Cardio Flashcards by JOSH WOHL

What are the branches of the coronary artery?

Left anterior descending
Left circumflex
right coronary artery

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intramural arteries

penetrate myocardium

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semilunar valves

aortic and pulmonic

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AV valves

mitral and tricuspid

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systolic dysfunction is caused by

ischemic injury and HTN, decreased contractility leads to inadequate CO

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diastolic injury is caused by

inability of heart to relax and expand effectively

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concentric hypertrophy is caused from

HTN/stenosis
Pressure-overload hypertrophy
Increase in wall thickness

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Volume-overload hypertrophy (eccentric)

Dilation of heart with increased ventricular diameter

Muscle mass and wall thickness increased in proportion of chamber diameter

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right sided heart failure is mostly caused by

cor pulmonale, chronic pulmonary HTN

- left sided heart failure

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left sided heart failure is caused by….

and shows these types of cells

ischemic heart disease
HTN
valvular disease
siderophages

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left sided heart failure effects on kidneys

-decreased perfusion, activate RAA, counteracted by ANP (diurectic)

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right sided heart failure effects on liver

ascites

- nutmeg liver

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presacral

anasarca

edema in sacral area of bedridden pts

general massive edema

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3 main malformations

Left-to-right shunt
Right-to-left shunt (cyanotic congenital heart disease)
Obstruction

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3 types of ASD

Secundum (90%): from oval fossa
Primum: adjacent to AV valves
Sinus venosus: near entrance of superior vena cava

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machinery like murmur

PDA

Tetrology of Fallot

VSD
Obstruction to right ventricular outflow tract
Aorta that overrides VSD
Right ventricular hypertrophy
(clinical severity depends on degree of pulmonary stenosis)

Tricuspid atresia

Complete occlusion of the tricuspid valve

R to L shunt necesary

Total Anomalous Pulmonary Venous Connection (TAPVC)

No pulmonary veins directly join the left atrium

drains into coronary sinus

Coarctation of the Aorta

associated w/turner syndrome

- 50% of the cases accompanied with bicuspid aortic valve

Acute Coronary syndrome

Myocardial ischemia precipitated by abrupt plaque change followed by thrombosis
Initiated by
Rupture/fissuring
Erosion/ulceration
Hemorrhage into the atheroma

Angina Pectoris

Transient (15 seconds-15 min) myocardial ischemia that does not cause necrosis

Stable
Prinzmetal
Unstable

most common
occurs at rest, coronary artery spasm
patterns of pain w/increased freq, sudden change in plaque morphology

transmural MI

subendocardial MI

Ischemic necrosis involving the full thickness of the ventricular wall (seen w/atherosclerosis)
Ischemic necrosis limited to inner one third or at most one half of the ventricular wall (plaque disruption/shock)

how long does myocardial necrosis take after after occlusion?

30 minutes

Coagulation necrosis occurs how long after occlusion? | Marginal contraction band necrosis, neutrophils infiltrate how long after occlusion?

4 - 12 hr | 12 - 24 hr

Cardiac specific biomarkers for MI

troponin-I and troponin-T, formerly CK-MB

complication post MI

- arrhythmias - mural thrombus - chronic ischemic heart disease

most common valvular stenosis locations

aortic-calcification | mitral-rheumatic heart disease

acute rheumatic heart disease shows....

Aschoff bodies “bread-and butter” pericarditis Anitschkow cells

chronic rrheumatic heart disease shows...

Acute inflammation and subsequent fibrosis | Valve leaflets become thick and retracted = permanent deformity

infective endocarditis

Aortic and mitral valve -- most common Destroy underlying cardiac tissue Most cases caused by bacterial endocarditis

causative organisms of infective endocarditis

Abnormal valves-Steptococcus viridans IV drug users-S. aureus Prosthetic valves Coagulase-negative staphylococci (S. epidermidis)

Dilated cardiomyopathy

- heart is 2-3x heavier than normal | - EF <25%

Hypertrophic cardiomyopathy

without ventricular dilation Harsh systolic ejection murmur Also know as idiopathic hypertrophic subaortic stenosis (IHSS)

Restrictive cardiomyopathy

Disease in ventricular compliance…impaired ventricular filling during diastole

Myxoma

Most common primary tumor of the heart in adults

Rhabdomyoma

Most frequent primary tumor of the heart in infants and children