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Clinical Pathology > Cardiovascular Diseases 2 > Flashcards

Cardiovascular Diseases 2 Flashcards

1
Q

Sterling’s hypothesis

A

Volume of blood in the chamber is proportional to the contractile ability of the heart in that chamber

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2
Q

What are the 3 causes of increased cardiac workload?

A

Hypertension, vascular disease or MI

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3
Q

What is the result of increased cardiac work?

A

Increased stress- hypertrophy and/or dilation= cardiac dysfunction

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4
Q

What are the 2 main results of left sided heart failure that have effects throughout the body?

A

Low output

congestion

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5
Q

What are the effects of low output resulting from left ventricular heart failure

A

pre-renal azotremia (high N2content in blood)
Salt and fluid retention (renin-angiotensin activation/natriuretic peptides)
Brain-irritability, decreased attention, stupor>coma

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6
Q

What are the effects of congestion, resulting from left ventricular heart failure?

A

Lungs: pulmonary congestion and oedema. Dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, blood tinged sputum, cyanosis, increased pulmonary wedge pressure

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7
Q

Causes of right sided heart failure

A

Left heart failure

Cor pulmonale

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8
Q

What is cor pulmonale

A

Abnormal enlargement of the right side of the heart as a result of lung disease or pulmonary blood vessels

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9
Q

Organs/areas affected by right sided heart failure

A

Liver and spleen
Kidneys
Pleura/pericardium
Peripheral tissues

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10
Q

What are the effects of right sided heart failure on the liver and spleen

A

Passive congestion (nutmeg liver)
Congestive splenomegaly
Ascites

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11
Q

Autopsy findings of cardiac heart failure

A

Cardiomegaly, chamber dilation, hypertrophy of myocardial fibres, BOXCAR nuclei, pulmonary/peripheral oedema

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12
Q

What are BOXCAR nuclei?

A

Rectangular nuclei in hypertrophied myocytes

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13
Q

Valvular opening problems

A

Stenosis

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14
Q

Valvular closing problems

A

Regurgitation

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15
Q

70% valvular heard disease is made up of what 2?

A

Aortic and mitral stenosis

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16
Q

Causes of aortic stenosis

A

Senile-old age

Rheumatic heart disease

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17
Q

Causes of mitral stenosis

A

Rheumatic heart disease

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18
Q

Rheumatic heart disease follows what infection?

A

Group A strep

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19
Q

Effects of rheumatic heart disease

A

Pancarditis:

1) endocarditis
2) myocarditis
3) pericarditis

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20
Q

5 acute effects of rheumatic heart disease

A 
Inflammation
Asschoff bodies (nodules)
Anitschlcow cells (enlarged macrophages with asschoff bodies)
Pancarditis
Vegetations on chordae tendinae
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21
Q

3 chronic effects of rheumatic heart disease

A

Thickened valves
Commisural fusion
Thick, short chordae tendinae

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22
Q

Left ventricular hypertrophy but no hypertension

A

Aortic stenosis

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23
Q

Calcification of the mitral skeleton, usually a result of regurgitation, but sometimes stenosis

A

Mitral annular calcification

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24
Q

What mitral valve dysfunction is more common in females than males?

A

Mitral annular calcification

mitral valve prolapse

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25
Q

Causes of aortic regurgitation

A

Syphilis
Rheumatoid arthritis
Marfan’s syndrome

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26
Q

Causes of mitral regurgitation

A 
Mitral valve prolapse
Infectious
Fen Phen (anti obesity drug)
Weakness in papillary muscles/chordae tendinae
Mitral annular calcification
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27
Q

Myxomatous (pathological weakening of tissue) degeneration of mitral valve. Associated with connective tissue disorders.

A

Mitral valve prolapse

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28
Q

Usually asymptomatic, mid-systolic ‘click’, holocystolic murmur if regurg present, occasional chest pain, dyspnoea

A

Mitral valve prolapse

29
Q

Effects of mitral valve prolapse

A

97% no significant effects

3% infective endocarditis, mitral insufficiency, arrythmias, sudden death

30
Q

Which congential heart defects may not be evident until adult life?

