Cardiovascular pathology Flashcards
New heart murmur
IE
Nutmeg liver
Haemosiderin-laden macrophages in lungs
DIlated ventricles on PM
Left-sided HF
Fever + pleuritic chest pain following MI
Dressler’s syndrome (AI)
4 early complications of MI (EXAM Q)
- Contractile dysfunction
- Arrhythmia
- Myocardial rupture (usually free wall - wall weakens when fibrosis occurring - tamponade)
- Papillary muscle rupture (> valve incompetence)
Later complications of MI (>1w)
Pericarditis (Dressler's syndrome) Ventricular aneurysm (ballooning of wall due to fibrosis - reduced motility can form thrombus - embolism e.g. to SMA)
Histology normal
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<6h post-MI
Necrotic cell death
Contraction band necrosis (red wavy lines across fibres)
Loss of nuclei
Homogenous cytoplasm
1d post-MI
Acute inflammatory response with neutrophils
1-4d post-MI
Early scar formation
Collagen synthesis
2w post-MI
Decellularising scar formation
2m post-MI
Episodic flushing, abdominal cramps and diarrhoea
5-hydroxyindoleracetic acid producing tumours
Right sided valve abnormalities
Carcinoid syndrome
Myocyte hypertrophy + disarray
AD
B-myosin heavy chain mutation
Too thick
HCM
Progressive loss of myocytes
Alcohol
Too thin
DCM
Mitral regurgitation
St Vitus Dance + pericarditis
Group A Strep throat a few weeks ago
Rheumatic fever
AR + aortic dissection
Marfan’s
Unexpected cardiac death No symptomatic cardiac disease or 1h after onset of symptoms Lethal arrhythmia Possible underlying HOCM or prolonged QT Ischaemia induced electrical instability
Sudden Cardiac death
Nutmeg liver
Ankle swelling
Oedema
Right sided HF
Critical stenosis
> 70%
Most common site of coronary plaques
First few cm of LAD or LCX
Entire length of RCA
Myocyte necrosis
MI
Aortic valve calcification
Aortic stenosis
Aortic regurgitation causes
Rigidity (rheumatic, degenerative)
Destruction (endocarditis)
Disease of aortic valve ring (Marfan’s, dissecting aneurysm, syphilis, ank spond = dilates - insufficient to cover increased area
True aneurysm
Ballooning of all layers of wall
Changes post-MI
1d: Necrosis
1-4d: Neutrophil infiltration
2w: Early scar formation with collagen
2m: Decellularising scar formation
