Cardiac Disorders Flashcards
Heart layer most susceptible to damage on stable angina
Endocardium
Subendocardial ischemia ECG change
ST depression
Unstable angina cell injury is reversible. TRUE OR FALSE
TRUE
Vasospasm of the coronary artery unrelated to exertion, leading to chest pain
Prinzmetal Angina
ECG manifestation of prinzmetal angina
ST elevation (transmural damage)
TRUE OR FALSE: Myocardial infarction requires complete occlusion of coronary artery
TRUE
Most sensitive and specific marker of MI
Troponin I
Cardiac marker rises 4-6 hours, and returns to normal after 72 hrs, useful for detecting reinfarction
CK-MB
Calcium reentry in necrotic cell leads to what finding in MI
Contraction band necrosis
Return of oxygen, generating free radicals which further injure dead myocardium
Reperfusion injury
Coagulative necrosis begins after how many hours of MI
4 hours
Sequence of events in MI
4 hrs Coagulative necrosis –
1 day - inflammation neutrophil macrophage (yellow pallor) –
1 week granulation –
1 month - fibrosis
Pathogenesis of myocardial wall rupture post MI
Macrophage eating infarcted debris, leading to weak wall
Fibrous scar is weaker than myocytes
Papillary muscle rupture is associated with occlusion of what vessel
Right coronary artery
Transmural infarction which leads to autoimmune pericarditis 6-8 weeks post infarction
Dressler syndrome
Sudden cardiac death is usually caused by
Fatal ventricular arrythmia
mitral valve prolapse
cardiomyopathy
Hemosiderin laden macrophages in the alveolar air sac is associated with
Congestive Heart Failure (pulmonary edema)
Most common cause of right sided heart failure
Left sided heart failure
Most common congenital heart defect
VSD
Congenital heart disease associated with fetal alcohol syndrome
VSD
Most common type of ASD
Ostium secundum
CHD associated with Down Syndrome?
Ostium primum ASD
Split of the S2 is associated with
Atrial Septal Defect
CHD associated with congenital rubella
Patent ductus arteriosus
Cyanosis of the lower extremities is associated with
Eisenmegerization of a Patent Ductus Arteriosus
Prostaglandin which keeps PDA open
PGE
Treatment which closes PDA
Indomethacin - PGE is reduced
TET spell logic
Squatting increases iarterial vascular resistance, so more blood is shunted to the lungs
TGA is associated with what maternal condition
Diabetes
Treatment for TGAwhile waiting for surgical repair
PGE2
Coarctation of the aorta infantile type is associated with?
PDA - distal to coarctation (cyanotic in)
Turner Syndrome
Adult form Coarctation is associated with
Bicuspid aortic valve
Manifestations of CoArc
Engorged intercostal collateral
Upper extremity HTN, and Lower extremity weak pulse
Rib notching is associated with
Coarctation of aorta - engorged intercostal collaterals cover the ribs, making it look like it is notched
Aschoff bodies are associated with?
Rheumatic heart disease myocarditis - fibrinoid material with histiocytes
Anitschkow cells or caterpillar cells are associated with
Rheumatic heaart disease - dfound in the aschoff bodies
Systolic ejection click with crescendo-decrescendo murmur is associated with what valvular disease
Aortic stenosis
Most common cause of aortic regurgitation
Isolated aortic root dilatation (ex: syphislis)
Early, blowing diastolic murmur with hyperdynamic circulation is associated with
Aortic regurgitation
Bounding pulses, pulsaing nail bed, wide pulse pressure is associated witgh what valvular disease
Aortic regurgitation
Concentric vs eccentric hypertrophy
Concentric - AS - pressure
Eccentric - AR - volume
Myxoid degeneration of mitral valve leads to
Mitral valve prolapse (MR)
Mid systolic click with systolic murmur is caused by
Mitral Valve prolapse
Papillary muscle rupture leads to what valvular problem
MR
Holosystolic blowing murmur louder in squatting or expiration is heard in what disease
Mitral Regurgitation
Opening snap followed by a diastolic rumble is associated by
Mitral Stenosis
Acute vs Chronic Rheumatic heart disease lesion
Acute - MR
Chronic - MS
Arrythmia associated with Mitral Stenosis
Atrial fibrillation
Most common cause of endocarditis (organism)
Streptococcus viridans (low virulence, subacute)
Pathogenesis of IE
Endocardial surface damage, develops thrombotic vegetations, then transient bacteria traps bacteria
Acute endocarditis caused by IV drug users caused by what organism
Staph aureus
Caused endocarditis in prosthetic heart valves
Staph epidermis
Causes endocarditis in patients with colorectal carcinoma
S. bovis
Endocarditis with negative blood cultures
HACEK
Hemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella
Janeway lesions and Osler nodes are associated with
Infective endocarditis
Causes of nonbacterial endocarditis
Hypercoagulable state
Adenocarcinoma
Libman sacks endocarditis morphology
Vegetations on both sides of valve
Most common cardiomyopathy
Dilated
Cardiac cycle affected by dilated cardiomyopathy
Dilated
Most common genetic mutation inheritance in dilated cardiomyopathy
Autosomal dominant
Pregnancy cardiomyopathy
Dilated
Infectgion common in dilated cardiomyopathy
coxsackie virus
Genetic mutation in hypertrophic cardiomyopathy
sarcomere protein
Sudden death in athletes is associated with
hypertrophic cardiomyopathy
Loeffler syndrome is
Eosinophilic infiltration of heart –> restrictive cardiomyopathy
Low voltage ecg with decreased QRS complex is found in what cardiomyopathy
Restrictive
Benign mesenchymal proliferation with gelatinous appearance
Myxoma
Most common primary cardiac tumor in adults
Myxoma
Location of myxoma
Left atrium -
Benign hamartoma of cardiac muscle
Rhabdomyoma
Most common primary cardiac tumor in children
Rhabdomyoma
Location of rhabdomyoma
Ventricle
Rhabdomyoma is associated with
Tuberous sclerosis
Metastasis to heart usually are in
Pericardium
Common tumors metastasizing to heart
Melanoma, breast, lymphoma
