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Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What valve has only 2 leaflets?

A

Mitral valve

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2
Q

3 layers of the heart wall

A

Epicardium: outer layer next to pericardial fluid
Myocardium: muscular part
Endocardium: next to blood

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3
Q

3 layers of blood vessels

A

Adventitia: connection between blood vessels and connective tissue (outer layer)
Media: contractile and smooth muscle
Endothelium: inner layer

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4
Q

Arteries versus veins for pressure, flow and walls

A

Veins have lower pressure, non-pulsatile flow, and thinner walls
Also have valves and bigger lumen

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5
Q

What is a congenital heart disease

A

Defects involving heart or large arteries and veins that are present at birth

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6
Q

3 general causes of congenital heart disease

A
  1. Heart developed and functional by 10th week of gestation (primitive tube that septates, twists, and segments)
  2. Endogenous causes (chromosomal)
  3. Exogenous causes (infections or toxins)
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7
Q

Atrial septal defect

and clinical presentations

A

Atrial septum is improperly closed
Various types
Clinical presentations: murmur, paradoxical emboli, infection, arrhythmia
Usually of minor consequence

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8
Q

Ventricular septal defect

and clinical presentations

A

Ventricular septum improperly closed
Various types
Clinical presentation: murmur, pulmonary hypertension, infection, cyanosis (late)
Spontaneous or surgical closure

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9
Q

Complex defects

A

Multiple anatomical abnormalities

Several types

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10
Q

Which disease has early versus late cyanosis

A

Late: ventricular septal defect
Early: Tetralogy of Fallot

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11
Q

Tetralogy of Fallot

A

10% of CHD
Clinical presentations: cyanosis (early), murmur, failure to thrive, infection
Requires surgical repair

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12
Q

4 problems in tetralogy of Fallot

A
  1. Overriding aorta
  2. Pulmonary stenosis
  3. Ventricular septal defect
  4. Right ventricle hypertrophy
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13
Q

Is atherosclerosis systemic or localized?

A

Systemic arterial disease

Usually involves multiple vascular territories so it is generalized

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14
Q

What hormone is protective against atherosclerosis?

A

Estrogen

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15
Q

What initiated atherosclerosis? (and 2 examples)

A

Initiated by endothelial injury

Ex: Physical (hypertension) or metabolic (diabetes, obesity)

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16
Q

Athero versus Sclero

A

Sclero is hard: collagen and calcified material

Athero is soft: lipids and necrotic debris

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17
Q

4 Modifiable risk factors

A

Dyslipidemia
Hypertension
Diabetes mellitus
Smoking

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18
Q

3 Not modifiable factors

A

Age
Sex
Family history

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19
Q

2 Protective factors

A

Exercise

Estrogen

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20
Q

Aortic dissection

A

Blood tunnels between aortic layers
Can appear as aneurysm
Unrelated to atherosclerosis

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21
Q

3 Aneurysm complications

A

Rupture
Thrombosis
Mass effect (impinges on other structures, like a tumor)

22
Q

Claudication

A

Cramping in the legs when exercising, caused by obstruction of the arteries
Can only walk a very little bit before they get tired and have pain in their legs/feet/butt

23
Q

4 presentations of ischemic heart disease

A

Angina pectoris
Acute myocardial infarction
Congestive heart failure
Sudden death

24
Q

At what percentage of stenosis do you start to get major problems?

A

Over 50%
Then can get ischemic heart disease
Under 50% and the arteries can dilate enough that the lumen stays the same diameter

25
Q

How can you date a myocardial infarction?

A 
Its irreversible injury from ischemia too long, so can date ischemic myocyte death
1-4 days: cell death, neutrophils
4-5 days: macrophages
1-2 weeks: granulation tissue
>2 weeks: scar formation
26
Q

5 outcomes after ischemic heart disease

A 
Thrombus
Rupture of heart wall
Aneurysm
Congestive heart failure
Death
27
Q

2 things you can look for as serologic evidence of myocyte death

A

Troponin I/T
Creatinine kinase-MB
(levels of both increase)

28
Q

What is infective endocarditis?

