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Systemic Pathology > Cardiovascular System Pathologies > Flashcards

Cardiovascular System Pathologies Flashcards

1
Q

What is hypertension?

A

Persistant elevation of diastolic, systolic, or both pressures

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2
Q

Hypertension

Why should blood be tested on two seperate occasions? How far apart should pressure be tested?

A
  • To show sustained elevation of pressure
  • Test two weeks apart
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3
Q

Cause of primary hypertension?
Secondary?

A
  • Primary: Idiopathic
  • Secondary: Identifiable cause
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4
Q

Pathogenesis

What is blood pressure related to?

(BP = CO x TPR)

A

Cardiac output
Total peripheral resistance

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5
Q

What are contributing factors to hypertension?

A
  • Abnormal sodium transport
  • Sympathetic nervous system stimulatin
  • renin-angiotensin-aldosterone system
  • Vasodilator deficiency
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6
Q

What are the pathological changes to early HTN

A

None

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7
Q

Pathological changes to late HTN

A
  • End-organ damage
  • CV system, brain, kidneys
  • Acceleration of atherosclerosis dev.
  • Death
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8
Q

Can hypertension be asymptomatic?

A

Yes

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9
Q

How is congenital heart defect defined?

A

Defect involving the heart or large vessels present at birth

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10
Q

In which trimester do congenital heart defects develop?

A

First trimester

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11
Q

Congenital heart defect causes

A
  • Idiopathic
  • Environmental
  • Genetic
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12
Q

What is the clinical manifestation of congenital heart defects?

A

Variable depending on severity

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13
Q

What is the most common congenital heart disease?

A

Septal defects

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14
Q

What is a septum defect defined as?

A

Defect in the septum b/w left and right side of heart

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15
Q

Where does a defect occur in a atrial septal defect?

A

foramen ovale

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16
Q

What is more common atrial or ventricular septal defect?
Which is more serious?

A

Ventricular more common and more serious

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17
Q

Ventricular Septal Defect

Explain the difference in pressures b/w left and right heart chambers for a ventricular septal defect

A

Pressure in left heart chamber exceeds pressure in right heart chamber

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18
Q

Ventricular Septal Defect

What is a left-to-right shunt?

A

Blood flows from left to right side of heart

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19
Q

Ventricular septal defect?

What occurs due to the left-to-right shunt and blood flowing into right side of heart?

A

Overburdens right side leading to right ventricular hypertrophy

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20
Q

Ventricular Septal Defect

What happens to pulmonary arteries due to increased flow of blood?

A

Pulmonary hypertension

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21
Q

Ventricular septal defect

what happens after right ventricular hypertrophy and pulmonary hypertension occurs?

A

Increased pressure on right side of heart causing right-to-left shunt

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22
Q

Ventricular septal defect

What does the right-to-left shunt cause?

A

Deoxygenated blood flowing into left side of heart leading to cyanosis

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23
Q

Ventricular septal defect

Clinical manifestations to VSD?

A
  • asymptomatic
  • heart murmur
  • cyanosis
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24
Q

Ventricular septal defect

Treatment of VSD

A
  • Self-limiting
  • surgery
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25
Q

What is Tetralogy of Fallot?

A

A complex congenital defect of the heart and major vessels

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26
Q

What is tetralogy of fallot the most common cause of?

A
  • neonatal cardiac cyanosis
  • 10% of congenital heart defects
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27
Q

What are the four abnormalities that make up tetralogy of fallot?

A
  1. Stenosis of pulmonary valve
  2. Ventricular septal defect
  3. Overriding of aorta
  4. Hypertrophy of right ventricle
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28
Q

Tetralogy of fallor

What does the stenosis of pulmonary artery cause?

A
  • limit blood that can enter lungs
  • Right ventricle needs to work harder
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29
Q

Tetralogy of fallot

What happens when RV pumps harder?

A

Blood shunted through septal defect into aorta and LV

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30
Q

Tetralogy of fallot

What occurs due to aorta overriding septum?

A

Deoxygenated blood goes into systemic circulation

31
Q

Tetralogy of fallot

Clinical manifestations

A
  • Cyanosis
  • Heart murmur
  • failure to thrive
32
Q

Treatment and prognosis of tetralogy of fallot

A
  • Treatment: Surgery
  • Prognosis: Good
33
Q

What is rheumatic fever?

A
  • Systemic disease related to infection by group A streptococcal
34
Q

Why is the incidence of rheumatic fever decreasing

A
  • Antibiotics
  • More effiecient treatment of bacterial infections
35
Q

When does rheumatic fever usually occur?

A
  • Around 2 weeks after acute strep throat
36
Q

During rheumatic fever, antibodies produced by the immune system do what?

