Acquired heart diseases

Question 1

Name causes of acquired heart diseases

Answer 1

1. Pericardium
   - pericarditis
   - pericardial effusion
2. Myocardium
   - myocarditis
   - cardiomyopathy
3. Endocardium
   - RHD
   - IE
4. Vascular
   - vasculitis

Question 2

Name causes of pericarditis

Answer 2

Infectious 
- 3rd world TB, S Aureus, pneumococcus
- 1st world cox, herpes, mumps, HIV
Autoimmune (SLE, RhF, JRA)
Cancer
Radiation
Renal failure
Drugs (INH, warfarin, heparin, cyclosporine)
Postpericardiotomy syndrome

Question 3

Name causes of pericardial effusion

Answer 3

Transudate - CCF, viral, thyroid, nephrotic syndrome
Exudate - TB, S Aureus, empyema
Haemorrhagic - malignancy, trauma

Question 4

Name causes of myocarditis

Answer 4

Viral - adeno, influenza, RSV, cox, entero, CMV, polio, EBV, PB19, corona
Bacterial - m pneumo, brucella, haemophilus, cholera, rickettsia
Protozoa - trypanosoma, toxoplasma
Fungal - aspergillus
Parasitic - ascaris, echinococcus, bilharzia, taenia solium
Toxins (chemo, alcohol, CO, snake venom, heavy metals, electric shock, radiation)
Autoimmune (SLE, scleroderma, sarcoidosis)

Question 5

Name types of cardiomyopathy

Answer 5

Restrictive (fibrotic, rigid mm)
Hypertrophic (grossly thickened)
Dilated (huge, weak heart)

Question 6

Which cardiomyopathy results in arrythmias?

Answer 6

Dilated

Question 7

Name causes of vasculitis?

Answer 7

Great aa - Takayasu, syphilis, HIV
Medium aa - Kawasaki, HIV
Small aa - bacteremia, varicella, HIV

Question 8

What are the functions of the pericardium?

Answer 8

1. Sets heart in mediastinum and limits motion
2. Protects from infections from other organs
3. Prevents excessive dilation
4. Lubricates the heart

Question 9

How do patients with pericarditis present clinically?

Answer 9

Chest pain
Fever
Weakness
Palpitations
Tachycardia
Pericardial rub
CCF
Distended neck veins
Hepatomegaly

Question 10

Which malignancies can cause pericardial effusion?

Answer 10

Mesothelioma
Breast Ca
Lung Ca

Question 11

What is Dressler syndrome?

Answer 11

An immune system response after damage to heart tissue or to the sac surrounding the heart (surgery)

Question 12

How do patients with pericardial effusion present clinically?

Answer 12

Chest pain
Dyspnoea
Low BP
Muffled heart sounds
Distended neck veins
Heptomegaly
Pulsus paradoxus

Question 13

Which electrolytes are important for the myocardium?

Answer 13

Calcium
Magnesium
Potassium

Question 14

How do patients with myocarditis present clinically?

Answer 14

High fever
Severe tachycardia
Low CO

Question 15

How do patients with infective endocarditis present clinically?

Answer 15

Splenomegaly
CCF
Lung abscess, meningitis, CVA, renal abscess
Splinter haemorrhages
Janeway lesions
Osler nodes
Haematuria
Clubbing

Question 16

Name causes of infective endocarditis

Answer 16

Common

• strep viridans
• staph aureus
• group D strep

Uncommon

• strep pneumo
• haemophilus
• HACEK
• fungi
• pseudomonas

Question 17

Which vessels are most affected by Kawasaki disease?

Answer 17

Coronary arteries

Question 18

Which vessels are most affected by Takayasu arteritis?

Answer 18

Aortic aa
Pulmonary aa
Renal aa

Question 19

Name causes of arrythmias

Answer 19

Cardiomyopathy
Myocarditis
Surgery
Trauma
Infections
Toxins
Electrolyte abnormalities

Question 20

Which cardiac structures are most likely to be affected in HIV?

Answer 20

DCMO (myocardium)

Vasculitis (vessels)