Cardio III - Q2,3 Flashcards
What is signifigant about an infected vegitation on a heart valve
Blood passing over valve can spread the infection throughout body via blood
infectious endocarditis chiefly effects what?
valves and the ring around valves
What is at increased risk from infectious endocarditis?
Damaged valves, fake valves, chordae tindinae lining of heart
what is merantic endocarditis?
sterile non infectious endocarditis
Where is merantic endocarditis often seen, presnetation
often seen in cancer, there are vegetations without infection due to a hypercoaguable state, can also show up in cancer.
how would merantic endocarditis present
new onset of murmur or old murmur getting louder.
how is infectious endocarditis tested for
blood culture, 3 tests within 24 hours.
what would the CBC look like if there are bacteria?
increased neutrophils.
why can old people not make fever as wel
they can make as many pyrogens.
communiyt accured endocarditis is what bacteria
staph aureus 50-50%
what is the bacteria associated with strep throat and thus Rheumatic fever?
strep pyogenes group a beta hemolytic\
what bacteria is moslty assiciated with endocarditis
s. aureus
what is probably the most common type of myocarditis
viral type, coxsackie virus
on a slide what does viral myocarditis look like
Lymphocytic infiltrates
What normaly causes pneumonic valve disease
congenital
Symptoms of heart valve disease
SOB, palpitations, weakness, edema and chest discomfort
is the symptom picture consistent with severity?
not really, could ave no symptoms and need immediate help, or have lots of symptoms and it be no big deal
what is normaly used to diagnos a valvular disease
echocardiography
when do you hear mitrial stenosis
S2
When do you hear aortic stenosis
S1
When do you hear mitrial regurg
S1
When do you hear aortic regurg
S2
what is a gegenerative calcified deposit that develops in the fibrous ring of mitral valve?
mitrial annular calcification
myxomatous degeneration what?
the pathological weakening of connective tissue that is the most common cause mitral valve prolapse.
how far back must mitral valve billow to be MVP
more than 2mm int left atrium above anular plane in a long axis view.
What are the 5 diagnostic criteria for rheumatic fever
Carditis, poly arthritis, subcutaneous nodules and erythema marginatum.
what are the 5 minor diagnostic criteria for RF
prolonged PR in EKG, elevated WBC, ESR, CRP
Rheumatic fever follows what infections
Pharyngitis with a Group A beta-hemolytic strep, (strep pyogenes)
what is the most importain cardiac related consequence of RHD
mitral stenosis
on PE, how is carditis detected
new murmur and tachycardia out of proportion with fever
dehisence
separation of prosthetic valve suture line from hear leadin to leak
Polyarthritis the the most common non cardiac manifestion of whhat heart issue
Rheumatic fever
what is polyarthritis
temporary migration inflammation of large joint, sarting in legs and migrating up.
erythema marginatum
characteristic rash in 5-13% of those with acute rheumatic fever. Non purent macules, never on face
how is pericarditis characterized? 5
Serous, fibrinous, hemorrhagic, purulent and casuous
what is pericarditis
inflammation of pericardium.
what can cause pericarditis?
idiopathic, infection, inflmmation post MI, autoimmune, trauma
Pain of pericarditis is made worse how?
deep breathing, torso movement and can be replicated by pressing sternum
what is the sound of pericarditis?
pericardial friction rub, velcro
what is dresslers syndrome?
autoimmune response to pericarditis weeks after MI **
what do we suspect is the cause for idiopathic pericarditis
virual, but down’t know why because biopsy is too invasive and would be required.
what would the pericardial fluid look like if their was in infection
Exudative, more proteins, cloudy, more fibrin, neutraphils and proteins
what happens to heart when BUN goes up
fluid will collect around heart, so renal failure can cause uremia that can cause pericartitis.
what is the two main causes of autoimmue pericarditis
RA or Lupis are number 1
What is hemorragic pericardits
when there is blood between the layers, often caused by trauma or cancer, TB.
what is probably the most common non trauma caused hemorragic pericarditis
Turburculosis,
what often seeds pericardium
tumors that metastizise the heart from other areas.
what does caseous pericardium probably mean
tB, caseous granuloma fibrous walling off.
what can cause serous pericarditis
not ususally infectious , uremia, RA or SLE, this is when there is extra serous fluicd is collecting
when does fibrounous pericarditis happen
Post MI, trauma, surgury etc
what does fibrounous pericarditis look like
bread and butter presentation.
what happens to pulse when blood pressure drops?
pulse will go up.
what is often the resolution of purulent pericarditis that has exudative pus and fibrin filled pericardial fluid
scarring and constrictive pericarditis potential.
what would cause purulent pericarditis?
from adjacent infection (TB) septic embolism, septisemai, and after heart procedures
what is the most likely cause of calcification of pericardial sack on a CXR
tB, caseous granuloma fibrous walling off.
how do tumors move around
metastasize through blood and lymph
what is the most common malignancy found in heart
metastatic tumors (malignancy only makes up 30% of heart tumors)
what is the most common heart tumor
atrial myxoma which is benign,
what % of primary heart tumors are benign
70% are benign, 30% are malignant, (most malignancies in heart have metastasized from somewhere else.
what is an atrial myoxoma
benign masses attached to the atrial wall mostly
studies for atrial myoxoma
echo then MRI c
atrial myoxoma may cause what
ball valve effect
can atrial myoxoma tmetastasize
yes although its rare, it can embolize
cellular fetures of atrial myxoma
hypocellular mass, elongated cell shape, multinucleated,eosinophilic cytoplasm. Or without normal cardic muscle cells,\
what is the most common tumor in the pediatric population
Cardiac rhabdomyoma
what is cardiac rhabdomyoma related to
arrhythmias and chamber obstructions althugh it benign.
histology of cardiac dhabdomyoma
cells are clear, round and enlarged.
what most commonly metastasizes to the heart
melanoma, there is lots of melanin
what follows melanoma for most common to metastasize to heart
lung and breast.
