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VMS 2004 > Cardiovascular Pathology I > Flashcards

Cardiovascular Pathology I Flashcards

1
Q

What is the main job of the heart?

A
  • To pump blood through the vasculature
  • Meet the cardiac output demands and the waste disposal demands
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2
Q

What happens when the body demands greater output from the heart?

A
  • The heart and vascular system employs mechanisms to compensate and meet demands (increase cardiac output)
  • Cardiomyocytes contract more
  • Increased flow and volume in the conduction system
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3
Q

What is pre-load?

A

Stretching of the cardiomyocytes just prior to contraction

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4
Q

What is after-load?

A

The force which the heart has to contract against to eject blood

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5
Q

What is inotropy?

A

The degree the muscle fibres shorten independent of the load

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6
Q

What is Frank-Starlings law?

A

Increased EDV and therefore pressure, increases the stroke volume

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7
Q

What does a persistently increased diastolic workload lead to?

A

pathologic dilation
* arteriovenous shunts
* AV and semilunar valve insufficiency
* Septal defects
* Fluid overloading

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8
Q

What is cardiac hypertrophy?

A

Reversible increase in mass with a minimal increase in the number of myocardial cells
* a compensatory response in order to increase mechanical work

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9
Q

When does concentric hypertrophy usually occur?

A
  • Concentric hypertrophy is when the walls begin to thicken
  • Usually occurs when there is a chronic pressure overload

increased resistance to the ventricles

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10
Q

When does eccentric hypertrophy occur?

A
  • Occurs when there is a chronic volume overload

eccentric= elongation of the cardiomyocytes

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11
Q

What is physiological hypertrophy?

A
  • Response to exercise or pregnancy
    (increased cardiac output demand)
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12
Q

What is pathological hypertrophy?

A
  • Decreased cardiac function
  • associated with a change in workload
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13
Q

What are the three major arteriovenous connections present during cardiac embryology?

A
  • between the aorta and pulmonary artery= ductus arteriosus
  • Between the atria = foramen ovale
  • separation of the ventricles
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14
Q

What is left to right shunting?

A
  • High to low pressure
  • Systemic -> Pulmonary (overload of pulmonary circulation)
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15
Q

What is Eisenmenger syndrome?

A

Vascular malformations lead to pulmonary hypertension
This leads to a reversal of the left to right shunting across pulmonary-systemic vasculature

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16
Q

What are some of the clinical findings of left to right pulmonary shunting?

A
  • Exercise intolerance
  • Syncope
  • Dyspnea
  • Sudden death
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17
Q

What three murmers might you see in systemic to pulomary shunting?

A
  • PDA- continuous ‘washing-machine’ murmer
  • VSD- right apical to basilar systolic, the smaller the defect the louder the murmer
  • ASD- left basilar systolic
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18
Q

What is a patent ductus arterious?

A

An extra blood vessel between the aorta and pulmonary artery

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19
Q

What are the three atrial septal defects?

A
  • Sinus venosus defects = (septum between right upper pulmonary veins and cranial vena cava)
  • Ostium primum defect= failed fusion of septum primum with endocardial cushions
  • ostium secundum defect = excessively large ostium
    secundum (patent foramen ovale) = most common
20
Q

What is a stenotic disease?

valvular malformation

A

aortic valve narrows and blood therefore cannot flow normally- affects the semilunar valves
(increases the afterload)

21
Q

What is dysplastic disease?

valvular malformation

A
  • an insufficincey -> increases the preload
  • More common in the AV than the semilunar valves
22
Q

What are the three different types of pulmonic stenosis?

narrowing of the valve

A
  • Subvalvular, valvular, supravalvular
23
Q

How is pulmonic stenosis caused?

A
  • Pulmonary outflow tract hypertension -> Pressure overload of the right ventricle -> RV concentric hypertrophy

In english bulldogs- > caused by circumpulmonary left coronary artery

24
Q

What is the most common form of aortic and subaortic stenosis in dogs and pigs?

A

Subvalvular

25
Q

What does pressure overload of the left ventricle cause?

A

Concentric hypertrophy

26
Q

What are the congenital features of AV valve dysplasia

A
  • Shortening, Thickening and rolling of leaflets
  • Direct insertion of valve edges onto papillary muscle
  • atrophy/ fusion/ malposition of papillary muscles and chordae tendinae
27
Q

What are transposition complexes?

A

Malpositioning of arterial trunks

28
Q

What is the most common transposition complex?

A

Overriding aorta
* Aorta straddles IVS, receives blood from both ventricles,

29
Q

What is Tetralogy of Fallot/ Partial transposition?

A
  • Obstruction of Right Ventricle outflow due to abnormal conotruncal positioning
  • overriding aorta
30
Q

What is a persistent right aortic arch?

A
  • Aorta forms from the right 4th aortic arch rather than the left
  • The ductus arteriosus that connects the aorta wraps around the oesophagus -> causing megaoesophagus
  • usually causes aspiration pneumonia
31
Q

What is lusitropy?

A

The rate of myocardial relaxation

32
Q

Why does left to right shunting result in increased left sided volume?

A
  • All of the blood on the right side is pumped into the left side
  • increased blood volume = increased preload for the LHS
33
Q

What is the implication of aortic valve stenosis?

A
  • Smaller aortic valve
  • increases afterload
34
Q

What is an overriding aorta?

A

Aorta lies over a heart defect

35
Q

What is partial transposition?

A

Aorta and pulmonary artery are on the right hand side of the heart

36
Q

What is complete transposition?

A

Aorta leaves the right ventricle
Pulomonary artery leaves the left ventricle

37
Q

What is an overriding pulmonary artery?

A

Aorta leaves through the right ventricle, the Pulmonary artery ‘straddles’ a defective Intra ventricular septum

38
Q

What is a partial transposition also known as?

A

Tetralogy of fallot

39
Q

What does left to right shunting cause?

A
  • Oxygenated blood from the left side flows into the right hand side
  • Volume overload of the pulmonary circulation
  • Therefore also volume overload of the left side as well
40
Q

What is the most common cause of pulmonic stenosis in dogs?

A

Valvular

41
Q

What valves are stenotic diseases most likely to affect?

A

Semilunar valves

42
Q

What valves are most likely to be affected by stenotic diseases?

A

Semilunar valves

43
Q

What valves are most likely to be affected by dysplastic diseases?

A

Atrioventricular

44
Q

What does stenosis and subaortic stenosis look like grossly?

A

White band of thickened tissue

45
Q

What is a frequent sequelae to persistent right aortic arch?

A

Aspiration pneumonia

VMS 2004 (34 decks)

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