Cardiovascular Pathology

Question 1

What is a thrombosis? And what key factors cause it?

Answer 1

Thrombosis: formation of a thrombus (coagulated blood containing platelets, fibrin & entrapped blood elements within a vascualr lumen). Key Factors: endothelial damage, alternation in blood flow (turbulence or stasis), increased coagulability of blood.

Question 2

Define Infarction

Answer 2

Process by which necrosis develops distal to occlusion of an end-artery (can happen anywhere

Question 3

Define Embolism

Answer 3

passage of any material through circulation capable of lodging in a blood vessel

Question 4

What are the symptoms of a Pulmonary Infarcton?

Answer 4

cough, shortness of breath, stabbing (pleuritic) chest pain, hemoptysis (cough blood)

Question 5

Define Edema

Answer 5

prescence of excess fluid in intersitial spaces or body cavities

Question 6

What is it called when you have GLOBAL edema?

Answer 6

anasarca

Question 7

Define Artherosclerosis

Answer 7

A vascular diases characterized by intimal lesions (atheromas or plaques) which protrude into the lumen & weaken the underlying media
*** responsible for more mortality and morbidity in Western society than any other disorder (~50%).

Question 8

What “arteries” are mainly affected by Artherosclerosis

Answer 8

abdominal aorta> coronary> popliteal

Question 9

Your patient has atherosclerosis, and does not want to exercise or take his medications. You want to educate him on why it is important to exercise and what the condition could lead to…..

Answer 9

MI, cerebral infarction (stroke), aortic aneurysm, PVD.

Question 10

You want to educate your patient on some modifiable risk factors for arteriosclerosis - which are…

Answer 10

hyperlipidemia, hypertension, cigarette smoking, and DM (non-mod: age, male, fam hx, and genetic abnormalities)

Question 11

What is ischemic heart disease (IHD) and what other clinical manifestations can it lead to (4)?

Answer 11

IHD: a group of closely related diseases caused by myocardial ischema (an imbalance between supply/perfusion and demand)
Manifestations - angina, MI, chronic IHD with failure, sudden cardiac death

Question 12

What is angina pectoris?

Answer 12

Angina pectoris - a syndrome characterized by paroxysmal, recurrent episodes of chest discomfort caused by transient myocardial schema (d/t imbalance of supply and demand).

Question 13

What are the 3 overall patterns of angina pectoris?

Answer 13

1) Stable angina - chronic, fixed obstruction - relieved by rest or nitroglycerin
2) Variant (Prinzmetal) angina - uncommon, occurs at rest and is caused by a coronary vasospasm. Unrelated to PA or workload by heart.
3) Unstable (Cresendo) angina - next slide

Question 14

What are the symptoms of someone who has unstable angina? *** (important to know)

Answer 14

1) occurs progressively with increasing frequency
2) is precipitated by less effort
3) often occurs at rest
4) is more prolonged
* * Often a prodrome of an acute MI

Question 15

Define ‘MI’

Answer 15

Also known as a ‘heart attack’ is death of heart muscle d/t ischemia
- loss of critical blood supply which causes profound functional, biochemical and morphological changes.

Question 16

What are the RF’s for MI?

Answer 16

Similar to artheroslerosis. M>W (hyperlipidemia, hypertension, cigarette smoking, and DM (non-mod: age, male, fam hx, and genetic abnormalities)

Question 17

What is the most common site of occlusion for an MI?

Answer 17

Left anterior descending (40-50%)

Question 18

Clinical features of MI (S&S (4) and Lab (2))

Answer 18

S&S: chest pain or discomfort with variable distribution and nature of pain, dyspnea, rapid pulse, profuse sweating
Lab: Troponins (rise at 2-4 hrs, peak at 24-48, stay elevated for 7-10 days). Creatine Kinase (same as above but only stays for 3 days) - both of these are released when the heart mm dies.

Question 19

What is pericarditis?

Answer 19

imflammation of the pericardium (“sac” around the heart)

Question 20

What is cardiac hypertrophy?

Answer 20

enlargement of the heart

Question 21

what are the 3 types of cardiac hypertrophy?

Answer 21

1) pathological hypertrophy (prolonged increased workload d/t pregnancy or exercise - can be L or R sided)
2) Concentric hypertrophy - walls in the L ventricle thicken d/t longstanding pressure.
3) Cor Pulmonale** - R ventricle wall is thickened, d/t increased P on the R side of the heart)

Question 22

What could cause Cor Pulmonale

Answer 22

Disease of lung parenchyma, disorders of chest movement, lung blood vessels, pulmonary arterial constriction

Question 23

One major cause of Cor Pulmonale?

Answer 23

COPD

Question 24

What is cardiomyopathy?

Answer 24

A myocardial disease in which the heart mm is structurally and functionally abnormal, in the absence of CAD, hypertension, vavular myocardial abmornalities. Mainly idiopathic

Question 25

Dilated cardiomyopathy?

Answer 25

Heart with increased mass, 4-chamber dilation, primarily systolic dysfunction (forward failure)

Question 26

Define hypertrophic cardiomyopathy

Answer 26

hypertrophied, hypercontracting heart; abnormalities in filling (diastolic dysfunction)
Presentation: rhythm disturbances, chest pain, SOB, heart failure (<10%) and sudden death.
Genetic cause 50% familial.