Cardiovascular Pathologies Flashcards
What is an Atheroma?
An accumulation of degenerative material in the tunica intimate (inner layer) of artery wall.
What type of degenerative materials are found in the tunica intima - Athetoma
Macrophage cells, or debris, and containing lipids (cholesterol and fatty acids), calcium and a variable amount of fibrous connective tissue.
What is the progressive form of Atheroma?
Atheromatous plaques over time in the vascular system- commonly named atherosclerosis.
Where does Atherosclerosis develop?
In the tunica intima of large and medium sized arteries and begins to form a fibrous cap.
What can happen to the plaques - Atherosclerosis
It can grow and spread into the lumen and long sections of the vessels can be affected.
It can rupture causing thrombosis and vasospasm stopping blood flow.
How are Atherosclerosis visible on x-ray?
It causes bleeding which can be seen on imaging in forms of PE, MI and stroke (myocardial infraction -heart attack).
It more visible postmortem in young children and develops with age.
What are some factors of Athetoma?
Obesity
Diabetes
Alcoholism
Increase in age
Smoking
Sedentary lifestyle
Diet (high cholesterol - sat fat)
What is the prevalence of Atheroma?
It’s more common in males and then females post menopausal
What is the most common type of Arteriosclerosis?
Atherosclerosis
What is Arteriosclerosis?
Degeneration of the arterial walls caused by ageing and hypertension
Hardening of arteries happens when arterial walls thicken and then hardens as calcium deposits
What is the radiographic presentation of Arteriosclerosis?
Large and medium: Dilated tortous and inelastic (e.g abdormial aorta)
Small: narrowed, hyaline material deposits, ischaemia
What is Ischaemia?
An organ or structure that blood supply normally goes to has been narrowed to a point that it is starving it of the nutrients and everything else.
This results in death and necrosis.
What is Atherosclerosis?
Type of hardening of arteries, resulting in lipds - cholesterol - build up on the arterial walls
What is an Aneurysm?
Abnormal local dilutions (ballooning of the vessels)
What are the predisposing factors of an Aneurysm?
The predisposing factors are: Artheroma
Arteriosclerosis
Hypertension
Defective formation of collagen in walls and trauma
What are the different types of Aneurysms?
Saccular (sack type shape)
Fusiform (egg type shape I think)
Pseudo (blood is bleeding out in between the layers in a rupture)
Dissecting (traumatic event - vessel wall weakness)
What does PVD stand for?
Peripheral Vascular Disease
What is Peripheral Vascular Disease (PVD)?
It’s a disease process that causes blockage of the extremity arteries which reduces blood flow and oxygen through the vessels to the extremities.
Development of Ischaemia and Necrosis is a result of what?
As a demand for oxygenated blood exceeded supply
What is the main symptoms of oxygenated blood demand exceeding blood suppy?
Intermittent claudication (cramp like pain) in the legs whilst walking that stops during rest
Due to demand not being met
Can result in loss of a limb or partial loss
What are some causes of PVD?
Smoking
Diabetes
Obesity
Infections
Injury to vessels
Sedentary lifestyle
High blood pressure
Autoimmune disease
High blood cholesterol
Emboli from other locations
Inflammation in blood vessels
What are some symptoms of PVD?
None at first
Coolness to touch
Poor skin, nail health
Infections/ injuries don’t heal
Pain while walking stops with rest
Discolouration: pale, blue, dark red
How does PVD get diagnosed?
Angiogram
Laboratory testing
Doppler ultrasound
Pulse palpitation and ankles
Blood pressure at arms, legs (ABI)
What is the prevelance of PVD?
Affects 5% of people over 50
Affects 12-20% of people over 65
What is Cardical Failure?
Cardiac output is not able to maintain the circulation of blood to meet the needs of the body
What are the different types of Cardiac failure?
Acute/chronic
Left ventricular failure (LVF)
Congestive cardiac failure (CCF)
How does the body try to combat cardiac failure?
The body puts in compensatory mechanisms in order to adapt
What is hypertrophy?
Due to the increased heart rate output the cardiac muscles fibers enlarge and the walls of the heart chambers thicken causing the heart to work harder
What are the different types of hypertrophy and meaning?