A

Infection of endocardial surfaces

Most often valvular

29
Q

4 predisposing factors to infective endocarditis

A

Structural diseases
Skin or mucosal breaks (portals of entry)
Immunosuppression
Intracardiac devices and prostheses

30
Q

What are the 3 main bacteria that cause infective endocarditis?

A

Staph
Strep
Enterococcus

31
Q

What are the 2 main fungi that cause infective endocarditis

A

Candida

Aspergillus

32
Q

Acute bacterial endocarditis

A

Febrile illness of sudden onset

33
Q

Subacute bacterial endocarditis

A

A lingering weakness accompanied by mild temperature elevations that wax and wane over a prolonged period

34
Q

Normal arterial blood pressure

A

120 (systolic) over 80 (distolic)

Measuring the left ventricle pressure

35
Q

2 vasoactive substances

A

Epinephrine

Norepinephrine

36
Q

What factor does contractility increase?

A

Stroke volume

37
Q

What pressure is considered hypertension

A

140 over 90 or higher

Only need to have one

38
Q

Essential disease

A

Same as primary

Dont know what the cause it

39
Q

Aortic coarctation

A

Narrowing of the lower descending aorta
Correctabe with surgery
BP in legs will be much lower than in the arms

40
Q

Cardiomegaly

A

Increase in heart weight
Reflects LV myocyte hypertrophy (increase in size)
Accompanied by interstitial fibrosis (stiff LV)
Takes many years to develop
Causes increased metabolic demands of the heart and leads to heart failure

41
Q

Pressure hypertrophy versus volume hypertrophy

A

Pressure: increase in the ventricular thickness, narrowing of the lumen, new sarcomeres assemble in parallel
Volume: thickness stays the same but there is a lot of dilation going on, new sarcomeres assemble in series

42
Q

Benign hypertension

A

Causes hyalinization of the arterioles and fibrosis of the wall of small arteries

43
Q

Malignant hypertension

A

Sudden onset
Systolic pressure over 200, and diastolic over 100
May cause fibrinoid necrosis of these vessels and concentric proliferation of smooth muscles in arterioles (proliferative endarteriolitis)

44
Q

Proliferative endarteriolitis

A

In malignant hypertension

May cause fibrinoid necrosis of these vessels and concentric proliferation of smooth muscles in arterioles

45
Q

Hypertensive encephalopathy

A

Refers to the vascular changes in the brain that usually cause acute or chronic cerebral ischemia

46
Q

Hypertensive retinopathy

A

Retinal changes that can impair vision and can eventually cause blindness

47
Q

Cardiomyopathy

A

A heterogenous group of diseases of the myocardium
Mechanical and/or electrical dysfunction
Inappropriate ventricular hypertrophy or dilatation
Due to a variety of causes that frequently are genetic
Exclude ischemic, hypertensive, valvular and congenital forms of heart disease
Incurable - need heart transplant

48
Q

Dilated cardiomyopathy

and complications

A

Ventricles are markedly dilated and the heart appears to have a myocardium that is either flabby or thinned and has been partially replaced by fibrous tissue
Systolic dysfunction and arrhythmia
No obvious causes
Complications: congestive heart failure, mural thrombus, sudden death

49
Q

Hypertrophic cardiomyopathy

A

Extensive thickening of the left ventricular myocardium
Runs in families - autosomal dominant (66% familial, 33% sporadic)
#1 cause of sudden death in young athletes
Diastolic dysfunction and arrhythmis
Mostly effects sarcomeric proteins

50
Q

Restrictive cardiomyopathy

A

Inability of the heart to expand adequately during diastole nor contract forcefully enough during systole
Often occurs because the myocardium is infiltrated with some abnormal material like amyloid
Diastolic dysfunction

51
Q

Arrhythmogenic cardiomyopathy

A

Common cause of sudden death in young athletes
Arrhythmia and systolic dysfunction
100% genetic (familial and sporadic are 50% each)
Mostly cell adhesion proteins
Fibrofatty myocardial replacement, frequently only RV involved

Pathology (19 decks)

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