Cardiovascular pathology 1

Question 1

Ischaemic Heart Disease definition

Answer 1

genetic designation for a group of syndromes resulting from myocardial ischaemia – an imbalance between oxygen supply and demand

Question 2

Myocardial infarction

Answer 2

duration and severity of ischaemia causes myocardial death

Question 3

Angina Pectoris =

Answer 3

Ischaemia is less severe and does not cause myocardial death (stable angina/prinzmetal angina/unstable angina)

Question 4

Risk factors of IHD

Answer 4

• High TC:HDL (total cholesterol:HDL = high ratio means higher proportion of LDL)
• high BP, lifestyle factors

Question 5

IHD aetiology

Answer 5

• Mostly due to atherosclerosis

- Sometimes due to hypertrophy

Question 6

IHD pathogenesis

Answer 6

Atherosclerosis and endothelial dysfunction = fixed vessel narrowing and abnormal vascular tone = imbalance between oxygen supply and demand

• Narrowing of lumen causes stable angina
• Damage to endothelium may cause a thrombus,
• Occlusive thrombus (complete block) = MI

Question 7

Types of MI

Answer 7

• Transmural – full thickness of myocardium

- Subendocardial – inner one third of the wall (least well perfused)

Question 8

Complications of MI

Answer 8

• Arrhythmia – damage to conduction system
• Congestive cardiac failure, can’t contract due to papillary muscle infarct
• Thromboembolism, pericarditis
• Ventricular aneurysm leading to cardiac tamponade (break in wall - fluid/blood fills pericardium, compressing heart = pericardial shock)
• Cardiogenic Shock = cannot deal with demand and pump of the blood

Question 9

Blood markers of IHD

Answer 9

• Troponins T&I
• Creatine Kinase MB
• Myoglobin
• Lactate dehydrogenase isoenzyme 1

Question 10

Hypertension Definition

Answer 10

• Primary (idiopathic/essential) or secondary

- Primary HT is one extreme on the distribution of BP – sustained 140/90

Question 11

Malignant hypertension =

Answer 11

• BP >180/120 – urgent treatment needed before organ damage occurs

Question 12

Aetiology of Primary hypertension

Answer 12

• Multifactorial:
• Associated with insulin resistance
• Obesity, alcohol, smoking
• Sodium intake

Question 13

Aetiology of Secondary hypertension

Answer 13

Caused by a condition:

• Cushing’s - increases Na + fluid uptake
• Conn’s - increases Na + fluid uptake
• Pheochromocytoma - narrows vessels and raises BP
• Coarctation of aorta
• Renal artery stenosis - RAAS activation

Question 14

Complications of Increased BP

Answer 14

• Renal disease
• Cerebrovascular disease = subarachnoid haemorrhage
• Systemic heart disease = left sided heart disease
• Cor pulmonale = right sided heart disease

Question 15

left sided heart disease =

Answer 15

Systemic hypertension = hypertrophy of the left ventricle due to pressure overload (becomes heart failure when it can no longer work efficiently)

Question 16

right sided heart disease =

Answer 16

• Due to hypertension in the pulmonary vessels = hypertrophy of the right ventricle due to pressure overload

Question 17

Aneurysm definition

Answer 17

A localised abnormal dilation of a blood vessel or the wall of the heart

Question 18

True aneurysm =

Answer 18

All arterial wall (tunica adventitia, media and intima) dilates outward

Question 19

False aneurysm =

Answer 19

A breach in the vascular wall leading to an extravascular hematoma that freely communicates with the intravascular space (“pulsating haematoma”)

Question 20

Arterial dissection =

Answer 20

Similar to a false aneurysm but the haematoma dissects the layers

Question 21

Mycotic aneurysm =

Answer 21

Infected aneurysm – can be secondary to infective endocarditis

Question 22

Aetiology of Aneurysms

Answer 22

• Atherosclerosis
• Cystic medial degeneration
• Trauma
• Congenital defects
• Infections