Cardiovascular Disease 2 (heart failure, common valvular disease and common congenital heart diseases) - Cardiovascular pathology

Question 1

What are the causes of left sided heart failure?

Answer 1

1) Hypertension (pressure overload)
2) Valvular disease (pressure and volume overload)
3) Myocardial infarction (regional dysfunction and volume overload)

All increase the cardiac work and stress of the wall. This leads to hypertrophy. Then cardiac dysfunction.

Question 2

What are the consequences of Low output Left sided heart failure?

Answer 2

Low output causes:
KIDNEYS to retain salt/fluid. Activation to RAAS increases BP.

BRAIN : irritability&raquo_space; coma

Question 3

What are the consequences of Left heart failure? (congestion)

Answer 3

LUNGS:

• Pulmonary congestion / oedema
• Dyspnea (difficulty breathing)
• blood in sputum
• cyanosis

Question 4

What are the symptoms of Right Sided Heart Failure?

Answer 4

• congestive SPLENOMEGALY
• ascities
• pleural / pericardial effucsion

Question 5

What are the problems associated with Valvular heart disease?

Answer 5

• Stenosis (opening problem)

- Regurgitation (closing problem)

Question 6

What are 70% of all Valvular heart Diseases caused by?

Answer 6

• Aortic Stenosis

- Mitral Stenosis

Question 7

What causes rheumatic heart disease?

Answer 7

it follows a group A streptococcus infection

Question 8

What are the signs of acute valvular heart disease?

Answer 8

• Inflammation
• Aschoff bodies
• Anitschkow cells
• Pancarditis
• Vegetations on chordae tendinae

Question 9

What are the signs of chronic valcular heart disease?

Answer 9

• Thickened valves
• commisural fusion
• Thick, short chordae tendinae

Question 10

What are the complications of Aortic Stenosis?

Answer 10

• Left ventricular hypertension
• angina
• If angina is present then 50% die within 5 years.
• If chronic heart failure present then 50% die within years.

Question 11

What is the association between aortic stenosis and angina?

Answer 11

If angina present then 50% of aortic stenosis will die within 5 years.

Question 12

What are the consequences of Mitral annular calcification?

Answer 12

Mitral Annular calcification is calcification of the mitral “skeleton”
-Usually there is Regurgitation but stenosis is possible

Question 13

What are the causes of Aortic dilations?

Answer 13

• Syphilis
• Rheumatoid Arthritis
• Marfan’s syndrome

Question 14

What is mitral valve prolapse?

Answer 14

MVP is myxomatous (weakening of connective tissue) degeneration of the mitral valve.

Question 15

What are the clinical features of a mitral valve prolapse?

Answer 15

• mid systolic click

- holosystolic murmur if regurgitation present.

Question 16

Faults during what time frame in the development of a baby causes congenital heart defects?

Answer 16

Faulty embryogenesis during weeks 3 - 8 can cause congenital heart defects.

Question 17

What is the most common congenital HD?

Answer 17

Ventricular septal defect.

Question 18

What disease can lead to Congenital HD?

Answer 18

-Rubella

Question 19

What are the clinical features of Left to Right shunts?

Answer 19

• NO Cyanosis

- Pulmonary hypertension (irreversible)

Question 20

What are the clinical features of Right to Left shunts

Answer 20

• Cyanosis

- venous emboli

Question 21

What congenital heart defect is associated with down syndrome?

Answer 21

Atrio Ventricular Septal Defect

Question 22

What are the features of tetralogy of fallot?

Answer 22

1) Overriding aorta
2) Ventricular Septal Defect (Right to Left Shunt)
3) Right Ventricular hypertrophy
4) Pulmonary stenosis

Question 23

What is Truncus Arteriosis?

Answer 23

Failure of separation of pulmonary artery and aorta causes cyanosis and increased pulmonary blood flow.