Cardiovascular Flashcards
Describe the distribution of atherosclerotic plaques
- Found within peripheral & coronary arteries
- Focal distribution along the artery length - patches
- Distribution may be governed by haemodynamic factors:
- Change in flow/turbulence cause the artery to alter endothelial cell function
- Wall thickness is also changed leading the neointima
- Altered gene expression in the key cell types is key
Which of the following is not in the artery walls?
- Tunica intima
- Tunica media
- Epithelial cells
- Neutrophils - any blood cell will enter the artery wall
Epithelial cells - IT IS THE ENDOTHELIUM
What are coronary stents used in patients today made of?
- Stainless steel
- Plastic
- Polymers
Stainless steel
(polymers would be ideal but not a strong enough one)
3 types of aortic stenosis
Supravalvular (narrowing above the valve)
Subvalvular
Valvular - majority
What does TAVI stand for?
Transcatheter aortic valve implantation
What is an aneurysm?
When an artery breaks or twists causing bleeding
How can acute rheumatic fever lead to infective endocarditis (IE)
Chronic scarring and deformity produced contracture of the valve and chordae tendinae
→ calcifies & distorts blood flow allowing local thrombosis
→ progressive cardiac dysfunction as a result of the slowly distorting valvular function
4 inflammatory disorders affecting cardiac valves
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis
Anky spond (AS)
Other connective tissue disorders
Describe mitral valve prolapse
Degeneration of mitral valve with accumulation of mucopolysaccharide material
The valve cusps bow upwards and may not close adequately → incompetence/regurgitation
Types of cardiomyopathy
- DCM - dilated
- HCM - hypertrophic
- ARVC - arrhythmogenic RV
- Restrictive CM
- Secondary
- (rare forms)
Define vasculitis
An inflammation of vessels
Define an embolus
A detached intravascular solid, liquid or gas
(almost all are thrombus in origin although cholesterol, bone marrow, foreign body, tumour, amniotic fluid etc emboli must be considered)
2 main groups of vascular tumour
Angiomas
Angiosarcomas
Describe a haemangioma
A benign proliferation of blood vessel tissue
What complications can occur with a haemangioma?
Can cause compressive effects.
At a site where trauma could occur, they can readily bleed
What is a haemangioendothelioma?
A vascular tumour of endothelial cells of low grade malignancy
What is an angiosarcoma?
Highly aggressive malignant neoplasm of endothelial cells
What does EDS stand for?
Ehler’s-Danlos syndrome
What occurs in Ehlers-Danlos syndrome in terms of blood vessels
Weakening in blood vessels → small areas of aneurysmal dilatation
Can affect larger arteries
Symptoms of heart failure
Breathlessness
Tiredness
Cold peripheries
Leg swelling
Increased weight
Signs of heart failure
Tachycardia
Displaced apex beat
Raised jugular venous pressure
Added heart sounds & murmurs
Hepatomegaly, especially if pulsatile & tender
Peripheral & sacral oedema
Ascites
In terms of hypertension, what can hypokalaemia cause?
A common cause of hyperaldosternosim
Which leads to high BP
Define malignant hypertension
Extremely high BP can lead to immediate damage to an organ, eg eyes or kidneys
Presentation of infective endocarditis
Presents as a really bad infection
Often presents non-specifically, most commonly with fever & symptoms/signs of embolism.
Consider historical sources of bacteraemia, such as indwelling vascular catheters, recent dental work, and intravenous drug use.
Symptoms are often subtle and&examination is often non-specific, but may demonstrate
- cardiac murmur
- peripheral emboli
- Osler nodes
- Roth spots
- Janeway lesions.