Antibodies developed in response to strep infection

A
  • Attack self-antigens of heart, brain, kidneys, muscles, joints
37
Q

Rheumatic heart disease occurs in 50% of rheumatic fever cases. What does this look like?

A

scarring and deformity of heart valves

38
Q

Clinical manifestation of Rheumatic fever

A
  1. Sydenhams Chorea (St. Vitus Dance)
  2. SOB
  3. Nocturnal cough
  4. Subcutaneous nodules
  5. Erythema marginatum (50%)
39
Q

Rheumatic Heart disease

What is Pancarditis

A

Involvement of all layers of heart

40
Q

Rheumatic heart disease

Match the follow terms with the terms below:
* Endocarditis
* Myocarditis
* Pericarditis

Most common, common, rare

A
  • Most common: Endocarditis
  • Common: Myocarditis
  • Rare: Pericarditis
41
Q

Treatment of rheumatic fever?

A
  • Antibiotics
  • Anti-inflammatories
  • corticosteroids
  • CNS depressants
  • Surgery
42
Q

Prognosis of Rheumatic Fever

A
  • 20% of cases will reoccur within 5 years
  • May cause long term heart damage
  • low mortality
43
Q

What is endocarditis

A

Infection of endocardium, including heart valves

44
Q

Where does damage occur most from endocarditis

A

Mitral valve

45
Q

Who has a higher chance of getting right-sided endocarditis?

A

IV drug users

46
Q

Endocarditis risk factors?

A
  • Damaged valves
  • Prosthetic heart valves
  • IV drug users
  • Immunocomprimised
47
Q

Endocarditis

When infection occurs, what is the result?

A

Inflammation and destruction of endocardium and CT

48
Q

What is the role of microorganisms in endocarditis?

A

Adhere to surface and release lytic enzymes that further erode valves

49
Q

Endocarditis

What covers the defect in surface endocardium? What does this covering do?

A
  • Fibrin and platelet thrombi
  • attract more thrombogenic material
50
Q

Endocarditis

What do the small wartlike vegetation structures that grow cause?

A

Verrucous endocarditis

51
Q

Endocarditis

If valves rupture, what could occur?

A

Regurgitation

52
Q

How quick can endocarditis develop?

A

Variable - insidously, over months, of immediately

53
Q

Endocarditis

If infected vegetations break off, what could occur?

A

Septic emboli that can effect brain, kidneys, extermities

54
Q

How does acute bacterial endocarditis present?

A

acute febrile illness of sudden onset

55
Q

How does subacute bacterial endocarditis present?

A

mild temperature elevations that wax and wane

56
Q

What is the prognosis for endocarditis?

A
  • Fatal if untreated
  • Poor prognosis in older people
57
Q

What is myocarditis?

A

Chronic or acute inflammatory condition of muscular walls of heart

58
Q

What is myocarditis also known as?

A

*
* Acquired inflammatory cardiomyopathy

59
Q

What are the active, healing, and healed stages of myocarditis characterized by?

A

Inflammatory cells leading to interstitial edema, focal necrosis, fibrosis

60
Q

Can ventricular arrythmias arise from myocarditis?

A

Yes

61
Q

What are the medications used in myocardis

A
  • antibiotics - bacteria infections
  • cardiac medications - improve CO/reduce arrythmia
  • Corticosteroids for patients w/ lupus carditis
62
Q

What is pericarditis

A

Inflammation of the pericardium

63
Q

Etiology of pericarditis

A
  • Most often viral infections
  • bacterial/fungal infections
  • drugs
  • autoimmune
  • infarcts
  • heart failure complications
64
Q

Peridcarditis symptoms

A
  • chest pain
  • fever
  • dyspnea
65
Q

Pericarditis complications

A
  • myocarditis
  • cardiac tamponade
  • heart failure
66
Q

What is cardiomyopathy

A
  • Group of conditions affecting heart muscles which impair contraction/relaxation
67
Q

Cardiomyopathy classifications

  • Primary
  • Secondary
A
    • Primary: genetic, mixed, confined to heart muscle
  • Secondary: Systemic conditions affecting heart + other tissues
68
Q
A
69
Q

Which population does dilated cardiomyopathy mostly affect?

A
  • Black men aged 40-60
70
Q

Causes of dilated cardiomyopathy?

A
  • 50% idiopathic
  • obesity, alcohol, smoking, hypertension
71
Q
A
72
Q

Cause of hypertrophic cardiomyopathy

A
  • Inherited chromosomal abnormality
73
Q

What does hypertrophic cardiomyopathy commonly cause?

A
  • cardiac death in young competitive athletes
74
Q

Cause of restrictive cardiomyopathy?

A
  • Result of myocardial fibrosis

Systemic Pathology (9 decks)

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