericarditis
2) Fibrinous pericarditis
3) purulent pericarditis
4) hemorrhagic pericarditis
What is serous pericarditis?
associated with systemic lupus erythematosus (SLE), Rheumatic fever, and a variety of viral infections.
-Characterized by production of clear, straw-colored, protein rich exudate containing small numbers of inflammatory cells.
What is Fibrinous pericarditis?
- Characterized by a fibrin-rich exudate.
- IT may be caused by uremia, myocardial infarction, or acute rheumatic fever
What is purulent pericarditis?
- Characterized by a grossly cloudy exudate.
- Almost always caused by bacterial infections
What is hemorrhagic pericarditis?
- Characterized by a bloody exudate
- Usually result from tumor invasion of the pericardium but also can result from TB or other bacterial infections.
What is Cardiac Tamponade?
- An increase in pericardial sac pressure caused by an accumulation of fluid in the pericardial sac.
- This results in reduced ventricular filling and subsequent hemodynamic compromise
Is cardia tamponade a medical emergency? explain
Yes, overall risk of death depends on the speed of diagnosis, the treatment provided, and the underlying cause of the tamponade.
How is pericardiocentesis done?
using a subxiphoid approach or parasternal approach
What is myocardial disease?
Disorders originating from within the myocardium, but not from cardiovascular disease
What are the 2 major forms of myocardial disease?
1) Myocarditis
2) Primary cardiomyopathies
What is myocarditis ?
- Inflammation of the heart muscle (and conduction system) without evidence of myocardial infraction
- Heart is thick and swollen
What are the causes of myocarditis?
1) #1 cause is VIRAL
2) drug toxicity (e.g cocaine)
3) autoimmune diseases
What does a myocarditis patient present as?
As bi-ventricular heart failure in young persons who do not have valvular, rheumatic or congenital heart disease.
What is Primary Cardiomyopathies ?
Diseases of the heart muscle that are non-inflammatory and are not associated w/ hypertension, congenital heart disease, valvular disease, or coronary artery disease
What is the onset of Primary Cardiomyopathies like?
Is silent, and symptoms do not occur until the disease is well advanced.
When is the diagnosis of Primary Cardiomyopathies suspected?
is suspected when a young, previously healthy, normotensive person experiences cardiomegaly and heart failure.
How are Primary Cardiomyopathies detected?
with PE Pulmonary Effusion (particularly in athletes )
What is the most common form of Primary Cardiomyopathies?
Dilated Cardiomyopathy
What is dilated cardiomyopathy ?
progressive cardiac hypertrophy and dilation & impaired pumping ability in one or both ventricles
