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BLOCK POSTING > Cardiac Pathology > Flashcards

Cardiac Pathology Flashcards

1
Q

What are the six principal mechanisms that can cause heart failure?

A

1) Failure of the pump
2) Obstruction to flow
3)Regurgitant flow
4)Shuntedflow
5)Disorders of cardiac conduction.
6)Rupture of the heart or major vessel.

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2
Q

What is congenital heart disease and what percentage of birth defects does it account for?

A

Congenital heart disease includes structural abnormalities from faulty embryogenesis; it accounts for 20-30% of all birth defects.

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3
Q

What are the main groups of congenital heart disease based on hemodynamics?

A

1) Left-to-right shunt
2) Right-to-left shunt (cyanotic)

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4
Q

What is the most common type of left-to-right shunt in congenital heart disease?

A

Atrial septal defects (ASDs) ventricular septal defects (VSDs)

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5
Q

What is Eisenmenger syndrome?

A

A condition where prolonged left-to-right shunting leads to pulmonary hypertension and reversal to a right-to-left shunt causing cyanosis.

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6
Q

What is Tetralogy of Fallot?

A

The most common cyanotic congenital heart disease with four key features: VSD right ventricular outflow obstruction

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7
Q

What causes the “boot-shaped” heart in Tetralogy of Fallot?

A

Right ventricular hypertrophy.

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8
Q

What is transposition of the great arteries?

A

A condition where the aorta arises from the right ventricle and the pulmonary artery from the left ventricle causing separation of systemic and pulmonary circulation.

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9
Q

What are the two classic forms of aortic coarctation?

A

1) Infantile (preductal) form
2) Adult (postductal) form.

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10
Q

What are Berry aneurysms?

A

Thin-walled outpouchings in cerebral vessels usually at branch points around the Circle of Willis; can rupture and cause fatal hemorrhage.

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11
Q

What is hypertensive vascular disease and what are its main effects?

A

High blood pressure leading to risks of stroke

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12
Q

What is the essential feature of hypertensive heart disease?

A

Left ventricular hypertrophy causing diastolic filling impairment and increased oxygen demand.

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13
Q

What is cor pulmonale?

A

Right-sided heart disease due to pulmonary hypertension often secondary to chronic lung disease or pulmonary vascular disease.

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14
Q

What are the two main types of arteriosclerosis?

A

1) Arteriolosclerosis (small arteries) with hyaline and hyperplastic types

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15
Q

What is atherosclerosis?

A

An intimal lesion (atheromatous plaque) that can obstruct blood flow rupture

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16
Q

What are modifiable risk factors for atherosclerosis?

A

Modifiable Major Risk Factors
i. Hyperlipidemia and, more specifically, hypercholesterolemia ii.hypertension. iii.cigarette smoking. iv.Diabetes mellitus. v.Inflammation. vi. Hyperhomocysteinemia.
vii. Metabolic syndrome

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17
Q

What is Monckeberg medial calcific sclerosis?

A

Calcification of the media in medium-sized muscular arteries; usually not clinically significant.

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18
Q

What is an aortic dissection?

A

An intimal tear with blood dissecting through the aortic media often due to HTN or connective tissue disorders.

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19
Q

What are the types of aortic dissections?

A

Type A (proximal) involving ascending aorta; Type B (distal) starting beyond subclavian artery.

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20
Q

What are the common causes of ischemic heart disease?

A

Reduced coronary blood flow due to atherosclerosis coronary thrombosis

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21
Q

What is angina pectoris and what are its types?

A

Chest pain from ischemia without cell death; types include stable

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22
Q

What are transmural and subendocardial infarctions?

A

Transmural: full-thickness infarct with ST elevation (STEMI). Subendocardial: inner third infarct without ST elevation (NSTEMI).

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23
Q

What is reperfusion injury?

A

Additional injury when blood flow is restored to previously ischemic tissue leading to inflammation and capillary damage.

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24
Q

What is dilated cardiomyopathy (DCM)?

A

A disease with four-chamber hypertrophy and dilation causing systolic dysfunction and heart failure.

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25
Q

What is hypertrophic cardiomyopathy (HCM)?

A

A condition with thickened ventricular septum hypercontractile heart

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26
Q

What is restrictive cardiomyopathy?

