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Nayla patho > Cardio > Flashcards

Cardio Flashcards

1
Q

What part of the heart is most involved in an MI

A

LAD, causing anterior wall infarct

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2
Q

What are other involved areas of the heart s/p MI

A

RCA causes RV and posterior LV wall infarct

LCA causes lateral wall of LV infarct

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3
Q

What is the main reason for sudden cardiac death

A

Major cardiac arrhythmia (VFib)

-Later on, complete heart block/pump failure

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4
Q

What are the two types of MI

A

Transmural MI: involves all 3 layers of of the heart (LV/IVS)
Intramural/subendocardial: involved endocardium and 1/2 of myocardium- some contraction possible, but weaker

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5
Q

What kind of MI has a worse prognosis

A

Transmural, because it involves all 3 layers of the heart

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6
Q

What are 3 complications of an MI

A

Ventricular rupture, aneurysm, and clot

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7
Q

What can MI complications listed lead to

A

HF, cariogenic shock, organ failure, and cerebral ischemia

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8
Q

What are the general features of myocarditis

A

virus can’t survive outside the cell, so it goes into actual muscle cells. IL and TNS go into muscle cell to kill virus, but end up damaging out heart as well

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9
Q

What are characteristic signs of myocarditis

A
  • Tiger effect: pale, congested areas with hypertrophy and biventricular dilation
  • Flabby, dilated heart
  • Patchy, diffuse interstitial infiltrate made of T cells and macrophages
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10
Q

What is the prognosis of myocarditis

A

Patients usually recover, if acute.

If patients die, it is due to co-morbid conditions (CHF, arrhythmia)

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11
Q

What is the cause of myocarditis

A

Coxsackie B virus

can be a primary dz, or secondary due to RF or other AI dz

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12
Q

Can myocarditis be caused by bacteria?

A

Rarely- if it is, then its due to diphtheria, strep, or Staph

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13
Q

How do you diagnose myocarditis

A

Endomyocardial biopsy (punch biopsy from LV or R heart)

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14
Q

How do you treat myocarditis

A

Supportive Tx!

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15
Q

What are the causes of pericarditis

A

Bacteria, Viruses, Fungi, RHD, Uremia (chronic renal failure)

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16
Q

What are the types of pericarditis and their specific causes

A

Serous pericarditis: Viral

Purulent exudate: bacteria, Staph and Strep

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17
Q

What is the cause of fibrinous pericarditis

A

Rheumatic fever or early bacterial infections

-Lupus is good example of serofibrinous effusion

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18
Q

What is another name for fibrinous pericarditis

A

Bread and Butter (friable fibrin strands between parietal and visceral layers of pericardium)

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19
Q

What is a cardiac myxoma

A

Primary cardiac tumor in ADULTS- found in LA- can cause mitral valve dysfunction- can lead to death by emboli to the brain

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20
Q

What is a Rhabdomyoma

A

Primary cardiac tumor in KIDS- In LV/RV, also atria

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21
Q

What is the difference physically between cardiac myxoma and rhabdomyoma

A

Cardiac myxoma is gelatinous with a stalk

Rhabdomyoma is a pale grey mass projecting into cardiac chamber

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22
Q

Where does the heart accept metastasis from

A

Lung, breast, and GI tract mainly

All lead to restrictive CM

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23
Q

What are the RF for atherosclerosis

A

A Small Happy Lamb Hopped Over Dads Cop Shoes;

–Age, Sex, Heredity, Lipid metabolism, Hypertension, Obesity, Diabetes, Cigarette smoking, Stress

24
Q

What are the 2 most common underlying conditions that start atherogenesis

A

Hypertension and Diabetes

25
Q

What are the common complications of atherosclerosis of the aorta

A

Aorta becomes a rigid tube with jagged internal surface covered in thrombi
Calcified aorta can’t adjust to changing pressure, Hypertension, aneurysm, rupture
(rupture is deadly, death by exsanguination)

26
Q

What cells are involved in atherogenesis

A

Platelets (release growth factors that stimulate smooth muscle proliferation)
Macrophages (eat lipids and become foam cells– also release TNF and cytokines, causing collagen production)

