Acquired cardiac pathology

Question 1

From which aortic branch do the coronary arteries emerge?

Answer 1

1st

Question 2

Layers of coronary arteries

Answer 2

• Adventitia
• Muscle
• Intima (inner, endothelium, connective tissue and internal elastic lamina)

Question 3

What is atherosclerosis?

Answer 3

Luminal narrowing due to plaque build up

Question 4

Vasculitis

Answer 4

Inflammation of coronary arteries

Question 5

Investigating heart pain

Answer 5

• ECG
• Blood markers - troponins, cardiac enzymes
• Cardiac CT or angiography

Question 6

4 heart valves and their locations

Answer 6

RHS: tricuspid separates RA and RV, pulmonary valve between RV and PA

LHS: mitral separates LA and LV, aortic separates LV and Ao

Question 7

Incompetent valves

Answer 7

Regurgitation - e.g. due to acute muscle rupture

Question 8

Aortic stenosis

Answer 8

• Separates LV and aorta
• Makes it difficult to pump blood into systemic circulation
• Left ventricular hypertrophy occurs when muscle of LV increases to overcome resistance
• Sx: chest pain, tiredness, palpitation, heart murmur

Question 9

Symptoms of conduction defect

Answer 9

• Palpitations
• Syncope
• Thromboembolism
• Sudden death

Question 10

Heart muscle pathology

Answer 10

• Can be due to ischaemia, cardiomyopathy, hypertrophic/dilated heart muscles
• LHS heart failure = pulmonary oedema
• RHS heart failure = peripheral oedema/hepatomegaly/ascites
• Stasis of blood, abnormalities of vessel wall and abnormalities of blood composition are Virchow’s triad