A

A rare condition with rigid ventricles and reduced cardiac output but normal contractility.

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27
Q

What is arrhythmogenic right ventricular cardiomyopathy?

A

Right ventricular failure and arrhythmia caused by defective desmosomes leading to fatty infiltration of the RV wall.

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28
Q

What are the two main causes of vasculitis?

A

1) Immune-mediated inflammation
2) Direct vascular invasion by infectious pathogens.

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29
Q

What is Takayasu arteritis?

A

Granulomatous vasculitis of large arteries causing weakened pulses and ocular symptoms

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30
Q

What is Kawasaki disease?

A

A self-limited vasculitis in children that affects medium-sized arteries especially coronary arteries

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31
Q

What is ischemic heart disease (IHD)?

A

A group of syndromes related to myocardial ischemia; the leading cause of death in the US.

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32
Q

What is the most common cause of IHD?

A

Atherosclerosis of coronary arteries, which decreases blood flow to the myocardium.

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33
Q

What are risk factors for IHD?

A

Similar to those for atherosclerosis, with incidence increasing with age.

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34
Q

What is stable angina?

A

Chest pain arising with exertion or emotional stress due to >70% coronary artery stenosis.

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35
Q

What type of injury occurs in stable angina?

A

Reversible injury to myocytes (no necrosis).

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36
Q

What are symptoms of stable angina?

A

Chest pain lasting < 20 minutes, radiating to left arm or jaw, with diaphoresis and shortness of breath.

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37
Q

What does EKG show in stable angina?

A

ST-segment depression due to subendocardial ischemia.

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38
Q

How is stable angina relieved?

A

By rest or nitroglycerin.

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39
Q

What is unstable angina?

A

Chest pain that occurs at rest, usually due to rupture of an atherosclerotic plaque with thrombosis and incomplete coronary artery occlusion.

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40
Q

What type of injury occurs in unstable angina?

A

Reversible injury to myocytes (no necrosis).

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41
Q

What does EKG show in unstable angina?

A

ST-segment depression due to subendocardial ischemia.

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42
Q

How is unstable angina relieved?

A

By nitroglycerin.

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43
Q

What is the main risk associated with unstable angina?

A

High risk of progressing to myocardial infarction.

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44
Q

What is Prinzmetal angina?

A

Episodic chest pain unrelated to exertion, due to coronary artery vasospasm.

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45
Q

What does EKG show in Prinzmetal angina?

A

ST-segment elevation due to transmural ischemia.

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46
Q

How is Prinzmetal angina relieved?

A

Nitroglycerin or calcium channel blockers.

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47
Q

What is a myocardial infarction (MI)?

A

Necrosis of cardiac myocytes due to ischemia.

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48
Q

What is the most common cause of MI?

A

Rupture of an atherosclerotic plaque with thrombosis and complete occlusion of a coronary artery.

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49
Q

What are other causes of MI?

A

Coronary artery vasospasm (Prinzmetal angina or cocaine), emboli, and vasculitis (e.g., Kawasaki disease).

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50
Q

What are clinical features of MI?

A

Severe, crushing chest pain lasting > 20 minutes, radiating to the left arm or jaw, with diaphoresis and dyspnea.

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51
Q

Does nitroglycerin relieve pain in MI?

A

No, symptoms are not relieved by nitroglycerin.

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52
Q

What part of the heart is most commonly affected in MI?

A

The left ventricle (LV); right ventricle (RV) and atria are generally spared.

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53
Q

What does occlusion of the left anterior descending artery (LAD) cause?

A

Infarction of the anterior wall and anterior septum of the left ventricle; LAD is the most commonly involved artery in MI.

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54
Q

What does occlusion of the right coronary artery (RCA) cause?

A

Infarction of the posterior wall, posterior septum, and papillary muscles of the left ventricle; RCA is the second most commonly involved artery.

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55
Q

What does occlusion of the left circumflex artery cause?

A

Infarction of the lateral wall of the left ventricle.

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56
Q

What does the initial phase of infarction cause?

A

Subendocardial necrosis involving < 50% of myocardial thickness (subendocardial infarction).

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57
Q

What does EKG show in a subendocardial infarction?

A

ST-segment depression.

