3: Cardiac Pathology 1 Flashcards
Leading cause of death in the US
Heart disease
What determines dominance pattern of blood supply to the heart?
Supply of lower posterior heart thru posterior descending artery (PDA) - can be right, left, or co-dominant
What vessel pattern is dominant in 65-70% of hearts?
Right dominant
Most sensitive and specific biomarkers of myocardial damage (2)
Troponin T and I (cTnT, cTnI)
Primary and secondary pacemaker of the heart
Primary: SA node
Secondary: AV node
What happens if SA node is damaged?
AV node takes over primary pacemaker function
Average bpm of SA vs AV node
SA: 60-100 bpm
AV: 40-60 bpm
Most common cause of sudden cardiac death
CAD -> arrhythmia -> ischemia
5 Common causes of sudden cardiac death in younger patients
- Drug abuse
- Hereditary conduction abnormalities
- Hypertrophic or dilated cardiomyopathy
- Myocarditis
- Mitral valve prolapse
What happens in diastolic vs systolic dysfunction
Diastolic: loss of ability to fill ventricles
Systolic: loss of myocardial contractile function
Three most common causes of left sided heart failure (CHF)
- Ischemic heart disease
- HTN
- L-sided valve disease
Normal amount and color of pericardial fluid
<50mL of clear/straw colored fluid
What type of tumors are myxomas, lipomas, papillary fibroelastomas, and rhabdomyomas?
Benign
Most common malignant tumor of the heart
Angiosarcoma
Most common cardiac tumor in adults**
Myxoma
Most common cardiac tumor in children**
Rhabdomyoma
Four things in McCune-Albright syndrome
- Polyostotic fibrous dysplasia
- Cafe au last spots
- Endocrine abnormalities
- Myxomas
Mutation in McCune-Albright syndrome vs Carney complex
McCune Albright: GNAS1
Carney: PRKAR1A null mutation
Carney complex: three things
- Skin lentigines
- Endocrine dysfunction
- Myxomas
What is more common than a primary tumor of the heart?
Metastases from lung, breast, melanoma, or lymphoma
Five effects of tumors in the heart
- Mass effect -> limits filling
- Decreased contractility
- Pericardial effusion
- SVC syndrome
- Circulating mediators/hormones
Heart transplant survival at 1 year vs 5 yrs
1yr: 90%
5yrs: >70%
List of changes in the aging heart**
- Reduction in elasticity/compliance
- Valves: calcification, stenosis, prolapse
- Chambers: LV size reduction, atrial dilation
- Atherosclerosis
- Increase in epicardial fat
- Lipofuscin + amyloid accumulates
- Basophilic degeneration + myocytes loss
Most common cause of arrhythmia**
Ischemic heart disease
Five common causes of arrhythmias
- Ischemic heart disease**
- Cardiomyopathies
- Myocarditis
- Valvular disease
- Congenital disorders
Sick sinus syndrome
SA node is damaged -> bradycardia
Hereditary channelopathies of the heart
Voltage-gated ion channels are abnormal -> arrhythmias
Most common hereditary channelopathy
Long QT syndrome
