Cardiac Pathophysiology I Flashcards
What is pericarditis?
Inflammation of the pericardium, either visceral or parietal layer
What are causes of pericarditis? (6)
- bacteria, viruses, fungi (rare)
- Rheumatic heart disease
- Lupus (SLE)
- Trauma
- Radiation
- open heart surgery
What is serositis?
inflammation of the epicardium, pleural cavity and GI serous compartment
What is the characteristic pathology of pericarditis? What distinguishes viral vs bacterial pericarditis?
- exudation of fluid into the pericardial sac
- viral: serous clear yellow fluid
- bacterial: suppurative/purulent fluid (Staph or Strep bacteria)
What are the two types of exudates found in pericarditis (2)?
- serofibrinous
- fibrinous
Describe Fibrinous Pericarditis?
- BREAD AND BUTTER APPEARANCE
- shaggy yellow layers of fibrin cover the heart
T/F Serofibrinous pericarditis can become fibrinous pericarditis?
TRUE
T/F Fibrinous pericarditis can become adhesive pericarditis if not treated with abx
TRUE
What is tx for constrictive pericarditis?
removal of entire pericardium
What is myocarditis?
-acute inflammation of the myocardium
What causes myocarditis?
- viruses, bacteria, fungi
- rheumatic fever
- lupus
- autoimmune disorders
T/F Over 80% of myocarditis cases are caused by viruses
True
What virus is the most common cause for myocarditis?
Coxsackie B virus
T/F Bacterial myocarditis is very common
False- bacterial myocarditis is very rare
What are some causes for bacterial myocarditis (3)?
- myocarditis is secondary to infections such as:
- Diphtheria
- Meningococcal
- Staph endocarditis
How do viruses cause myocarditis?
- viruses invade the myocardial cells and kill the vital cell organelles that lead to cell death
- T -lymphocytes are recruited to the area and release TNF and IL (lymphokines)
- these issues cause the muscle to weaken and eventually leads to CHF
What is the pathology in viral myocarditis (4)?
- TIGGER EFFECT
- pale congested areas
- biventricular dilation
- hypokinesis
What is the clinical presentation of myocarditis (4)?
- SOB
- malaise
- fever
- if severe will show signs of CHF
i. peripheral cyanosis
ii. pulmonary edema
iii. tachycardia
How do you diagnose myocarditis?
- endomyocardial punch biopsy
- access via inserting catheter into neck or femoral vein
- 1-2mm piece is retrieved
What is the etiology of atherosclerosis?
- injury to the blood vessel endothelium all the way to the tunica media
- the injury creates a pocket where LDL and platelets can deposit
- macrophages are recruited to the area to engulf the fat but in the process become foam cells
- platelets secrete growth factors which stimulate the proliferation of smooth muscle cells and tell the smooth muscle cells to uptake lipids (smooth cells begin acting like foam cells)
What is etiology of atherosclerosis continued?
- smooth cells die and release lipids which are degraded and deposited into cholesterol crystals
- Macrophages release TNF and cytokines which induce collagen production
- The collagen production causes the blood vessel to scar and thus harden /sclerosis
What is the name for the primary bulge produced in atherosclerosis?
-atheroma
Describe an atheroma?
- fibrous capsule
- necrotic center -gooey ( contains foam cells, cell debris, and crystals ,the center calcifies over time
What is a major complication of atheromas?
-calcification and hardening of the vessel