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58
Q

What does severe ischemia cause in MI?

A

Transmural necrosis involving most of the myocardial wall (transmural infarction).

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59
Q

What does EKG show in a transmural infarction?

A

ST-segment elevation.

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60
Q

What are the main cardiac enzymes in MI diagnosis?

A

Troponin I (most sensitive and specific) and CK-MB (useful for detecting reinfarction).

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61
Q

How do troponin I levels change after MI?

A

They rise 2-4 hours post-MI, peak at 24 hours, and normalize in 7-10 days.

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62
Q

What is CK-MB used for in MI?

A

Detecting reinfarction; levels rise 4-6 hours post-MI, peak at 24 hours, and normalize in 72 hours.

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63
Q

What are treatments for MI?

A

Aspirin/heparin, oxygen, nitrates, beta-blockers, ACE inhibitors, fibrinolysis or angioplasty.

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64
Q

What is contraction band necrosis?

A

Hypercontraction of myofibrils upon reperfusion of irreversibly-damaged cells.

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65
Q

What is reperfusion injury?

A

Free radical damage when oxygen and inflammatory cells return to ischemic tissue.

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66
Q

What is sudden cardiac death?

A

Unexpected death due to cardiac disease, often from fatal ventricular arrhythmia.

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67
Q

What is the most common cause of sudden cardiac death?

A

Acute ischemia, with 90% of patients having severe preexisting atherosclerosis.

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68
Q

What is chronic ischemic heart disease?

A

Poor myocardial function due to chronic ischemic damage, leading to congestive heart failure (CHF).

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69
Q

What is congestive heart failure (CHF)?

A

A condition of pump failurewhich can involve either right- or left-sided heart failure.

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70
Q

What are common causes of left-sided heart failure?

A

Ischemia hypertension

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71
Q

What clinical features result from left-sided heart failure?

A

Decreased forward perfusion and pulmonary congestion.

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72
Q

What symptoms does pulmonary congestion cause in left-sided heart failure?

A

Dyspnea paroxysmal nocturnal dyspnea

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73
Q

What are “heart failure cells”?

A

Hemosiderin-laden macrophages resulting from burst capillaries in pulmonary congestion.

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74
Q

How does left-sided heart failure affect the kidneys?

A

Decreased renal perfusion activates the renin-angiotensin system leading to fluid retention and worsening CHF.

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75
Q

What is the mainstay treatment for left-sided heart failure?

A

ACE inhibitors.

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76
Q

What are common causes of right-sided heart failure?

A

Most commonly left-sided heart failure as well as left-to-right shunts and chronic lung disease (cor pulmonale).

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77
Q

What clinical features result from right-sided heart failure?

A

Congestion in systemic circulation causing symptoms such as JVD

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78
Q

What is “nutmeg liver”?

A

A congested liver appearance due to right-sided heart failure which may progress to cardiac cirrhosis.

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79
Q

What are congenital heart defects?

A

Structural abnormalities arising during embryogenesis typically between weeks 3-8.

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80
Q

What is the most common congenital heart defect?

A

Ventricular septal defect (VSD).

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81
Q

What is Eisenmenger syndrome?

A

A condition where prolonged left-to-right shunting causes pulmonary hypertension and shunt reversal leading to late cyanosis.

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82
Q

What are the main types of congenital heart defects based on shunting?

A

Left-to-right shunts and right-to-left shunts.

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83
Q

What is a ventricular septal defect (VSD)?

A

A defect in the septum dividing the right and left ventricles leading to a left-to-right shunt.

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84
Q

What congenital condition is VSD associated with?

A

Fetal alcohol syndrome.

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85
Q

What is the typical treatment for VSD?

A

Surgical closure though small defects may close spontaneously.

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86
Q

What is an atrial septal defect (ASD)?

A

A defect in the septum dividing the right and left atria most commonly of the ostium secundum type.

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87
Q

What congenital condition is the ostium primum type of ASD associated with?

A

Down syndrome.

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88
Q

What is a key complication of ASD?

A

Paradoxical emboli.

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89
Q

What is patent ductus arteriosus (PDA)?

A

Failure of the ductus arteriosus to close after birth leading to a left-to-right shunt.

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90
Q

What congenital condition is PDA associated with?

