Cardiovascular pathology Flashcards
What is regurgitation? What is functional regurgitation?
When the valve is incompetent. When the valve becomes incompetent due to dilation of the ventricle.
What is valvular calcification?
Caused by high mechanical stress. Calcification becomes apparent in 70-80 year olds. Happens in normal and congenitally bicuspid aortic valves.
What is the most common valvular disease in the world?
Floppy mitral valve disease
What is rheumatic fever?
Acute immunologically mediated multisystem inflammatory disease to Group A streptococcus. Features include polyarthritis, carditis, nodules, rash and Sydenham chorea
What are the antigens in rheumatic fever?
M antigens resembling group A strep
What is the infection before RF?
Group A beta heamolytic streptococcus (GABS) pharyngitis
What are some unique signs of rheumatic heart disease?
Syndenham chorea
Subcutaneous nodules
What are some microscopic features of rheumatic fever?
Endocardium - vegetations
Myocardium - Aschoff bodies
Pericardium - group a streptococus
What can RF cause to happen to the mitral valve?
Mitral stenosis
What is a mnemonic for rheumatic fever?
Vegetations Aschoff bodies Group A beta strep Infections Neurological symptoms - Sydenhams Arthritis
What is the difference between acute and subacute endocarditis?
Acute has a 50% mortality and an acute onset where the valve was normal.
Subacute is an insidious onset where there is less destruction and the valve was previously abnormal.
What organisms cause infective endocarditis?
Alpha haemolytic streptococcus
Staph aureus in IV drug users
Staph epidermidis in protesthetic valve patients
What is a cardiomyopathy?
A heart disease resulting from a primary abnormality in the myocardium
What are the 3 types of cardiomyopathy?
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy (least common)
What causes dilated cardiomyopathy?
Alcohol, peripartum, myocarditis, haemochromatosis, chronic anaemia, sarcoidosis
What is hypertrophic cardiomyopathy?
More of a genetic component
What is restrictive cardiomyopathy characterised by?
Normal sized ventricles, normal chambers, both atria dilated, myocardium is firm
What causes restrictive cardiomyopathy?
Radiation fibrosis Amyloidosis Sarcoidosis Tumour Inborn errors of metabolism Endomyocardial fibroses
What is hypertrophic cardiomyopathy characterised by?
Smaller chambers
Less diastolic filling
What is dilated cardiomyopathy characterised by?
Hypertrophy Dilation of chambers Contractile dysfunction Congestive heart failure Large flabby heart Regurgitation
