8. Cardiac Pathoma Flashcards by Trevor Johnson

Whats an Aortic Dissection

What disorders are prone for Dissections Most common Cause of death

When a rip in the INTIMA of a vessel causes blood to penetrate and create a lumen between intima and media

Literally rips through and dissects the two layers due to Pre-existing weakens of the media (HTN)Connective tissue disorders (Marfan Syndrome)Cardiac tamponade

How well did you know this?

Not at all

Perfectly

Thoracic AneurysmWhat dz most commonly leads to it whats the most common clinical presentatoin

Balloon like dilation of the aorta. must have weakness in the wall Tertiary syphilis - caused by endarteritis of vaso casorum (prevents nutrients to the wall of vessels so it atrophies)Pulsatile abdominal mass

How well did you know this?

Not at all

Perfectly

Chest pain that arises with exertion or stress is ____ What dz commonly leads to it Whats the most common presentatoin

Stable angina

atherosclerosis- not enough blood getting to the heart so it becomes hypoxic/ischemic

Chest pain that radiates to left arm or jaw -St depression Tx- rest or Nitroglycerin

How well did you know this?

Not at all

Perfectly

Chest pain that occurs at rest is ____What causes it? Tx?

Unstable anginaRupture of atherosclerotic plaque with thrombosis and incomplete occlusion of the coronary artery-Nitroglycerin high risk of MI

How well did you know this?

Not at all

Perfectly

Vasospasm of the coronary artery?Tx

Prinzmetal anginatx-CCB’s or Nitrates

How well did you know this?

Not at all

Perfectly

Difference between myocardial infarct (MI) and unstable angina

MI has Thrombosis of a Plaque with complete occlusion. also has IRREVERSIBLE damage to myocytes

unstable angina has about 80% occlusion

How well did you know this?

Not at all

Perfectly

Which chamber of the Heart does MI mostly occur? Which coronary artery usually gets occluded

LEFT VENTRICLE1-Left anterior descending (LAD) anterior wall and atrial septum necrosis2. Right coronary artery-poserior wall of heart

How well did you know this?

Not at all

Perfectly

ST elevation MI (STEMI)What type of infarct thickness?

TransmuralFull thickness

How well did you know this?

Not at all

Perfectly

non ST elevation MI (NSTEMI) thickness?

subendocardial infarcts

How well did you know this?

Not at all

Perfectly

Which enzymes are indicative of an MI

TROPONINrises at 2-4hrspeaks at 24 hrselevated for a weekCK-MBrises and goes down quicklycan be used to determine multiple infarcts

How well did you know this?

Not at all

Perfectly

Which cardiac enzyme is used to determine multiple infarcts

CK-MBbecause it rises and galls quicker than TROPONIN

How well did you know this?

Not at all

Perfectly

Tx for Myocardial infarction

Aspirin/Heparin (to prevent further clotting)Supp. O2NitroglycerinBeta Blockers

How well did you know this?

Not at all

Perfectly

What is the progression of an MI (days weeks months)

1 day / 1 week / 1 monthcoagulative necrosis (dead cells) / Neutrophils and macrophages / granulation tissue and scar

How well did you know this?

Not at all

Perfectly

Type of pericarditis that occurs 6 weeks after an infarct due to autoantibodies against the pericardium

Dresslers Syndrome

How well did you know this?

Not at all

Perfectly

Whats congestive heart failure mainstay treatment?

When the heart fails to pump appropriately (usually backs into the lungs) Tx-ace inhibitors

How well did you know this?

Not at all

Perfectly

Hemosiderin-laden macrophages

Heart failure cells found in lungs with pulmonary edema

How well did you know this?

Not at all

Perfectly

Whats the most common congenital heart defect and what syndrome is it associated with

Ventricular septal defect (VSD) associated with FETAL ALCOHOL SYNDROME

What is the mnemonic for left to right shunt yes right to left?

