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Pathology > Cardiovascular Pathology II > Flashcards

Cardiovascular Pathology II Flashcards

1
Q

What is ischemic heart disease?

A

Coronary heart disease, damage to the arteries of the heart

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2
Q

What is present in more than 90% of IHD cases?

A

Coronary atherosclerosis

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3
Q

What are the four basic forms of ischemic heart disease?

A

Angina pectoris, myocardial infarction, chronic ischemia leading to CHF, sudden death from arrhythmia

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4
Q

What are risk factors for ischemic heart disease?

A

Hypertension, hypercholesterolemia, diabetes, smoking, lifestyle, diet, genetic

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5
Q

What is myocardial infarction?

A

Heart attack, death of cardiac muscle from ischemia

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6
Q

What are 90% of myocardial infarctions caused by?

A

Thrombosed artery
Disruption of the atherosclerotic plaque leading to formation of thrombus
Results in total occlusion

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7
Q

What are the symptoms of myocardial infarction?

A

Crushing pain in chest, sweating, nausea, vomiting, dyspnea

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8
Q

What are complications of myocardial infarction?

A

Coagulative necrosis, cardiogenic shock (sudden loss of pumping strength), cardiac failure, arrhythmias, mural thrombosis, valvular dysfunction (due to rupture of papillary muscle), rupture, tamponade or death

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9
Q

Describe the gross morphological changes associated with myocardial infarction.

A

18-24 hours: pallor of myocardium
24-72 hours: pallor with some hyperaemia
3-7 days: hyperaemic border with central yellowing
10-21 days: minimally yellow and soft with vascular margins
7 weeks: White fibrosis

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10
Q

What are two types of myocardial infarctions?

A

Transmural infarction and subendocardial infarct

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11
Q

What is a transmural infarction?

A

Ischemic necrosis of full or nearly full thickness of ventricular wall in distribution of single coronary artery

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12
Q

What causes a transmural infarction?

A

Coronary atherosclerosis, acute plaque change, superimposed thrombosis

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13
Q

What is a subendocardial infarct?

A

Necrosis limited to inner on third or half of the ventricular wall, localised or circumferential

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14
Q

What causes a subendocardial infarct?

A

Acute coronary thrombosis, hypotension

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15
Q

How are myocardial infarctions diagnosed?

A

Symptoms, ECG pattern, cardiac biomarkers

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16
Q

What is different about an ECG in myocardial infarction?

A

ST elevation, new Q waves in silent infarction

17
Q

Which cardiac biomarkers indicate recent myocardial infarction?

A

Raised cardiac troponin (T and I): remain elevated for up to two weeks
CK-MB: MB subtype of creatine kinase raised

18
Q

What is congestive heart failure?

A

Diminished pumping ability of left ventricle

19
Q

What is the result of congestive heart failure?

A

Inadequate supply of blood and oxygen to cells, back up of blood in pulmonary vasculature leading to pulmonary edema, peripheral edema

20
Q

What is heart failure?

A

Diminished out volume of either ventricle, often due to loss of contractility of myocardium

21
Q

What is forward failure?

A

Diminished cardiac output

22
Q

What is backward failure?

A

Damming of blood in venous system

23
Q

What is systolic failure?

A

Loss of pumping strength leading to backup of blood and atherosclerosis leading to chronic ischemia

24
Q

What is diastolic failure?

A

Reduced ability of ventricle to fill, constriction or trapping of ventricle

25
Q

What are adaptations to congestive heart failure?

A

Activation of neurohumoral systems (sympathetic mediated peripheral vasoconstriction, renin-angiotensin-aldosterone system and ANP), Frank-Starling mechanism (cardiac output increases or decreases in response to changes in HR or SV), hypertrophy

26
Q

Why does congestive heart failure cause edema?

A

Increased hydrostatic pressure due to backup of blood resulting in water being driven into interstitial spaces

27
Q

What causes the clinical symptoms of congenital heart diseases?

A

Mixing of blood

28
Q

What causes congenital heart diseases?

A

Environmental/developmental factors, eg. maternal infection, foetal alcohol syndrome; genetic factors are rare

29
Q

What are three types of congenital heart diseases?

A

Left-to-right shunts, right-to-left shunts, obstructive anomalies

30
Q

What are three left-to-right shunt congenital heart diseases?

A

Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA)

31
Q

What is a right-to-left shunt congenital heart disease?

A

Tetralogy of Fallot: transposition of great arteries (aorta from RV, pulmonary artery from LV), present with cyanosis

32
Q

What are three congenital obstructive anomalies?

A

Coarction of the aorta, pulmonary stenosis and atresia, aortic stenosis and atresia

Pathology (5 decks)

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