Cardiovascular Pathologies Flashcards
What test can you perform to see blockages in heart vessels?
Coronary angiography
What does an echocardiogram do?
Ultrasound to assess: heart size, clots, tumours, contract and relaxation
What is an ejection fracture (EF), how is it measured and what can it indicate?
What is the criteria for a defibrillator?
It is the EF is the volumetric fraction of fluid that leaves the chamber with contraction.
It is measured by an echocardiogram and indicates the prognosis of any heart condition:
Lower = higher chance of sudden cardiac death
<35%: criterion for a defibrillator
What are the 2 main causes of ischemic heart disease
- Occlusion of coronary arteries, e.g; coronary atherosclerosis
- Increase in demand: hypertrophy, shock, increase HR
What’s creates angina and where does it radiate? Why?
Pain in chest wall and down L hand side
Symptoms derived from a ‘transient MI’ (inadequate blood supply to heart muscle)
Radiates down L side because…
- The heart has NO nerve endings for touch/cold/pain/heat.
- But ischemia triggers visceral pain endings in the myocardium
- These visceral pain nerves run through the sympathetic trunk into the spinal cord (T1-T5) especially on the L side, and use the same ganglia to get into the spinal cord as sensory nerves coming from the arm
- Brain confuses inputs as it has NO mechanism for localizing visceral pain – SO it processes the pain as coming from the arm
Name the 3 types of Angina, what tends to aggravate and alleviate each one?
- Stable: most common (middle age), chronic stenosing atherosclerosis that generates symptoms when demand increases, typically relieved by rest or a vasodilator
- Prinzmetal angina; chest pain occurring at rest. The cause is mostly unknown; arterial spasm, stress, unrelated to physical activity or HR - generally responds to vasodilators
- Unstable angina: pain occurs with progressive frequency and duration, associated with disruption of atherosclerotic plaque, superimposed thrombosis, embolization or spasm - predictor of an MI
What defines an MI? Name 2 symptoms and some acute effects
Myocardial cell death
Symptoms: pain, SOB
Acute effects: contractile dysfunction, arrhythmia, cardiac rupture, sudden death, pericarditis
How can a ventricular wall aneurysm lead to cardiac tamponade? What can happen as a result of this?
Ventricular wall aneurysm is a rupture in the ventricle leading to blood leaking into the pericardial sac, the blood buildup will eventually adversely affect heart function (cardiac tamponade) and put pressure on the heart and can stop it from working
What’s a transmural infarction?
Infarction that involves the full thickness of the myocardium
What is heart valvular disease responding to?
Name 5 ‘types’:
Response to Injury
- Mechanical Injury; superficial fibrous thickening
- Stenosis
- Inflammation
- Degenerative changes: calcification, cholesterol
- Incompetence: (can be due to any of these things) valves don’t shut properly allowing backflow of blood
Name 2 things that can occur as a direct result of congestion of the lungs
- Pulmonary hypertension
2. R Heart failure
Name the pathology of what can occur specifically to atria from a Mitral stenosis and how this can affect the body
- increased atrial volume and pressure
- Atrial dilation (also leads to congested lungs)
- Atrial thrombus
… systemic embolization
What is Rheumatic fever?
What triggers it?
An immune-mediated multi-system inflammation disease:
After exposure to streptococcal pharyngitis, it can trigger (a few weeks later) an inflammatory reaction that kicks the immune system into overdrive – factors attack the heart tissue and myocardium
What is a heart sign of rheumatic fever?
Rheumatic valvulitis: vegetation on the valve leaflet, deposits of bacteria, waste, etc.
What is chronic rheumatic valvular disease?
Which valve is almost always affected?
A consequence of rheumatic fever: inflammatory deformity of valves, commonly the mitral valve posing problems to the systemic circulation (but others can be involved)
