Cardiovascular Flashcards
Where do Mycotic Aneurysms originate?
- Embolization of a septic embolus, usually as a complication of infective endocarditis
- An extension of an adjacent suppurative process
- Circulating organisms directly infecting the arterial wall
What are the most common locations of arterial aneurysms?
Thoracic and Abdominal Aortic Aneurysms
How does Tertiary Syphilis affect the Thoracic Aorta?
Can cause obliterative endarteritis in the vaso vasorum of the thoracic aorta
What are some characteristics of Giant Cell Arteritis?
- most common among older patients
- presents with facial pain, headache
- T cell-mediated, involves the temporal arteries
- May cause double-vision
- biopsy to confirm diagnosis
What are some characteristics of Takayasu Arteritis?
- Ocular disturbances and weakening of pulses of upper extremities
- younger age group, Japanese population
- Involves medium and larger arteries
What are some characteristics of Polyarteritis Nodosa?
- Almost 1/3 of patients have chronic Hepatitis B
- Classically affects young adults
- Involves renal vessels
What are some characteristics of Kawasaki disease?
- Often involves the coronary arteries
- Presents with erythema of conjunctiva, palms, and soles
- IV Ig and Aspirin are indicated for tx
What are some characteristics of Microscopic Polyangitis?
- small vessels
- Renal glomeruli and lung capillaries are most common
- associated with MPO-ANCA
- leukocytoclastic vasculitis or hypersensitivity vasculitis
What are some characteristics of Churg-Strauss Syndrome?
- aka allergic granulomatosis
- resembles PAN or Microscopic Polyangitis, but has eosinophils and granulomas
- less than 1/2 show MPO-ANCA
What are some characteristics of Behcet disease?
- aphthous ulcers of the oral cavity, genital ulcers, uveitis
- associated with HLA-B51
- neutrophilic involvement is heavy
What are some characteristics of Wegener Granulomatosis?
- Focal necrotizing, crescentic glomerulonephritis
- Associated with PR3-ANCA
- T-cell mediated hypersensitivity response to innocuous inhaled agents
What causes Kaposi Sarcoma?
HHV8
What are the different forms of Kaposi Sarcoma?
- Aids associated
- Classic KS (middle east/Mediterranean - not HIV related)
- Endemic African
- Transplant associated
What are the most common congenital heart defects?
Left-to-right shunts
What are the Left-to-Right shunts?
ASD
VSD
PDA
What causes ASD? What can it lead to?
Most ASDs are classified as “secundum”
Can cause pulmonary hypertension, right heart failure, paradoxical embolization
What is important to know about a PFO?
Can lead to paradoxical embolus!
What is the most common congenital heart disease?
VSD
What does a PDA sound like?
Harsh, machinery-like murmur
What type of shunts can cause cyanosis?
Right-to-left shunts
What are the right-to-left shunts?
- Tetralogy of Fallot
- Persistent truncus arteriosus
- Tricuspid atresia
- Total anomalous pulmonary venous connection
What are the cardinal features of Tetralogy of Fallot?
- Overriding of the Aorta
- VSD
- Obstruction of the RV outflow tract
- RV hypertrophy
Boot shaped heart due to RV hypertrophy
What is the most common genetic cause of congenital heart disease?
Down Syndrome
-About 40% patients with Down Syndrome have a heart defect (VSD)
Coarctation of the Aorta is most associated with…?
Turner Syndrome (45X) -Webbing neck, broad chest and wide nipples, streak ovaries, pigmented nevi
What arteries are involved in Heart Attacks?
- LAD (40-50%) Apex, LV anterior wall, anterior 2/3 of septum
- RCA (30-40%) RV free wall, LV posterior wall, posterior third of septum
- LCX (15-20%) LV lateral wall
What are some characteristics of Dilated Cardiomyopathy?
- impairment of contractility, systolic dysfunction
- Alcohol is strongly linked
- Iron overload from hereditary hemochromatosis
- dilation of all chambers
- causes progressive CHF
What are some characteristics of Hypertrophic Cardiomyopathy?
- impairment of compliance, diastolic dysfunction
- genetic: friedreich ataxia
- mostly b-myosin heavy chain mutation
- causes myocyte disarray
- Harsh systolic ejection murmur
Describe a myxoma
- Globular hard mass, mottle with hemorrhage to soft, translucent, papillary or villous with a gelatinous appearance
- “ball-valve” obstruction
