cardiac diseases Flashcards
What is the definition of myocarditis?
Inflammation of the myocardium, typically affecting young males.
Myocarditis can lead to various cardiac complications.
What are common viral causes of myocarditis?
- HHV6
- Coxsackie (most common cause in UK)
- Parvovirus B19
Viral infections are a leading cause of myocarditis.
What bacterial infections can lead to myocarditis?
- Group A beta hemolytic strept
- Lyme disease
- Mycoplasma
Bacterial causes are less common but significant.
What autoimmune condition is associated with myocarditis?
Systemic lupus erythematosus (SLE)
SLE can lead to inflammation of the myocardium.
Which medications have been linked to myocarditis?
- Sulfonamides
- Adriamycin
Certain drugs can induce myocardial inflammation.
What are the common symptoms of myocarditis?
- Fatigue
- Chest pain
- Pericarditis
- Arrhythmias
- Congestive heart failure (CHF)
- May be asymptomatic
Symptoms can vary widely among patients.
What ECG findings are associated with myocarditis?
- Sinus tachycardia
- Low voltage
- Electrical alternans
- ST elevation
- May have any ECG pattern
ECG changes can be quite variable in myocarditis.
What laboratory tests are important in the diagnosis of myocarditis?
- Elevated cardiac enzyme levels
- Increased ESR
- Serum viral titers
These tests help in assessing myocardial injury and inflammation.
What imaging findings might be seen on a chest X-ray in myocarditis?
Cardiomegaly
An enlarged heart may indicate myocarditis.
What echocardiogram finding may be present in myocarditis?
Decreased ejection fraction (EF)
This finding indicates impaired cardiac function.
What is the pathology of coarctation of the aorta?
Congenital narrowing of the aorta distal to the insertion of the ductus arteriosus.
This condition leads to significant hemodynamic changes.
What are the classic presentations of coarctation of the aorta?
- Chest pain
- Murmur
- Hypertension in a young patient
- Radio-femoral delay
- Mid-late systolic murmur
- 70% have a bicuspid aortic valve
These signs and symptoms help in clinical diagnosis.
What is the significance of radio-femoral delay in coarctation of the aorta?
It indicates delayed pulses in the legs due to reduced perfusion.
This is a key clinical finding in diagnosing coarctation.
What imaging finding is indicative of coarctation of the aorta?
Rib notching on chest X-ray due to erosion by collateral arteries.
Rib notching is a classic sign of chronic coarctation.
What is the normal range for pulmonary artery pressure (PAP)?
10-14 mmHg
This is considered very low compared to systemic arterial pressures.
What defines pulmonary hypertension?
PAP > 25 mmHg at rest
This condition can lead to right heart failure (RHF).
What are the main pathological changes in pulmonary hypertension?
Increase in pulmonary vascular resistance and increase in pulmonary blood flow
What are common clinical presentations of pulmonary hypertension?
- Exertional dyspnea
- Lethargy and fatigue
- Loud pulmonary S2 sound
- Right parasternal heave
- RHF symptoms (peripheral edema, hepatomegaly, distended JVP, prominent V wave)
What is the primary diagnostic tool for pulmonary hypertension?
Right heart catheterization
This confirms increased PAP and determines pulmonary wedge pressure (PWP).
What other diagnostic methods are used in pulmonary hypertension?
- CXR
- ECG
- Echocardiogram
These help identify the underlying cause.
What are the treatment options for pulmonary hypertension?
- Oxygen
- Warfarin
- Diuretics
- Oral CCB
- Treat underlying cause
What causes pulmonary artery prominence due to high volume?
- Left to right shunt (VSD, ASD, PDA)
- Plethoric lung field
- QP:QS > 2:1
- Frequent, severe chest infections
- Cardiac overactivity (ASD → LPH)
- Hyperdynamic apex (VSD, PDA)
- Cardiomegaly
What are the symptoms of high volume pulmonary artery prominence?
No murmur or symptoms until regression of pulmonary vascular resistance after the newborn period
What causes pulmonary artery prominence due to high pressure?
- Pulmonary HTN
- Left heart disease
- Eisenmenger syndrome
- Chronic lung disease
- Recurrent pulmonary TE
- CT diseases (SLE, scleroderma)
- Peripheral pulmonary artery stenosis
What are the treatment options for high pressure pulmonary artery prominence?
- Bosentan
- Sildenafil
What are the examination findings in high pressure pulmonary artery prominence?
- Loud P2
- Left parasternal heave (RVH)
- Graham steel murmur (early diastolic)
- PR and TR murmurs
- JVP: Prominent a from RVH, Prominent V from TR
What is the characteristic lung field finding in pulmonary stenosis?
Oligemic lung field
What population is most affected by pulmonary stenosis?
Young, asymptomatic patients
What happens in valvular pulmonary stenosis over time?
Starts acyanotic then becomes R-L shunt
What are the examination findings in pulmonary stenosis?
- Heave
- Systolic thrill
- JVP: Prominent a
- Ejection systolic murmur best at inspiration
- Soft P2 and delayed
