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01. Cardiopulm Renal > Cardiac Pathology > Flashcards

Cardiac Pathology Flashcards

1
Q

lambl excresences

A

small filiform processes form on closure lines of aortic valves and mitral valves

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2
Q

pump failure

A

in some conditions the myocardium contracts weakly during systole and there is inadequate cardiac output. Myocardium may also relax insufficiently during diastole to permit adequate ventricular filling

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3
Q

flow obstruction

A

lesions can obstruct blood flow through a vessel or prevent valve opening or otherwise cause increased ventricular chamber pressure. With valvular blockage, the increased pressure overloads the chamber that pumps against the obstruction

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4
Q

regurgitant flow

A

a portion of the output from each contraction flows backward through an incompetent valve, adding a volume overload to the affected atria or ventricles

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5
Q

shunted flow

A

blood can be diverted from one part of the heart to another through defects that can be congenital or acquired. Shunted flow can also occur between blood vessels, as in PDA

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6
Q

disorders of cardiac conduction

A

conduction defects or arrhythmias due to uncoordinated generation or transmission of impulses lead to nonuniform and inefficient myocardial contractions, and may be lethal

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7
Q

rupture of the heart or a major vessel

A

in such circumstances there is cataclysmic exsanguination, either into body cavities or externally

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8
Q

what do the myocytes look like in cardiac hypertrophy due to pressure overload?

A

thickened myocytes with increased left ventricle thickness concentrically

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9
Q

what do the myocytes look like in cardiac hypertrophy due to volume overload?

A

myocytes elongate with ventricular dilation

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10
Q

heart failure cells

A

hemosiderin-laden macrophages

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11
Q

most common cause of right sided heart failure

A

left sided heart failure

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12
Q

in heart failure, what is systolic dysfunction

A

loss of myocardial contractile function (insufficient ejection fraction)

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13
Q

in heart failure, what is diastolic dysfunction

A

loss of ability to fill the ventricles; left ventricle is abnormally stiff and cannot relax during diastole

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14
Q

right-sided heart failure symptoms

A

peripheral edema and visceral congestion

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15
Q

cause of left sided heart failure

A

ischemic heart disease, systemic hypertension, mitral or aortic valve disease

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16
Q

symptoms of left sided heart failure

A

pulmonary congestion and edema

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17
Q

single most common genetic cause of congenital heart disease

A

trisomy 21

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18
Q

pathway associated with bicuspid aortic valve

A

NOTCH 1

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19
Q

pathway associated with tetralogy of fallot

A

JAG1 and NOTCH2

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20
Q

what type of heart failure is nutmeg liver associated with?

A

right sided heart failure

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21
Q

ischemic heart disease

A

results from insufficient perfusion to meet the metabolic demands of the myocardium

22
Q

angina pectoris

A

transient, often recurrent chest pain induced by myocardial ischemia, insufficient to induce myocardial infarction

23
Q

stable angina

A
  • stenotic occlusion of coronary artery
  • induced by physical activity or stress
  • relieved by rest or vasodilators
24
Q

Prinzmental variant angina

A
  • episodic coronary artery spasm
  • relieved with vasodilators
  • UNRELATED to physical activity, HR, or BP
25
Q

unstable “crescendo” angina

A
  • frank pain
  • increasing in frequency, duration, and severity with progressively lower levels of physical activity
  • usually rupture of atherosclerotic plaque with partial thrombus
  • acute MI may be imminent
26
Q

onset of ATP depletion with ischemia of myocytes

A

seconds

27
Q

loss of contractility with ischemia of myocytes

A

<2 minutes

28
Q

ATP reduced to 50% of normal with ischemia of myocytes

A

10 minutes

29
Q

ATP reduced to 10% of normal with ischemia of myocytes

A

40 minutes

30
Q

irreversible cell injury with ischemia of myocytes

A

20-40 minutes

31
Q

microvascular injury with ischemia of myocytes

A

> 1 hour

32
Q

what vessel is occluded 40-50% of MIs

A

LAD

33
Q

what parts of the heart are affected with occlusion of LAD?

A

Apex, LV anterior wall, anterior two thirds of septum

34
Q

what vessel is occluded 30-40% of MIs

A

RCA

35
Q

what parts of heart are affected by occlusion of RCA

A

RV free wall, LV posterior wall, posterior third of septum

36
Q

what vessel is occluded 15-20% of MIs

A

left circumflex

37
Q

what part of the heart is affected with occlusion of the left circumflex artery

A

LV lateral wall

38
Q

what is seen on light microscope 12-24 hours after myocardial infarction?

A
  • pyknosis of nuclei
  • hypereopsinophilia
  • marginal contraction band necrosis
  • neutrophilic infiltrate
39
Q

what is seen on light microscope 1-3 days after myocardial infarction?

A

coagulative necrosis
loss of nuclei and striations
neutrophils

40
Q

what is seen on light microscope 3-7 days after myocardial infarction?

A
  • beginning of disintegration of dead myofibers
  • dying neutrophils
  • macrophages at infarct border
41
Q

what is seen on light microscope 7-10 days after myocardial infarction?

A

well-developed phagocytosis of dead cells [MACROPHAGES]; granulation tissue at margins

42
Q

what is seen on light microscope 10-14 days after myocardial infarction?

A

well established granulation tissue with new blood vessels

43
Q

what is seen on light microscope 2-8 weeks after myocardial infarction?

A

increased collagen deposition with decreased cellularity

44
Q

reperfusion injury

A

mediated by oxidative stress, calcium overload, and recruited inflammatory cells; can cause hemorrhage and endothelial swelling that occludes capillaries

45
Q

time of elevation of cardiac enzymes

A

CKMB, cTnT, and cTnl elevate at 3-12 hours

46
Q

what enzymes peak at 24 hours?

A

CK-MB and cTnl

47
Q

when do CK-MB levels return to normal?

A

48-72 hours

48
Q

when do cTnl levels return to normal?

A

5-10 days

49
Q

when do cTnT levels return to normal?

A

5 to 14 days

50
Q

describe typical death due to MI

A

occur within 1 hour of onset and are usually secondary to an arrhythmia

01. Cardiopulm Renal (9 decks)

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