Cardio - Mechanisms of Disease - Valvular Heart Disease; Arteriosclerosis; Hypertension Flashcards
What are the layers of any heart valve underneath the endothelium?
Fibrosa (collagen);
spongiosa (central core)
Any/all valve diseases predispose to __________ _______itis.
Any/all valve diseases predispose to infective endocarditis.
Cardiac valvular _________ is almost always chronic, while valvular _________ can be either acute or chronic.
Cardiac valvular stenosis is almost always chronic, while valvular regurgitation can be either acute or chronic.
The mitral valve has a(n) _________ leaflet and a(n) _________ leaflet.
The mitral valve has an anterior leaflet and a posterior leaflet.
Aortic stenosis can lead to what sort of effects in the left ventricle?
Hypertrophy;
ischemia;
dilation
Stenosis of the cardiac valves most commonly leads to _________ ventricular hypertrophy.
Stenosis of the cardiac valves most commonly leads to concentric ventricular hypertrophy.
Valvular insufficiency of the cardiac valves most commonly leads to _________ ventricular hypertrophy.
Valvular insufficiency of the cardiac valves most commonly leads to eccentric ventricular hypertrophy.
Syncope is loss of consciousness due to what?
Poor brain perfusion
What is the main etiology of mitral stenosis?
Rheumatic fever
Mitral stenosis has what effect on the left atrium?
How does this present on EKG?
Left atrial overload/dilation;
‘notched’ P wave
True/False.
Rheumatic fever can lead to mitral stenosis, myocarditis, and fibrinous pericarditis.
True.
What type of histological change is apparent in cases of myocarditis resulting from rheumatic fever?
Aschoff bodies
(granulomas made of Anitschkow cells surrounding areas of fibrinoid necrosis)
Describe the Aschoff bodies seen in cases of myocarditis resulting from rheumatic fever.
Granulomas made of Anitschkow cells surrounding areas of fibrinoid necrosis
Rheumatic fever most commonly causes what two valvular lesions?
- Mitral stenosis
- Aortic stenosis
The mitral stenosis associated with rheumatic fever is often referred to as having a ‘______-mouth’ deformity.
The mitral stenosis associated with rheumatic fever is often referred to as having a ‘fish-mouth’ deformity.
Name the described valvular disorder:
degenerative calcium deposits in the mitral valve near the base of the leaflets
Mitral annular calcification
Mitral annular calcification is most common in what patient population?
Females over 60
How severely does mitral annular calcification typically affect valvular function?
It typically does not.
Although typically asymptomatic, what are some of the major complications associated with mitral annular calcification?
Mitral regurgitation or stenosis;
AV conduction defects (and associated arrhythmias);
thrombosis, endocarditis
True/False.
Cardiac valvular regurgitation almost always results due to defects in the valve leaflets.
False.
Cardiac valvular regurgitation can occur due to defects in the valve leaflets, valve annulus, and/or papillary muscles.
True/False.
Both mitral stenosis and mitral regurgitation can lead to left atrial dilatation.
True.
About 50% of cases of mitral regurgitation results from what?
Floppy valve
(often acute)
Most cases of mitral valve prolapse are ___________ (cause).
Most cases of mitral valve prolapse are idiopathic.
Mitral prolapse is most often a result of ___________ degeneration that leads to a floppy valve.
Mitral prolapse is most often a result of myxomatous degeneration that leads to a floppy valve.
Mitral valve prolapse can be found in ____% of the population, most commonly in females between ages ____ and ____.
Mitral valve prolapse can be found in 5% of the population, most commonly in females between ages 20 and 40.
What are the three major forms of arteriosclerosis?
- Atherosclerosis
- Arteriolosclerosis
- Mönckeberg medial calcific sclerosis
Atherosclerosis is a thickening of the tunica ________ in medium or large arteries.
Arteriolosclerosis is a thickening of the tunica ________ in arterioles (i.e. small arteries).
Mönckeberg medial sclerosis is a thickening of the tunica ________ in medium or large arteries.
Atherosclerosis is a thickening of the tunica intima in medium or large arteries.
Arteriolosclerosis is a thickening of the tunica intima in arterioles (i.e. small arteries).
Mönckeberg medial sclerosis is a thickening of the tunica media in medium or large arteries.
Atherosclerosis is a thickening of the tunica intima in ________ (size) arteries.
Arteriolosclerosis is a thickening of the tunica intima in ________ (vessel).
Mönckeberg medial sclerosis is a thickening of the tunica media in ________ (size) arteries.
Atherosclerosis is a thickening of the tunica intima in medium or large arteries.
Arteriolosclerosis is a thickening of the tunica intima in arterioles (i.e. small arteries).
Mönckeberg medial sclerosis is a thickening of the tunica media in medium or large arteries.
What are the two main forms of arteriolosclerosis?
Hyaline;
hyperplastic
Mönckeberg medical calcific sclerosis occurs in what blood vessel layer?
The medial layer (in the elastic lamina)
Atherosclerosis refers to what?
Lipid accumulation in vascular lesions
Atherosclerosis most commonly occurs in which vessels?
Elastic and muscular arteries
In descending order, name the four arteries most commonly affected by atherosclerosis.
- Abdominal aorta
- Coronary arteries
- Popliteral arteries
- Internal carotid arteries
Why is atherosclerosis often seen at vessel branch points?
Increased turbulence
What process converts a fatty streak into a true atheroma?
Smooth muscle proliferation
Atheromas are more likely to rupture if they have a _____ core and _____ fibrous cap.
Atheromas are more likely to rupture if they have a necrotic core and thin fibrous cap.
What is the initial step of atherosclerosis?
Endothelial damage
The steps of atherosclerosis:
- ____________ cell damage
- _________ oxidation/deposition beneath the endothelium
- _________ enter the area and are converted to _______ cells
- __________ response, ________, and smooth muscle _________
The steps of atherosclerosis:
- Endothelial cell damage
- Lipid oxidation/deposition beneath the endothelium
- Monocytes enter the area and are converted to foam cells
- Inflammatory response, fibrosis, and smooth muscle proliferation
Describe the appearance/structure of an atheroma in a coronary artery.
An atheromatous lesion shows a variety of small slits and spaces in the layer of plaque beneath endothelium. What are these called?
Cholesterol clefts
(places where now-phagocytosed lipids used to be)
Do atheromas typically develop in the medial or lateral walls of arterial branch points?
Lateral
(where flow is slowest and eddies can form)
What form of arteriolosclerosis is shown here?
Hyaline arteriolosclerosis
What form of arteriolosclerosis is shown here?
Hyperplasic arteriolosclerosis
Hyperplastic arteriolosclerosis often occurs due to hypertension and is most often seen in the vessels of the ________. It is probably a result of increased cytokine release calling for increased _______ _______ proliferation.
Hyperplastic arteriolosclerosis often occurs due to hypertension and is most often seen in the vessels of the kidney. It is probably a result of increased cytokine release calling for increased smooth muscle proliferation..
How might Mönckeberg calcific sclerosis appear on X-ray?
Opaque, twisted vessels
(highly visible due to calcium deposits)
Type ____ aortic dissections involve the ascending aorta.
Type A aortic dissections involve the ascending aorta.
Type ____ aortic dissections involve the descending aorta.
Type B aortic dissections involve the descending aorta.
Type A aortic dissections involve the ___________ aorta.
Type B aortic dissections involve the ___________ aorta.
Type A aortic dissections involve the ascending aorta.
Type B aortic dissections involve the descending aorta.