A

Congenital rubella.

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91
Q

What is the clinical presentation of PDA?

A

Asymptomatic at birth with a “machine-like” murmur may progress to Eisenmenger syndrome.

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92
Q

What is the treatment for PDA?

A

Indomethacin which decreases PGE to promote closure.

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93
Q

What is Tetralogy of Fallot?

A

A congenital heart defect characterized by four features: right ventricular outflow obstruction right ventricular hypertrophy

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94
Q

How does Tetralogy of Fallot typically present?

A

Early cyanosis due to right-to-left shunting.

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95
Q

What is a classic finding on X-ray for Tetralogy of Fallot?

A

“Boot-shaped” heart.

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96
Q

What is transposition of the great vessels?

A

A congenital condition where the pulmonary artery arises from the left ventricle and the aorta from the right ventricle.

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97
Q

What condition is associated with transposition of the great vessels?

A

Maternal diabetes.

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98
Q

What is required for survival in transposition of the great vessels?

A

Creation of a shunt (e.g. maintaining a PDA with PGE until surgery).

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99
Q

What is truncus arteriosus?

A

A single large vessel arising from both ventricles due to failure of truncus division.

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100
Q

What is tricuspid atresia?

A

Failure of the tricuspid valve to develop resulting in a hypoplastic right ventricle and an associated right-to-left shunt.

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101
Q

What is coarctation of the aorta?

A

Narrowing of the aorta which can present in infantile or adult forms.

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102
Q

What is infantile coarctation of the aorta associated with?

A

A patent ductus arteriosus (PDA) and is commonly seen in Turner syndrome.

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103
Q

How does infantile coarctation of the aorta present?

A

Cyanosis in the lower extremities in infancy.

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104
Q

What is the adult form of coarctation of the aorta associated with?

A

Not associated with PDA; presents with hypertension in the upper extremities and hypotension in the lower extremities.

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105
Q

What is a key X-ray finding in adult coarctation of the aorta?

A

“Rib notching” due to collateral circulation across intercostal arteries.

106
Q

What is congestive heart failure (CHF)?

A

A condition where the heart’s pump function is inadequate divided into right- and left-sided failure.

107
Q

What are common causes of left-sided heart failure?

A

Ischemia
hypertension

108
Q

What symptoms does pulmonary congestion cause in left-sided heart failure?

A

Dyspnea paroxysmal nocturnal dyspnea

109
Q

What are “heart failure cells”?

A

Hemosiderin-laden macrophages resulting from burst capillaries in the lungs due to left-sided heart failure.

110
Q

How does left-sided heart failure affect the kidneys?

A

Decreased renal perfusion activates the renin-angiotensin system leading to fluid retention and worsening CHF.

111
Q

What is the main treatment for left-sided heart failure?

A

ACE inhibitors.

112
Q

What are common causes of right-sided heart failure?

A

Most often secondary to left-sided heart failure but also left-to-right shunt and chronic lung disease (cor pulmonale).

113
Q

What clinical features are associated with right-sided heart failure?

A

Jugular venous distension painful hepatosplenomegaly with “nutmeg” liver

114
Q

What is congenital heart defect?

A

Structural abnormalities of the heart that arise during embryogenesis typically between weeks 3-8.

115
Q

What is Eisenmenger syndrome?

A

A condition where prolonged left-to-right shunting leads to pulmonary hypertension and shunt reversal resulting in late cyanosis.

116
Q

What are the types of congenital heart defects based on shunting?

A

Left-to-right shunts and right-to-left shunts.

117
Q

What is a ventricular septal defect (VSD)?

A

A defect in the wall separating the right and left ventricles causing left-to-right shunting.

118
Q

What condition is associated with VSD?

A

Fetal alcohol syndrome.

119
Q

What is atrial septal defect (ASD)?

A

A defect in the septum separating the right and left atria leading to a left-to-right shunt.

120
Q

What type of ASD is most common?

A

Ostium secundum type (90% of cases).

121
Q

What condition is associated with ostium primum type of ASD?

A

Down syndrome.

122
Q

What are potential complications of ASD?

A

Paradoxical emboli due to the shunt.

123
Q

What is patent ductus arteriosus (PDA)?

