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Clinical pathology > Cardiovascular pathology 3 > Flashcards

Cardiovascular pathology 3 Flashcards

1
Q

Peripheral Vascular Disease definition

A

Narrowing of blood vessels (usually arteries) = restricts blood flow. Mostly in the legs.

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2
Q

Peripheral Vascular Disease aetiology

A

Agents that can damage the endothelium

- Oxidative stress – smoking, hypertension, diabetes, hypercholesterolaemia, obesity

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3
Q

Peripheral Vascular Disease pathogenesis

A
  • Chronic or acute – gradual atherosclerosis or plaque rupture/thrombus formation.
  • Narrow artery = ischaemic = cell damage/death
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4
Q

Peripheral Vascular Disease clinical features

A
  • Acute Ischaemia: 6 Ps pale, pulseless, painful, paralysed, paraesthetic, perishing cold
  • Chronic peripheral vascular disease: start as intermittent claudication then get coagulative necrosis
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5
Q

Vasculitis: Giant Cell Arteritis definition

A

Chronic granulomatous inflammation of large to small sized arteries, principally in head (temporal arteritis). Considered a medical emergency as it can lead to blindness

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6
Q

Vasculitis: Giant Cell Arteritis epidemiology

A
  • Most common form of vasculitis
  • Older individuals >50
  • F > M
  • PMH of polymyalgia rheumatica
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7
Q

Vasculitis: Giant Cell Arteritis Pathogenesis

A

Chronic granulomatous inflammation = narrows artery = ischaemia = cell damage

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8
Q

Vasculitis: Giant Cell Arteritis clinical features

A
  • Flu-like symptoms = fatigue, weight loss, fever
  • Pain = tender superficial temporal artery/scalp, jaw claudication
  • Vision problems = blurred vision, blindness
  • Stroke
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9
Q

Claudication =

A

Pain and/or cramping in the muscles due to inadequate blood flow to the muscles

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10
Q

Infective Endocarditis definition

A
  • Infection and inflammation of endocardium; lining of heart/mainly valves
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11
Q

Infective Endocarditis epidemiology

A
  • Structurally abnormal valves
  • Foreign material in heart
  • Immunosuppressed
  • Bacteraemia
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12
Q

Infective Endocarditis Aetiology

A
  • Infection enters heart via any route of bacteria in blood stream
  • Streptococcus Viridans/Bovis
  • Staphylococcus Aureus/Epidermis
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13
Q

Infective Endocarditis pathogenesis

A
  • Hear failure due to valve regurgitation
  • Fibrin is deposited over the damaged valves and circulating bacteria colonise the fibrin - This leads to vegetations forming
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14
Q

Infective Endocarditis clinical features

A
  • Fever
  • Murmurs - 90% = left sided IE
  • “FROM JANE” – Fever, Roth, Osler’s, Murmurs, Janeway, Anaemia, Nail Haemorrhage, Emboli
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15
Q

Pericarditis definition

A
  • Definition = inflammation of pericardial sac
  • Acute (< 6/12): serofibrinous, caseous, haemorrhagic & purulent
  • Chronic (>6/12): constrictive
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16
Q

Pericarditis aetiology

A
  • Infections - viruses (Coxsackie B)
  • Autoimmune - Rheumatic fever, SLE
  • Uraemia, cardiac surgery, neoplasia
17
Q

Pericarditis pathogenesis

A

Serous: inflammation caused clear fluid accumulation - caused by non-infectious
- Serofibrinous: Serous fluid and/or fibrinous exudate in pericardial sac

18
Q

Pericarditis clinical features

A 
- Pericardial friction rub
Sharp central chest pain:
- Exacerbated by: movement, respiration, lying flat.
- Relieved: sitting forwards.
- Radiating: shoulders/neck.
- Differentials: angina, pleurisy.
19
Q

Rheumatic Fever definition

A
  • Acute, immunologically mediated, multi-system inflammatory disease following group A streptococcal pharyngitis
20
Q

Rheumatic Fever epidemiology

A
  • Rare in developed world but typically, children 5-15yrs and history of sore throat
21
Q

Rheumatic Fever pathogenesis

A
  • Combined antibody and T cell mediated response to self-antigens in the heart
  • Antibodies made for Strep attack cells in the heart as they have same antigen
22
Q

Rheumatic Fever Clinical features

A
  • Heart = pancarditis
  • Endocarditis
  • Mitral valve stenosis
  • Vegetations “verrucae”
  • Myocarditis
  • Pericarditis
  • arthritis
  • CNS = Sydenhams chorea
23
Q

4 types of cardiomyopathy

A
  • Dilated
  • Hypertrophic
  • Restrictive
  • Arrhythmogenic right ventricular cardiomyopathy (dysplasia)
24
Q

Pathogenesis of cardiomyopathy’s

A
  • Heart Failure (abnormal muscle cannot cope with workload)
  • Emboli (Virchow’s Triad)
  • Arrhythmias (disruption of electrical conduction pathways)
25
Q

Clinical features of Dilated Cardiomyopathy

A
  • Thin walled ventricular chambers = weak pump
  • Can cause heart failure
  • Heart enlarged, heavy, flabby
  • Thrombus +/- emboli
  • Arrhythmias and sudden death
26
Q

Clinical features of Hypertrophic Cardiomyopathy

A
  • Impaired ventricular filling +/- left ventricular outflow obstruction
  • Relative ischaemia
  • Mural thrombus formation
  • Heart failure
27
Q

Clinical features of Restrictive Cardiomyopathy

A
  • Causes impaired ventricular filling
  • Can lead to heart failure, arrhythmias, mural thrombi
  • Often secondary to fibrosis and errors of metabolism
28
Q

Clinical features of Arrhythmogenic RV Cardiomyopathy

A
  • Young males/athletes
  • Genetic disease – autosomal dominant
  • Mutation in desmosome proteins = cells detach = fibrofatty tissue forms, interferes with contraction and conduction
  • RV dilation and impaired filling
29
Q

Myocarditis definition

A

inflammation of myocardium

30
Q

Myocarditis aetiology

A
  • Caused by infection
  • Viruses - Coxsackie etc
  • Bacteria - Dipth + meningococcus
  • Fungi - Candida
  • Protozoa
  • Helminths
31
Q

Myocarditis pathogenesis

A

Inflammation of myocardium = dysfunctional myocardium = electrical dysfunction = arrhythmias/ sudden death or mechanical dysfunction = heart failure

Clinical pathology (69 decks)

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