3: Cardiac Pathology 2

Question 1

Most common structural birth defect

Answer 1

Congenital heart abnormality

Question 2

Most common congenital heart disease**

Answer 2

VSD

Question 3

General presentation of left->right vs right->left shunts

Answer 3

LtR: initially asymptomatic
RtL: cyanotic and symptomatic bc blood bypasses pulmonary circulation

Question 4

Three left to right shunts

Answer 4

1. ASD
2. VSD
3. PDA

Question 5

Three right to left shunts

Answer 5

1. tetralogy of fallot
2. Transposition of great arteries
3. Tricuspid atresia

Question 6

Mortality of ASD and why

Answer 6

Low, bc most smaller defects spontaneously close

Question 7

What % of small VSDs close spontaneously

Answer 7

50-75%

Question 8

What congenital heart defect causes increased pulmonary pressure and can cause pulmonary HTN?

Answer 8

PDA

Question 9

Most common cyanotic congenital heart disease

Answer 9

Tetralogy of fallot

Question 10

Paradoxical embolism

Answer 10

Embolism in an individual that normally would only go to lungs but ended up elsewhere due to a heart defect

Question 11

Where would a paradoxical embolism end up if a pt has PDA?

Answer 11

Lower body

Question 12

Most common genetic cause of congenital heart disease

Answer 12

Down syndrome

Question 13

Physiologic mechanism of cor pulmonale

Answer 13

Poorly functioning alveolus -> hypoxia -> increased lung pressure -> increased right heart pressure

Question 14

Most common valve abnormality

Answer 14

Calcification aortic stenosis

Question 15

Timeline of death in aortic stenosis once: angina, syncope, and CHF develop

Answer 15

Angina: die in 5 years
Syncope: die in 3 years
CHF: die in 2 years

Question 16

Three most common valves affected (in order) in rheumatic heart disease**

Answer 16

MAT: mitral -> aortic -> tricuspid

Question 17

Which two bacterial can cause early (<2 months) prosthetic valve infection once in the body? (Infective endocarditis)

Answer 17

Staph aureus, staph epidermidis

Question 18

In carcinoid heart disease, why do lesions only occur on the right side?

Answer 18

Left side protected by pulmonary vascular degradation of mediators

Question 19

Major risk in a mechanical valve vs tissue valve (bioprosthetic)

Answer 19

Mechanical: thromboembolism

Tissue valve: mechanical failure (tearing, incompetence)

Question 20

Definition of cardiomyopathy

Answer 20

Heart is structurally and functionally abnormal with mechanical and/or electrical dysfunction in the absence of CAD, HTN, valvular disease, and congenital heart disease