A

A condition where the ductus arteriosus fails to close resulting in a left-to-right shunt.

124
Q

What congenital condition is associated with PDA?

A

Congenital rubella.

125
Q

What is the clinical presentation of PDA?

A

Asymptomatic at birth with a “machine-like” murmur which may progress to Eisenmenger syndrome.

126
Q

What is the treatment for PDA?

A

Indomethacin which decreases PGE and promotes ductus arteriosus closure.

127
Q

What is Tetralogy of Fallot?

A

A congenital heart defect with four features: (1) right ventricular outflow tract stenosis
2) right ventricular hypertrophy

128
Q

What symptom is associated with Tetralogy of Fallot?

A

Early cyanosis due to right-to-left shunting.

129
Q

What is the classic x-ray finding in Tetralogy of Fallot?

A

“Boot-shaped” heart.

130
Q

What is transposition of the great vessels?

A

A congenital defect where the pulmonary artery arises from the left ventricle and the aorta from the right ventricle.

131
Q

What condition is associated with transposition of the great vessels?

A

Maternal diabetes.

132
Q

What is required for survival in transposition of the great vessels?

A

A shunt to allow blood mixing; PGE can be given to maintain a PDA until surgery.

133
Q

What is truncus arteriosus?

A

A single large vessel arising from both ventricles failing to divide.

134
Q

What is tricuspid atresia?

A

Absence of the tricuspid valve leading to a hypoplastic right ventricle and right-to-left shunt.

135
Q

What is coarctation of the aorta?

A

Narrowing of the aorta which can present in an infantile or adult form.

136
Q

What condition is associated with infantile coarctation of the aorta?

A

A patent ductus arteriosus (PDA) and Turner syndrome.

137
Q

What are symptoms of infantile coarctation of the aorta?

A

Lower extremity cyanosis in infancy.

138
Q

What is the adult form of coarctation of the aorta?

A

A condition without a PDA characterized by upper extremity hypertension and lower extremity hypotension.

139
Q

What is a classic x-ray finding in adult coarctation of the aorta?

A

“Rib notching” due to collateral circulation across the intercostal arteries.

140
Q

What are the two main types of valvular lesions?

A

Stenosis (narrowing) and regurgitation (backflow).

141
Q

What is acute rheumatic fever?

A

A systemic complication of group A beta-hemolytic streptococcal pharyngitis affecting children 2-3 weeks after strep throat.

142
Q

What causes acute rheumatic fever?

A

Molecular mimicry where streptococcal M protein resembles human tissue proteins.

143
Q

How is acute rheumatic fever diagnosed?

A

Using the Jones criteria: evidence of prior streptococcal infection plus major and minor criteria.

144
Q

What are the major criteria in the Jones criteria?

A

Migratory polyarthritis
pancarditis

145
Q

What are the components of pancarditis in rheumatic fever?

A

Endocarditis (mitral valve) myocarditis (Aschoff bodies)

146
Q

What are Aschoff bodies?

A

Chronic inflammation Anitschkow cells

147
Q

What is chronic rheumatic heart disease?

A

Valve scarring from repeated acute rheumatic fever episodes often causing mitral stenosis.

148
Q

What is the classic appearance of valves in chronic rheumatic heart disease?

A

“Fish mouth” appearance due to thickened and fused valve cusps.

149
Q

What are complications of chronic rheumatic heart disease?

A

Most commonly infectious endocarditis.

150
Q

What is aortic stenosis?

A

Narrowing of the aortic valve often due to age-related “wear and tear.”

151
Q

What increases the risk for aortic stenosis?

A

A bicuspid aortic valve which causes more “wear and tear” on each cusp.

152
Q

How does rheumatic aortic stenosis differ from age-related stenosis?

A

Rheumatic stenosis usually involves both the mitral and aortic valves and features commissural fusion.

153
Q

What are key symptoms of aortic stenosis?

A

Systolic ejection click with crescendo-decrescendo murmur angina

154
Q

What is aortic regurgitation?

A

Backflow of blood from the aorta into the left ventricle during diastole.

155
Q

What causes aortic regurgitation?

A

Aortic root dilation or valve damage; most commonly isolated root dilation.

156
Q

What are clinical features of aortic regurgitation?

