Cardio - FA Patho p 304 - 312 303 Flashcards
What path is associated with systolic regurg’n murmur, balloon appearence is CXR?
dilated cardiomyopathy
What path is assoc with hypertrophic cardiomyopathy, muscle weakness, loss of DTR, vibratory sense, and proprioception?
Friedrich ataxia
Define Kussmaul sign
Inc JVP on inspiration instead of normal dec
Mech of Kussmaul sign
Inspiration –> neg intrathoracic pressure not transmitted to heart –> impaired filling of RV, blood backs up to venae cavae –> JVD
3 pathologies assoc with Kussmaul sign
- Constrictive pericarditis
- restrictive cardiomyopathies
- RA/RV tumors
Most common cardiac tumor in children?
Rhabdomyoma - assoc w/ tuberous sclerosis
What pathology is associated with a “tumor plop” sound in early diastole?
Myxoma
90% of myxomas occur where?
LA
Most common cardiac tumor
Metastasis
What particular structure is disrupted with tertiary syphilis ?
Vasa vasorum of aorta
What protein is most commonly mutated in hypertrophic cardiomyopathy?
Sarcomere proteins, like myosin binding protein C and B myosin heavy chain
Main cause of death in hypertrophic cardiomyopathy?
Ventricular arrythmia
In hypertrophic cardiomyopathy, what leads to outflow obstruction?
asymmetric septal hypertrophy and systolic anterior motion of mitral valve.
Sx of hypertrophic cardiomyopathy?
syncope, dyspnea
What type of hypertrophy do you see in dilated cardiomyopathy
eccentric
Etiologies of dilated cardiomyopathy?
chronic Alcohol abuse wet BeriBeri Coxsackie B viral myocarditis chronic Cocaine use Chagas disease Doxorubicin toxicity Hemochromatosis Sarcoidosis Peripartum cardiomyopathy
Endomyocardial fibrosis with a prominent eosinophilic infiltrate that can lead to restrictive cardiomyopathy
Loffler syndrome
ECG of restrictive cardiomyopathy?
Low voltage ECG despite have a thick myocardium
Causes of Restrictive cardiomyopathy?
Postradiation fibrosis Loffler syndrome endocardial fibroelastosis amyloidosis sarcoidosis hemochromatosis (more likely dilated though)
Rx that reduces mortality during CHF?
ACE inhibitors, AGII-R blockers, BB, spironolactone
Rx that helps both symptoms and reduces mortality in CHF?
Hydralazine with nitrate therapy.
Rx that helps alleviate symptoms of CHF?
Thiazides, loops diuretics
Different between systolic and dystolic dysfunction in CHF?
Diastolic dysfunction would still have preserved EF, normal EDV. Systolic dysfunction will have DEC EF, INC EDV
Most likely causes of culture negative endocarditis?
Coxiella burnetti, Bartonella, HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella)
Causes of nonbacterial endocarditis?
malignancy, hypercoaguable state, lupus
Early and Late lesions in Rheumatic fever?
Early - mitral regurgitation Late - mitral stenosis
Treatment of Rheumatic fever?
Penicillin
What are Anitschkow cells?
enlarged macrophages with ovoid wavy rod-like nucleus
Order of most affected valves in Rheumatic fever?
mitral > aortic»_space; tricuspid
ECG changes in acute pericarditis?
widespread ST segment elevation, and/or PR depression, possible T wave inversion
Describe pain in acute pericarditis?
Sharp pain, aggravated by inspiration, and relieved by sitting up and leaning forward.
Round white spots on retina surrounded by hemorrhages associated with what pathologies?
Roth spots; Bacterial endocarditis
tender raised lesions on finger or toe pads? what causes them?
Osler nodes; immune complex deposition
Hypotension, distended neck veins, distant heart sounds are signs of what?
Beck triad - sign of Cardiac tamponade
What is pulsus paradoxus, and what diseases is it seen with?
Dec in amplitude of systolic BP by > 10 mmHg during inspiration. Seen in cardiac tamponade, asthma, obstructive sleep apnea, pericarditis, croup
What CV disease can present with jaw pain?
Temporal arteritis
What disease presents wtih weak upper extremity pulses, fever, night sweats, skin nodules, and ocular issues?
Takayasu arteritis
Which CV disease associated with Hep B infection?
Polyarteritis nodosa
Symptoms of Kawasaki’s?
Conjunctival injection Rash (polymorphous --> desquamating) Adenopathy (cervical) Strawberry tongue Hand-foot changes - red, edematous Fever
CRASH and burn (fever)
Which arteries are most commonly affected in Buerger disease?
Esp tibial and radial a.
Which vasculitis could affect v. and n?
Buerger - only vasculitis that spreads to v/n
Which vasculitis can present with a saddle nose, an ear infection, cough and red cell casts?
Granulomatosis with polyangiitis
Which vasculitis is assoc with MPO-ANCA?
microscopic polyangiitis, Churg Strauss
Which vasculitis that is ANCA positive is not assoc with granuloma formation?
microscopic polyangiitis
Which vasculitis assoc with eosinophilia and inc IgE?
Churg Strauss
Which vasculitis assoc with IgA nephropathy and upper respiratory tract infection?
Henoch Schonlein
Which vasculitis is assoc with anti-proteinase 3?
Granulomatosis with polyangiitis
palpable purpura on buttocks/legs, arthralgias, abdominal pain?
Henoch Schonlein purpura
Which disease can affect coronary a, and lead to coronary a aneurysm?
Kawasaki disease
Blanching skin lesions, recurrent nose bleeds, GI issues, hematuria, and AV malformations
Hereditary Hemorrhagic Telangiectasia
Multitude of renal aneurysms and spasms on angiogram
Polyarteritis nodosa
affects renal, visceral arteries but not pulmonary arteries
Polyarteritis nodosa
