Cardiovascular Pathology Flashcards
Describe the pathology of atherosclerosis
end inj -> LDL gets trapped in Sub-intimal space -> inflam -> macrophages take up oxidised LDL -> foam cells -> apoptosis -> cholesterol core of plaque -> more macrophages and T cells enter + Vasc SMCs form fibrous cap
presence of arrhythmia after an MI
90% of pt develop arrhythmia following MI
what are the results of heart failure on fluid levels and contractibility
Dec CO -> activation of RAS -> eventual fluid overload
Dec SV -> baroR activate SNS -> inc TPR -> inc afterload -> LVH and inc EDV -> dilation and poor contractibility
cause of hypertrophic cardiomyopathy
auto dom mut in B MHC gene
Also Troponin T mut
what does hypertrophic cardiomyopathy cause
myocardial hypertrophy without ventricular dilation
-> sudden cardiac death in young
what causes HOCM
hypertrophic obstructic CM
septal hypertrophy -> outflow tract obs
age range for acute rheumatic fever and presentation
5-15
sympto develop 2-4w after Group A strep throat inf
what are the criteria for diagnosis of acute rheumatic fever
Group A strep inf + 2 major sympto or 1 major + 2 minor
major = carditis, arthritis, sydenhams cholera, erythema marginatum, subcut nodules Minor = fever, inc ESR/CRP, long PR interval, malaise, tachy
most common site infected in acute rheumatic fever
70% = just mitral valve 25% = mitral valve + aortic
histology of actue rheumatic fever
beady fibrous vegetations, aschoff bodies, anitschkov myocytes
what is the main pathogen in acute rheumatic fever
lancefield group A strep
what is the treatment for acute rheumatic fever
benzylpenicillin
what heart feature might you see with acute rheumatic fever
antigenic mimicry - cross-reaction of anti-strep antibodies with heart tissue
what is infective endocarditis
colonisation of heart valves/mural endocardium by microbe
causes of acute infective endocarditis
staph a, strep pyrogenes
causes of subacute inf endocarditis
strep viridans, strep epid
features and spread of acute and subacute inf endocarditis
acute - large vegetations, spread to aorta
subacute - sml thrombi, spread to chordae
duke criteria for diagnosis of inf endocarditis
Major = + ve blood culture of typical org, evidence of veregation/abscess on echo or new murmer Minor = inc RFs, fever > 38, thromboembolonic phenomena, immune phenomena, + ve blood cultures
risk factors for infective endocarditis
prosthetic valve, IVDU, congen valve abn
treatment for inf endocarditis
Acute - MRSA = rifampicin + vancomycin + gentamycin
- MSSA = Fluclox
Subacute - benzylpenicillin + gentamicin
Or - Vancomycin
Causes of aortic stenosis
= narrow aortic valve
calcification (inc with age), congen bicuspid valve
causes of aortic regurg
= incompetent aortic valve
inf endo, dissecting aortic aneurism, LV diation, connective tissue disease
causes of mitral stenosis
Rheumatic fever
causes of mitral regurg
inf endo, connective tissue disease post MI, rheumatic fever, LV dilation
4 types of pericarditis and causes
Fibrinous - MI/uraemia
Purulent - staph
Granulomatous - TB
haemorrhagic - TB, tumour
causes of pericardial effusion
= serous fluid in pericardial sac
usually due to chronic HF
cause of haemopericardiyum
myocardial rupture from MI/trauma