End-diastole - Chambers (ventricles) relax (filled with blood)
End-systole - Chambers pumped blood out (when the blood pressure is at the highest)
What is systolic and diastolic dysfunction?
Diastolic dysfunction is a problem with diastole and occurs when the ventricles are stiff and don’t relax properly
Systolic dysfunction happens when the left ventricle of the heart cannot contract completely meaning the heart will not pump blood forcefully enough to move blood throughout the body efficiently
What are the factors of Systolic dysfunction?
Output decreases by 40% from normal
Usually as a result of coronary disease
LV struggles to contract due to contract due to ischaemia
What are the factors of diastolic dysfunction?
Hypertension
Due to chronic hypertrophy there is a decrease in distension of the left ventricle
What is pulmonary oedema?
An abnormal buildup of fluid in the lungs (Aka the bat wing appearance)
What is a pleural effusion?
A buildup of fluid in the space between the lungs and the chest wall
What is a cardiomedley?
It is an enlarged heart seen on any imaging X-ray it is a sign of another condition and is not a disease
What is a perihilar Haze?
It is a poor definition of and slightly increased opacity surrounding the perihillar vessels it’s distinctive With A Hazy or ground glass appearance (around the heart in an xray)
What is kerley b Lines?
They are horizontal lines in the long periphery that extends to the pleural space (visible in an xray)
Which disease is kerley B-Line most common in?
Pulmonary oedema
What does acute cardiac failure cause?
MI (Myocardial Infarction)
PE (Pulmonary embolism)
Severe arrhythmia
Rupture of chamber or valve cusp
Heart infections - then can lead to chronic heart failure
What is MI?
Branch of a coronary artery becomes blocked most common atheromatoys plaques complicated by thrombosis and damage depends on site
What is pericardial effusion?
The pericardium fills with abnormal fluid and compresses the heart
Abnormal accumulation
Cardiac tamponade: pericardial effusion with enough pressure to adversely affect heart function
What are the types of pericardial effusion?
Pericarditis and cardiac tamponade
What is pericarditis and cardiac tamponade?
Pericarditis: the heart wall is either inflamed or has an infection (inflamed pericardium)
Cardiac tamponade: blood in the pericardial sac
What is ischemic heart disease (IHD)?
Narrowing of the heart vessels which causes the heart to not get enough blood
What is a sinus rhythm?
It’s highly tuned and balanced wave of electrical stimulation which causes perfect filling and emptying of the heart
What happens when a normal Rhythm Is Altered? And how can this be managed?
Coordinated output becomes disorganised
With the use of a pacemaker
REVISION
ANEURYSM -PATH
Incidence - 1 in 20 or 1 in 100 people
Prevalence - 2-3% of people, more common I women than men, more common I adults
Epidemiology - it’s difficult to say as they cause no symptoms and Pass undetected
Aetiology - a weakness in the walls of blood vessels in the brain 🧠
Clinical features/ presentation - sudden agonising headache, feeling or being sick
Radiological consideration -
REVISION
PERIPHERAL VASCULAR DISEASE - PATH
Incidence - 6.5 million people age 40 and older
Prevalence - men over 50 and postmenopausal women
Epidemiology -
Aetiology - furring of large arteries, buildup of plaque inside the artery wall
Clinical features/ presentation - absent or dimished pulses, abnormal skin colour, poor hair growth Radiological consideration - MRA
REVISION
CARDIAC FAILURE - PATH
Incidence - affects 900,000 people
Prevalence - 5% of those aged over 75, 15% in the very old, 6.2 million adults
Epidemiology -
Aetiology - High blood pressure
Clinical features/ presentation - breathlessness after activity or at rest, swollen ankles or legs, fainting, light-headedness, chest pain
Radiological consideration - cardiomegaly, increased Central systemic venous volume, cardiothoraxic ratio increase, ground glass appearance
REVISION
PULMONARY OEDEMA 🫁 - PATH
Incidence -
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REVISION
ISCHAEMIA & MI
Incidence -
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REVISION
ARRHYTHMIA
Incidence -
Prevalence -
Epidemiology -
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