(R)ight to (L)eft shunts are eaRLy cyanosis(L)eft to (R)ight occur LateR cyanosis

What is atrial septum defect? what defect causes this

defect in the septum between atriumsOsmium secundum defects

Holocystolic machine like murmur cyanosis of lower extremities How do you treat thisWhat disorder is it associated with

Patent ductus arteriousus PDAfailure of ductus arterioles to close cyanosis of lower extremitiesTx-ENDomethacin ends PDACongenital rubella

Tetralogy of Fallot

R–>L shuntmost common cause of eaRLy cyanosis (fixed with squatting)Pulmonary stenosisBoot shaped heart (hypertrophy)Overriding aorta/VSD

Transposition of the Great vessels?What dz is it associated with

Failure of the aorticopulmonary system to spiral (they swap places)Maternal diabets

What is rheumatic fever? What is it usually caused by?

occurs 2-3 weeks after strep throat (alpha-beta hemolytic streptococci) M- proteinJONES criteria which is joints, heart problems, nodules, erythema marginatum, s-chorea arthritis, pan(all layers)carditis (mitral valve), subQ nodules, rash, rapid movement

Jones criteria whats it used to diagnosis

joints, heart problems, nodules, erythema marginatum, s-chorea arthritis, myocarditis (mitral valve), subQ nodules, rash, rapid movement

Aortic Valve Stenosishow do you get it? What cardiopathy and other symptoms does it lead to?

Narrowing of the aortic valve Systolic ejection click followed by crescendo- decrescendo murmur"wear and tear of valve" -presents in late adult hoodor when you have a bicuspid valve instead of (tri)leads to Left ventricular hypertrophySADScope, Angina, and Dyspnea on exertion

Aortic Regurgitation why does it happen?

"blowing murmur"Back flow of blood from aorta into LV during diastoleAortic root DILATION or valve problemsHyperdynamic circulation (bounding pulse, pulsating nail bed, head bobbing)

What is hyper dynamic circulation and what causes it?

Seen in aortic regurgitationBounding pulse, pulsating nail bed, head bobbingthe regurg increases the volume of the next stroke in LV so it keeps adding and adding pressure

Mitral valve prolapse

ballooning of the mitral valve into left atrium during systoleMyxoid degeneration of the valve (floppy)\*mid systolic click\* like a parachute

Mitral Stenosiswhat happens to the atrium

Narrowing of the mitral valve, usually due to rheumatic valve dzOpening snap followed by a rumble LA overload- pulmonary congestion (edema)

Which organism causes Endocarditis (low virulence)

S viridiansmost common cause of endocarditis, infects previously damaged valvesresults in small vegetations that don't destroy valves

Which organism is the most common cause of (acute) Endocarditis in IV drug users and which valve is involved

S. Aureus (acute)Large vegetations on normal valves Most commonly Tricuspid

Which organism causes Endocarditis of prosthetic valves?

S. Epidermidis

Which organism causes Endocarditis with underlying colorectal cancer

S. Bovis

Endocarditis with Negative Blood cultures

HACEKHaemophilus, actinobacilus(aggregatibacter, Cardiobacterium, Eikenella, Kingella)

Clinical features of endocarditis

Fever, murmur, Janeway lesions(painless on palm or sole), Osler (ouch) nodes (painful on fingers or toes)

endocarditis with nodules on both sides of the valveAnd what is it associated with

Libman-Sacks EndocarditisSLEmitral valve

Dilated Cardiomyopathy (most common cardiomyopathy)What causes ittx-

Dilation of all 4 chamberssystolic dysfunction (dilated so it can't contract properly), valve regurgitationABCCCD + palcohol abuse, Beri beri, COXSACKE, cocaine use, Chagas, Doxorubicin toxicity and pregnancyTransplant

Hypertrophic Cardiomyopathywhats a huge problem with this

Hypertrophy of left ventricle commonly due to genetic mutations in Sarcomere proteinDecreased cardiac output due to the heart being so tight. (it can't dilate to get blood in)Can lead to SUDDEN DEATH due to ventricular arrhythmia myofibrillar disarray

Restrictive cardiomyopathywhat are the causes

Decreased compliance of ventricles (won't dilate so you have a diastolic problemssarcoidosis, fibrosis, endocardial fibroelastosis (thick fibroelastic tissue in endocardium of young children), hematochromatosisLOFFLER SYNDROME- endomyocardial fibrosis with a prominent eosinophilic infiltrate

Loffler syndrome and does it lead to

endomyocardial fibrosis with a prominent eosinophilic infiltrateleads to restrictive cardiomyopathy

Myxomaswere does it usually occur (which valve)

Most common primary cardiac tumor in ADULTSUsually occurs in the left atrium and causes syncope described as "Ball valve" obstruction

Rhabdomyoma

most common primary cardiac tumor in CHILDREN associated with tuberous sclerosis