Cardiovascular disease 1 Flashcards
Define ischaemic heart disease
inadequate blood supply to the myocardium
What causes ischaemic heart disease?
- reduced coronary blood flow (due to atheroma/thrombus)
- myocardial hypertrophy, usually due to systemic hypertension
- any imbalance in supply/demand
What is the most common cause of ischamic heart disease?
atheroma
How quickly must myocardium be re-perfused in order to recovery?
15-20 minutes
What is typical angina pectoris?
caused by a fixed luminal narrowing of a vessel, that will only cause difficulty at a certain level of work, predictable and not getting worse
Which is the most vulnerable layer of the heart walls?
subendocardium
What is a transmural infarct?
A severe blockage that causes cell death through the whole thickness of the wall - can only heal by scarring
What is normal blood pressure?
120/80 mmHg
What is a phaechromocytoma?
tumour of the adrenal medulla
Define endocarditis
inflammation of the endocardium of the heart
What are the two forms of endocarditis?
infective and non-infective
What is infective endocarditis?
colonisation/invasion of heart valves or heart chamber endocardium by a microbe
What are the vegetations of infective endocarditis formed from?
mixture of thrombotic debris and organisms
What is the most common cause of infective endocarditis?
streptococcus viridans from the mouth
What clinical features do you see in infective endocarditis?
fever, non-specific symptoms (flu-like etc), murmurs (with left sided IE)
What is libman-sacks endocarditis associated with?
systemic lupus erthematosis (SLE)
What is rheumatic fever?
acute, immunologically mediated, multi-system inflammatory disease following group A strep pharyngitis
What is virtually the only cause of mitral valve stenosis?
rheumatic fever
What criteria is used to diagnose rheumatic fever?
Jones criteria
What is pericarditis?
inflammation of the pericardium
What are the main causes of pericarditis?
- infections
- immunologically mediated processes
- miscellaneous conditions
What causes a purulent/suppurative pericarditis?
infection
What are the common causes of haemorrhagic pericarditis?
- neoplasia
- infections
- post cardiac surgery
What is constrictive pericarditis?
heart encased in fibrous scar (limits cardiac function)
Define cardiomyopathy
heart muscle disease
What is dilated cardiomyopathy?
progressive dilation of heart causing contractile dysfunction
What are the 2 main causes of cardiomyopathy?
genetic and alcohol
What treatment can you give someone with dilated cardiomyopathy?
- cardiac transplantation
- long-term ventricular assist
Do you get diastolic dysfunction in hypertrophic or dilated cardiomyopathy?
hypertrophic
What is the only cause of hypertrophic cardiomyopathy?
genetics (mutations sacromeric proteins)
How do you treat hypertrophic cardiomyopathy?
decrease heart rate and contractility (beta blockers)
reduction of the mass of the septum
What is restrictive cardiomyopathy?
primary decrease in ventricular compliance
Which cardiomyopathy is caused by disorder of cell-cell desmosomes?
arrythmogenic right ventricular cardiomyopathy
Define vasculitis
inflammation of the vessel walls
What is the most common form of vasculitis?
giant cell arteritis
How is giant cell arteritis pathologically defined?
chronic granulomatous inflammation of large to medium-sized arteries, especially in the head
How do you diagnose giant cell arteritis?
biopsy and histology - segmental disease so 2-3cm taken
How do you treat giant cell arteritis?
corticosteroids
anti-TNF therapy
Define aneurysms
localised, permanent, abnormal dilatations of a blood vessel
What is the main risk factor for AAA rupture?
SIZE
What is a dissecting aneurysm?
characterised by tear in the wall and blood tracks between intimal and medial layers
What are the classical symptoms of dissecting aneurysms??
tearing pain in chest radiating to upper left shoulder
When do Charcot-Bouchard aneurysms occur?
in intracerebral capillaries in hypertensive disease
What are mycotic aneurysms?
weakening of arterial wall secondary to bacterial/fungal infection
What is a false aneurysm?
blood filled space around a vessel, usually following traumatic rupture or perforating injury
What are the 6 Ps of acute ischaemia?
pale, pulselessness, painful, paralysis, paraesthesia, perishing cold
