Cardiology Flashcards
Angina
Can be stable, variant or unstable
Acute Coronary Syndrome
MI or unstable angina
MI
Neutrophils and macrophages go to infarcted area
Hypertension
Primary= ANS or RAS dysfunction
Secondary= CKD, Conn’s, Cushing’s, phaechromocytoma
Risk calculated by Framingham score
Conn’s Syndrome
High aldosterone
Sodium and water retention
RAS System
Renin cleaves angiotensinogen to angiotensin I (changed to II in lungs)
Angiotensin stimulates aldosterone
Left Heart Failure
Causes= high BP, vascular disease, MIs Symps= irritability, stupor, coma, dyspnoea, orthopnoea, PND, cyanosis, sputum
Right Heart Failure
Causes= LHF, cor pulmonale (high lung BP) Symps= hepatomegaly, splenomegaly, ascites, effusions, oedema, fatigue
Mitral Stenosis
Rheumatic heart disease
Causes= group A strep, inflam, pericarditis, vegetations, calcifications, fused valves
Aortic Stenosis
Causes= LV hypertrophy, ischaemia, hypertension, CHF, angina
Aortic Regurgitation
Causes= rheumatic, infections, aortic dilations
Mitral Prolapse
Flappy valve
Causes= infection, calcification, degeneration
Symps= click, chest pain, dyspnoea
Comps= endocarditis, insufficiency, arrhythmias, death
Left to Right shunts
No cyanosis
Pulmonary hypertension
Atrial Septal Defect
LtoR
Primary= next to AV valves
Secondary= defective fossa ovale
Sinus venosus= next to sup vena cavae
Ventricular Septal Defect
LtoR
Mostly membranous septum
If muscular, have many holes
Patent Ductus Arteriosus
Shunts either way if pressure equalises
Harsh murmur
Needs closing
AV Septal Defect
LtoR
Defective valves
Partial or complete
Associated with Down’s
Right to Left Shunts
Get cyanosis
Truncus Arteriosus
RtoL
Aorta+pulmonary artery continuous
Associated with VSD
Tetralogy of Fallot
RtoL VSD Pulmonary Stenosis Overriding Aorta RV Hypertrophy
Transposition of Great Arteries
RtoL
Aorta goes to lungs, PA goes to body
Need shunt, ASD, VSD or PDA to survive
Total Anomalous Pulmonary Venous Connection
RtoL
Pulmonary vein goes into wrong place
Often as small left atrium
Need PFO or VSD to survive
Coarctation of the Aorta
Bad if proximal to PDA
50% have bicuspid aortic valve
Pulmonary Stenosis/Atresia
Hypoplastic right ventricle with ASD
Infective Endocarditis
Acute= necrotising, ulcerative, cured with surgery Sub-acute= deformed valves, cured with abx RFs= abnormalities, rheumatism, fake valves Bacteria= strep viridans from mouth, s aureus, coag -ve staph Comps= glomerulonephritis
Non-Infective Endocarditis
Causes= SLE, hypercoaguable state, trauma, catheter
Rheumatic Fever (endocarditis)
Causes= group A strep, pharyngitis, inflam
Aschoff bodies= transmural lesions
Get mitral stenosis
Comps= mural thrombi, RV hypertrophy
Pericarditis Causes
Infections (coxsackie)
SLE
Post MI
Acute Pericarditis
Serou, supparative, haemorrhagic (cancer, infections, surgery) or caseous (TB or fungal)
Chronic Pericarditis
Adhesive or constrictive
Dressler’s Syndrome
Post MI (AI response to Ags) Get pericardial effusion
Dilated Cardiomyopathy
Causes= genetics, alcohol, chemo, SLE, DM
Can die from LVF, arrhythmias or emboli
Hypertrophic Cardiomyopathy
Myocytes lose arrangement Genetic Low SV Systolic ejection murmur Treatment= beta blockers, surgery
Restrictive Cardiomyopathy
Decreased ventricular competence
Causes= unknown, fibrosis, sarcoidosis, cancer
Arrhythmogenic Right Ventricular
Genetic
Affects desmosomes
RV dilation and thin myocardium
Myocarditis
Causes= coxsackie, Chagas, echoviruses, HIV, post viral, rheumatic fever, SLE, sarcoidosis
Vasculitis
Causes= giant cell arthritis
Get chronic granulomatous infection
Thick intima
Need corticosteroids
Aneurysms
Micro syphilitic= intracerebral capillaries
Mycotic= weak wall due to infection
False= blood fills around vessel