27
Q

What does collagen build up in an arterial lesion lead to

A

stenosis (calcification)

28
Q

What is acute endocarditis

A

highly destructive infection of previously normal valve causing necrotic valvular lesions
Death within days, even with abx

29
Q

What are symptoms of acute endocarditis

A

fever, murmur, QUICK onset, chills, weakness

30
Q

What is subacute endocarditis

A

slower, less virulent infection of previously abnormal valve.
Patients recover well w/ abx

31
Q

What are symptoms of subacute endocarditis

A

low grade fever, murmur, flu Sx

32
Q

What are the specific causes of each type of endocarditis

A

Acute: Staph Aureus
Subacute: Strep. Viridans

33
Q

What are RF for endocarditis

A 
Artificial valves
Bicuspid aorta
Valvular stenosis
MVP
Congenital defects
34
Q

What organism is most commonly involved with prosthetic valve endocarditis

A

Staph Epidermidis

also enterococci, gram - bacteria

35
Q

Where are vegetations found in RHD

A

along the closure of the valves, they are sterile lesions

36
Q

What is the most common complication of RHD

A

secondary bacterial endocarditis

37
Q

Which valve is most involved in IVDU, and which organism

A 
Tricuspid valve (R heart)
Staph Aureus (then strep, and candida)
38
Q

What is the end result of valvular INSUFFICIENCY

A

Mitral: atria dilate d/t blood reflux in systole
Aortic: LVH/dilation d/t backflow in diastole

39
Q

What are the end results of valvular STENOSIS

A

Mitral: clot in LA goes into pulmonary circulation causing RVH/RHF
Aortic: eventually RHF

40
Q

What is responsible for most deaths after the acute phase of RHD

A

Endocarditis

41
Q

What is CAFE P (jones criteria for RF)

A 
CRP elevated
Arthralgia
Fever
ESR elevated/EKG
Previous RF
42
Q

What is CANCER (jones criteria for RF)

A 
Carditis
Arthritis
Nodules 
Chorea
Erythema marginatum 
(rheumatic fever)
43
Q

What is pancarditis

A

inflammation of all three layers of the heart d/t RHD

44
Q

What is Sydenhams chorea

A

involuntary, continuous jerky movements of limbs, trunk, and face d/t RHD

45
Q

What is fish mouth stenosis

A

in endocarditis, the chordae tendinae of mitral valve are thick short and fused causing fish mouth structure

46
Q

What are Aschoff bodies

A

clumps of lymphocytes and macrophages around central necrosis in Myocarditis
Eventually they form a scar

47
Q

What is an ASO titer

A

serum testing presence of antibodies to Strep antigen O, which develops in all RF patients

48
Q

What is erythema marginatum

A

in RF, maculopapular erythematous rash over trunk and proximal limbs but NOT face
No scarring

49
Q

What lab findings are associated with RHD

A

ESR and CRP (though nonspecific)
ASO titer indicates recent Strep Progenies (concrete evidence)
Throat culture will be negative (bacteria present 2-3 weeks ago)

50
Q

How is native tissue destroyed in RF

A

ASO abs develop against strep antigens, but they cross react with similar antigens in the heat leading to valve destruction

51
Q

What is the most common cardiomyopathy

A

Dilated CM: progressive chamber dilation and systolic dysfunction= reduced EF

52
Q

What is popcorn for hypertrophic CM

A

Banana septum! extensive LVH=LV obstructs flow

AKA IHSS

53
Q

What are characteristics of restrictive CM

A

decrease in ventricular compliance causing abn diastole

Patty interstitial fibrosis

54
Q

What can restrictive CM be due to

A

abnormal infiltrate (amyloid, sarcoidosis, tumor)

55
Q

What CM yields the largest heart

A

Hypertrophic; can reach 1200g

56
Q

What are causes of dilated CM

A 
#1: alcohol induced!
#2: anti-cancer drugs (Adriamycin)
cocaine, cobalt exposure, viral myocarditis, pregnancy, pheochromocytoma
57
Q

What are causes of restrictive CM

A

idiopathic

amyloid, sarcoidosis, metastatic tumor

Nayla patho (9 decks)

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