A

“Blowing” diastolic murmur bounding pulses (water-hammer pulse)

157
Q

What is mitral valve prolapse?

A

Ballooning of the mitral valve into the left atrium during systole often due to myxoid degeneration.

158
Q

What conditions are associated with mitral valve prolapse?

A

Marfan syndrome and Ehlers-Danlos syndrome.

159
Q

What are clinical features of mitral valve prolapse?

A

Mid-systolic click with regurgitation murmur; louder with squatting.

160
Q

What is mitral regurgitation?

A

Backflow of blood from the left ventricle to the left atrium during systole.

161
Q

What causes mitral regurgitation?

A

Mitral valve prolapse left ventricular dilation

162
Q

What are the clinical features of mitral regurgitation?

A

Holosystolic “blowing” murmur that becomes louder with squatting and expiration.

163
Q

What is mitral stenosis?

A

Narrowing of the mitral valve orifice usually due to chronic rheumatic heart disease.

164
Q

What are symptoms of mitral stenosis?

A

Opening snap with diastolic rumble pulmonary congestion

165
Q

What are risks associated with left atrial dilation in mitral stenosis?

A

Atrial fibrillation and mural thrombi formation.

166
Q

What are the two main types of valvular lesions?

A

Stenosis (narrowing) and regurgitation (backflow).

167
Q

What is acute rheumatic fever?

A

A systemic complication of group A beta-hemolytic streptococcal pharyngitis occurring 2-3 weeks after strep throat.

168
Q

What causes acute rheumatic fever?

A

Molecular mimicry where the bacterial M protein resembles human tissue proteins.

169
Q

How is acute rheumatic fever diagnosed?

A

Using the Jones criteria: evidence of prior streptococcal infection plus major and minor criteria.

170
Q

What are the major criteria in the Jones criteria?

A

Migratory polyarthritis
pancarditis

171
Q

What is migratory polyarthritis?

A

Swelling and pain that moves from one large joint to another resolving within days.

172
Q

What is pancarditis in rheumatic fever?

A

Inflammation of the heart involving endocarditis

173
Q

What is the most common cause of death in acute rheumatic fever? .

A

Myocarditis

174
Q

What are Aschoff bodies?

A

Areas of chronic inflammation with Anitschkow cells giant cells

175
Q

What is erythema marginatum?

A

Annular non-itchy rash with red borders

176
Q

What is Sydenham chorea?

A

Rapid involuntary muscle movements due to CNS involvement in rheumatic fever.

177
Q

What is chronic rheumatic heart disease?

A

Valve scarring from repeated acute rheumatic fever episodes usually causing mitral stenosis.

178
Q

What is the characteristic appearance of valves in chronic rheumatic heart disease?

A

“Fish mouth” appearance due to thickened and fused valve cusps.

179
Q

Which valves are most affected in chronic rheumatic heart disease?

A

Mitral valve (most common) and sometimes the aortic valve.

180
Q

What are complications of chronic rheumatic heart disease?

A

Increased risk of infectious endocarditis.

181
Q

What is aortic stenosis?

A

Narrowing of the aortic valve often due to age-related calcification or chronic rheumatic disease.

182
Q

What increases the risk of aortic stenosis?

A

A bicuspid aortic valve which causes faster “wear and tear.”

183
Q

What murmur is associated with aortic stenosis?

A

Systolic ejection click followed by a crescendo-decrescendo murmur.

184
Q

What are complications of aortic stenosis?

A

Concentric LV hypertrophy angina

185
Q

What is aortic regurgitation?

A

Backflow of blood from the aorta into the left ventricle during diastole.

186
Q

What causes aortic regurgitation?

A

Aortic root dilation (e.g. syphilitic aneurysm

187
Q

What are clinical features of aortic regurgitation?

A

Blowing diastolic murmur bounding pulse

188
Q

What is the treatment for aortic regurgitation?

A

Valve replacement once left ventricular dysfunction develops.

189
Q

What is mitral valve prolapse?

A

Ballooning of the mitral valve into the left atrium during systole often due to myxoid degeneration.

190
Q

What conditions are associated with mitral valve prolapse?

A

Marfan syndrome and Ehlers-Danlos syndrome.