A

Coarctation of the aorta and ASD

31
Q

Give 4 examples of left to right shunt congenital heart defects

A

VSD
ASD
Atrioventricular septal defect
Patent ductus arteriosus

32
Q

Give 5 examples of right to left shunt congenital heart defects

A 
Tetralogy of fallot
Transposition of the great arteries
Truncus arteriosus
Total anomalous pulmonary venous connection
Tricuspid atresia
33
Q

Gene abnormalities account for what percentage of CHDs

A

10%

34
Q

What are the most common genetic defects in CHDs

A

Trisomies
Mutations of single genes (TBX5 for ASD and VSD, NKX2.5 for ASD)
Deletion of a specific region of chromosome 22

35
Q

Environmental factors that can result in CHDs

A

Rubella

Teratogens

36
Q

Name of the gap between the 2 parts of the septum primum

A

ostium secundum

37
Q

The septum secundum grows on what side of the septum primum?

A

The right side

38
Q

The border of the septum secundum delineates what foramen?

A

Foramen ovale

39
Q

In the development of the aorticopulmonary system of the heart, the septum divides what 2 parts of the heart into the spiralling aorta and pulmonary artery?

A

bulbis cordis

Truncus

40
Q

Does ASDs include a patent forament ovale?

A

NO

41
Q

What are the 3 types of ASD

A

Secundum (90%)
Primum (5%)
Sinus venosus (5%)

42
Q

A type of ASD with a defective fossa ovalis

A

Secundum

43
Q

A type of ASD next to AV valves,mitral cleft

A

Primum

44
Q

A type of ASD next to superior vena cava, anomalous pulmonary veins draining to SVC on right atrium

A

Sinus venosus

45
Q

Most common CHD

A

VSD

46
Q

The majority of VSD involve with septum

A

Membranous

47
Q

If msucular septum is involved in VSD, what appearance can this have?

A

Multiple holes ‘swiss cheese septum’

48
Q

What can be the result of a large VSD?

A

Pulomary hypertension

49
Q

What happens both initially and evenutally in patent ductus arteriosus?

A

Left to right shunt, possibly reverse shunt as pulmonary hypertension approaches systemic pressure.

50
Q

What treatment is given to keep the ductus arteriosus patent?

A

Protstaglandin E1

51
Q

Continuous harsh, machinery like murmur

A

Patent ductus arteriosus

52
Q

More than 30% patients with Atrioventricular septal defect have what other medical condition?

A

Down’s syndrome

53
Q

Atrioventricular septal defect is associated with what part of the heart?

A

AV valves

54
Q

What does complete atrioventricular septal defect mean?

A

All 4 chambers freely communicate

55
Q

What are the 4 characteristics of tetralogy of fallot?

A

Pulomonary stenosis
VSD
Right ventricular hypertrophy
Over-riding aorta

56
Q

Abnormal formation of truncal and aortopulmonary septa, needs a shunt for survival

A

Transposition of great artereis

57
Q

What classes as an unstable shunt for transposition of the great arteries- the majority

A

PDA or PFO

58
Q

What calsses as stable shunt for transposition of the great arteries- the minority

A

VSD

59
Q

In transposition of the great arteries, which ventricular wall is thicker?

A

Right

60
Q

What is the prognosis for transposition of the great arteries?

A

Fatal in the first few months unless surgically repaired

61
Q

Developmental failure of separation of truncus arteriosus and associated VSD

A

Truncus arteriosus

62
Q

Produces systemic cyanosis as well as increased pulmonary blood flow

A

Truncus arteriosus

63
Q

pulmonary veins do not go into LA but into L.innominate vein or coronary sinus

A

total anomalous pulmonary venous connection

64
Q

Name 3 obstrucive congenital heard diseases

A

Coarctation of the aorta
Pulmonary stenosis/atresia
Aortic stenosis/atresia

65
Q

Is coarcation of the aorta more common in males or females?

A

Males, common in turner’s syndrome

66
Q

Which is more serious, preductal coarctation of the aorta or post ductal ?

A

Preductal

67
Q

What other heart defects present with pulmonary stenosis/atresia

A

If 100% stenosed, hypoplastic RV with ASD.

68
Q

What are the 3 types of aortic stenosis/atresia

A

Valvular
Subvalvular
Supra-valvular

Clinical Pathology (53 decks)

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