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Spring Cardiac Theory > Cardiac Masses > Flashcards

Cardiac Masses Flashcards

1
Q

How do you diagnose endocarditis?

A

Definitive = 2 major; 1 major + 3 minor; 5 minor
Possible = 1 major + 1 minor; 3 minor

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2
Q

What is considered MAJOR?

A
  1. Positive blood culture
  2. Evidence of endocardial involvement by echo or new murmur
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3
Q

What is considered MINOR?

A
  1. Predisposing heart condition or IV drug use
  2. Fever > 38 C (100.4 F)
  3. Vascular Phenomena
  4. Immunologic Phenomena
  5. Suspect blood culture
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4
Q

What are SIGNS/SYMPTOMS of endocarditis?

A
  1. Can be acute or subacute (more gradual)
  2. Flu like symptoms: fever, fatigue, chills, joint pain, night sweats
  3. New or changed murmur
  4. SOB, chest pain with inspiration, tachycardia
  5. Red spots on hands, fingers, eyes/lids
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5
Q

How does endocarditis present on ECHO?

A
  1. vegetations
  2. regurgitation
  3. paravalvular abscess
  4. paravalvular aneurysm
  5. fistula
  6. prosthetic valve dehiscence
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6
Q

How do VEGETATIONS appear on echo?

A
  1. Irregularly shaped, small pedunculated masses adhered to thickened valve
  2. Attached to proximal side of valve (MV → LA side ; AV → LV side)
  3. Exhibits chaotic motion
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7
Q

Regurgitation due to endocarditis on echo is due to?

A

to leaflet destruction i.e. perforation or from vegetation preventing closure

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8
Q

Paravalvular abscess due to endocarditis appears as what?

A

an echolucent contour outpouching of the infected annulus

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9
Q

Who are CANDIDATES for endocarditis?

A
  1. Patients with preexisting valvular heart disease (rheumatic)
  2. Valve prosthesis or other artificial devices/catheters/wires
  3. Congenital abnormalities
  4. IV drug users/past history of endocarditis
  5. Recent surgical, dental, or medical procedures; gum disease
  6. Lupus, AIDS, autoimmune patients
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10
Q

Endocarditis on AUTOIMMUNE patients is what type?

A

marantic = noninfectious/nonbacterial

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11
Q

Vegetations on AUTOIMMUNE patients are called what?

A

Libman Sachs

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12
Q

NON PRIMARY TUMORS are due from what?

A

another source

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13
Q

What are the common sites of origin for NON PRIMARY TUMORS?

A
  1. Lung, breast, blood account for ¾
  2. Lymph ( lymphomas associated with AIDS have frequent and extensive cardiac involvement)
  3. Others: stomach, skin, melanoma (high rate of pericardial metastases), liver and colon
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14
Q

NON PRIMARY TUMORS often involve what?

A

the pericardium/epicardium

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15
Q

How does NON PRIMARY tumors present on echo?

A
  1. malignant pericardial effusion
  2. pericardial masses, myocardial masses
  3. invading masses from adjacent malignancies
  4. extension type tumors
  5. carcinoid heart disease
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16
Q

What are the types of EXTENSION TUMORS for Non Primary?

A
  1. renal cell carcinoma - fingerlike projection from kidney into RA from IVC
  2. hepatoma - from liver thru IVC
  3. uterine tumors
  4. others that migrate thru PVs
17
Q

What is CARCINOID HEART DISEASE?

A

when metastatic carcinoid tissue in liver produces serotonin leading to thickening, retraction and rigidity of TV, PV and regurgitation

18
Q

PRIMARY TUMORS originate where?

A

the heart

19
Q

What % of PRIMARY tumors are benign?

A

75%

20
Q

What are the TYPES of BENIGN tumors?

A
  1. Myxomas
  2. Papillary Fibroelastoma
  3. Hemagiomas
  4. Mesothelioma on AV node
  5. Lipomatous hypertrophy
  6. Pericardial or bronchogenic cyst
  7. Fibroma
  8. Rhabdomyoma
21
Q

What are the TYPE of MALIGNANT tumors?

A
  1. Angiosarcomas
  2. Rhabdomyosarcomas
  3. Pericardial Mesotheliomas
  4. Fibrosarcomas
22
Q

How do ANGIOSARCOMAS PRESENT?

A

as bloody effusion with tamponade and atrial or pericardial wall masses

23
Q

How RHABDOMYOSARCOMAS PRESENT?

A

forms in soft tissue; striated muscle

24
Q

How do PERICARDIAL MESOTHELIOMAS PRESENT?

A

forms in pericardial lining due to asbestos exposure

25
Q

How do FIBROSARCOMAS PRESENT?

A

forms in fibrous tissue of the heart

26
Q

What is the most common type of CARDIAC MASS?

A

thrombus

27
Q

Name the FOUR types of CARDIAC THROMBUS

A
  1. LV thrombus
  2. LA thrombus
  3. Right heart thrombus
  4. Extracardiac thrombus

Spring Cardiac Theory (11 decks)

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