191
Q

What are clinical features of mitral valve prolapse?

A

Mid-systolic click with a regurgitation murmur louder with squatting.

192
Q

What is mitral regurgitation?

A

Backflow of blood from the left ventricle into the left atrium during systole.

193
Q

What are common causes of mitral regurgitation?

A

Mitral valve prolapse LV dilation

194
Q

What murmur is associated with mitral regurgitation?

A

Holosystolic blowing murmur louder with squatting and expiration.

195
Q

What are consequences of mitral regurgitation?

A

Volume overload and left-sided heart failure.

196
Q

What is mitral stenosis?

A

Narrowing of the mitral valve orifice usually due to chronic rheumatic heart disease.

197
Q

What murmur is associated with mitral stenosis?

A

Opening snap followed by a diastolic rumble.

198
Q

What are complications of mitral stenosis?

A

Pulmonary congestion
pulmonary hypertension

199
Q

What is endocarditis?

A

Inflammation of the endocardium often affecting the surface of cardiac valves

200
Q

What is the most common cause of endocarditis?

A

Streptococcus viridans a low-virulence organism that infects previously damaged valves

201
Q

How does Streptococcus viridans cause endocarditis?

A

It adheres to thrombotic vegetations on damaged valves often following transient bacteremia.

202
Q

What is the most common cause of endocarditis in IV drug users?

A

Staphylococcus aureus a high-virulence organism that infects normal valves (commonly tricuspid)

203
Q

What organism is associated with endocarditis in prosthetic valves?

A

Staphylococcus epidermidis.

204
Q

What organism is associated with endocarditis in patients with colorectal carcinoma?

A

Streptococcus bovis.

205
Q

What are HACEK organisms?

A

Haemophilus Actinobacillus

206
Q

What are common clinical features of bacterial endocarditis?

A

Fever murmur

207
Q

What are Janeway lesions?

A

Erythematous non-tender lesions on palms and soles due to septic emboli.

208
Q

What are Osler nodes?

A

Tender lesions on fingers or toes due to immune complex deposition.

209
Q

What is nonbacterial thrombotic endocarditis?

A

Sterile vegetations that arise in hypercoagulable states or adenocarcinoma typically on the mitral valve

210
Q

What is Libman-Sacks endocarditis?

A

Sterile vegetations on both surfaces of the mitral valveassociated with SLE

211
Q

What is dilated cardiomyopathy?

A

Dilation of all four heart chambers causing systolic dysfunction and often leading to biventricular CHF.

212
Q

What are causes of dilated cardiomyopathy?

A

Idiopathic genetic mutations

213
Q

What is the treatment for dilated cardiomyopathy?

A

Heart transplant.

214
Q

What is hypertrophic cardiomyopathy?

A

Massive hypertrophy of the left ventricle commonly due to genetic mutations in sarcomere proteins (autosomal dominant).

215
Q

What are clinical features of hypertrophic cardiomyopathy?

A

Decreased cardiac output sudden death (ventricular arrhythmias)

216
Q

What is a common cause of sudden death in young athletes?

A

Hypertrophic cardiomyopathy.

217
Q

What does biopsy show in hypertrophic cardiomyopathy?

A

Myofiber hypertrophy with disarray.

218
Q

What is restrictive cardiomyopathy?

A

Decreased ventricular compliance due to stiff endomyocardium restricting diastolic filling.

219
Q

What are causes of restrictive cardiomyopathy?

A

sarcoidosis Amyloidosis

220
Q

What is a classic EKG finding in restrictive cardiomyopathy?

A

Low-voltage EKG with diminished QRS amplitude.

221
Q

What is myxoma?

A

A benign mesenchymal tumor with gelatinous appearance usually forming a pedunculated mass in the left atrium.

222
Q

What are clinical symptoms of a cardiac myxoma?

A

Syncope due to mitral valve obstruction.

223
Q

What is rhabdomyoma?

A

A benign hamartoma of cardiac muscle most common primary cardiac tumor in children.

224
Q

What condition is associated with rhabdomyomas?

A

Tuberous sclerosis.

225
Q

Where do rhabdomyomas usually arise?

A

In the ventricles.

226
Q

What are common sites of metastatic cardiac tumors?

A

Most commonly the pericardium leading to pericardial effusion.

227
Q

What are common primary cancers that metastasize to the heart?

A

Breast and lung carcinoma melanoma

228
Q

What is endocarditis?

A

Inflammation of the endocardium lining the heart valves often due to bacterial infection.

229
Q

What is the most common cause of endocarditis overall?

A

Streptococcus viridans a low-virulence organism that infects previously damaged valves

230
Q

How does Streptococcus viridans cause endocarditis?

A

It infects thrombotic vegetations on damaged valves often following transient bacteremia.

231
Q

What is the most common cause of endocarditis in IV drug users?

A

Staphylococcus aureus a high-virulence organism infecting normal valves

232
Q

What type of endocarditis does Staphylococcus aureus cause?

A

Acute endocarditis with large vegetations that destroy the valve.

233
Q

What organism is associated with endocarditis of prosthetic valves?

A

Staphylococcus epidermidis.

234
Q

What organism is associated with endocarditis in patients with colorectal carcinoma?

A

Streptococcus bovis.

235
Q

What are HACEK organisms?

A

Haemophilus Actinobacillus

236
Q

What are clinical features of bacterial endocarditis?

A

murmur Fever

237
Q

What are Janeway lesions?

A

Non-tender erythematous lesions on palms and soles due to septic emboli.

238
Q

What are Osler nodes?

A

Tender lesions on fingers or toes often due to immune complex deposition.

239
Q

What laboratory findings are typical in bacterial endocarditis?

A

Positive blood cultures anemia of chronic disease

240
Q

What is nonbacterial thrombotic endocarditis?

A

Sterile vegetations on the mitral valve in hypercoagulable states or adenocarcinoma causing mitral regurgitation.

241
Q

What is Libman-Sacks endocarditis?

A

Sterile vegetations on both surfaces of the mitral valve associated with SLE

242
Q

What are cardiomyopathies?

A

A group of diseases affecting the myocardium causing cardiac dysfunction.

243
Q

What is dilated cardiomyopathy?

A

Dilation of all four heart chambers leading to systolic dysfunction and often biventricular CHF.

244
Q

What are common causes of dilated cardiomyopathy?

A

Idiopathic genetic mutations

245
Q

What are complications of dilated cardiomyopathy?

A

Mitral and tricuspid regurgitation arrhythmia

246
Q

What is the treatment for dilated cardiomyopathy?

A

Heart transplant.

247
Q

What is hypertrophic cardiomyopathy?

A

Massive left ventricular hypertrophy often due to genetic mutations in sarcomere proteins (autosomal dominant).

248
Q

What are clinical features of hypertrophic cardiomyopathy?

A

Decreased cardiac output sudden death (ventricular arrhythmias)

249
Q

What is a common cause of sudden death in young athletes?

A

Hypertrophic cardiomyopathy.

250
Q

What does biopsy show in hypertrophic cardiomyopathy?

A

Myofiber hypertrophy with disarray.

251
Q

What is restrictive cardiomyopathy?

A

Decreased compliance of the ventricular endomyocardium causing restricted filling during diastole.

252
Q

What are causes of restrictive cardiomyopathy?

A

sarcoidosis Amyloidosis

253
Q

What is a classic EKG finding in restrictive cardiomyopathy?

A

Low-voltage EKG with diminished QRS amplitude.

254
Q

What is a cardiac myxoma?

A

A benign mesenchymal tumor with a gelatinous appearance most commonly a pedunculated mass in the left atrium.

255
Q

What are clinical features of cardiac myxoma?

A

Syncope due to obstruction of the mitral valve by the tumor.

256
Q

What is rhabdomyoma?

A

A benign hamartoma of cardiac muscle the most common primary heart tumor in children.

257
Q

What condition is associated with rhabdomyomas?

A

Tuberous sclerosis.

258
Q

Where do rhabdomyomas typically arise?

A

In the ventricles.

259
Q

What is the most common type of heart tumor?

A

Metastatic tumors more common than primary tumors.

260
Q

What are common sites of metastasis to the heart?

A

Breast and lung carcinoma melanoma

261
Q

What are the common effects of metastatic heart tumors?

A

Pericardial involvement often leading to pericardial effusion.

BLOCK POSTING (17 decks)

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