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Cardiology > Causes and Complications > Flashcards

Causes and Complications Flashcards

1
Q

Primary Hypertension

Risk Factors

A
  • Family history of hypertension or heart disease
  • High sodium diet
  • Obesity
  • Smoking
  • Diabetes
  • Excess alcohol intake
  • Physical inactivity
  • Ethnicity (blacks > whites)
  • Advanced age
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2
Q

Secondary Hypertension

Causes

A
  • Primary renal disease (often unilateral parenchymal)
  • Renal artery stenosis (fibromuscular dysplasia [young patients] or atherosclerosis [old patients])
  • Chronic use of OCPs
  • Pheochromocytoma
  • Conn’s syndrome (hyperaldosteronism)
  • Cushing’s syndrome
  • Coarctation of the aorta
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3
Q

Hypertension

Complications

A
  • Cardiovascular:
  • Left ventricular hypertrophy
  • Congestive heart failure
  • Coronary artery disease
  • Atrial fibrillation (AF)
  • Accelerated atherosclerosis (major risk factor)
  • Aneurysm formation and rupture
  • Dissection
  • Brain:
  • Stroke (ischemic or hemorrhagic [major risk factor])
  • Impaired cognition (dementia)
  • Hypertensive encephalopathy (severe headache, nausea, vomiting [often projectile], focal neurological signs and altered mental status)
  • Eyes: hypertensive retinopathy
  • Kidneys: hypertensive nephropathy and end-stage renal disease
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4
Q

Atherosclerosis

Major or Modifiable risk factors

A
  • Hyperlipidemia
  • Hypertension
  • Smoking
  • Diabetes
  • Obesity
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5
Q

Atherosclerosis

Minor or Non-modifiable risk factors

A
  • Male gender
  • Sedentary lifestyle
  • Stress (type A personality)
  • Elevated homocysteine
  • Oral contraceptive use
  • Increasing age
  • Familial/genetic factors
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6
Q

Atherosclerosis

Complications

A
  • Aneurysms
  • Ischemia
  • Infarcts
  • Peripheral vascular disease
  • Thrombus
  • Emboli
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7
Q

Aortic Dissecting Aneurysms

Complications

A
  • Organ ischemia due to obstruction of aortic branches by pressure like renal or coronary arteries
  • Aortic rupture
  • Death
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8
Q

Superficial Varicose veins of lower extremities

Causes

A
  • Lack of structural support from superficial fat

- Incompetent valves

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9
Q

Superficial Varicose veins of lower extremities

Risk factors

A
  • Pregnancy

- Prolonged standing or sitting

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10
Q

Superficial Varicose veins of lower extremities

Complications

A
  • Edema
  • Thrombosis
  • Stasis dermatitis
  • Ulceration
  • Source of emboli (rarely)
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11
Q

Esophageal Varices

Causes

A

Portal hypertension

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12
Q

Esophageal Varices

Complications

A

Life-threatening hemorrhage

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13
Q

Hemorrhoids

Risk factors

A
  • Constipation

- Pregnancy

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14
Q

Hemorrhoids

Complications

A
  • Bleeding

- Thrombosis (painful)

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15
Q

Stable Angina

Cause

A

Coronary artery atherosclerosis with luminal narrowing greater than 75%, so the pain is brought up by increased cardiac oxygen demand (stress or exercise). It is a subendocardial ischemia

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16
Q

Prinzmetal variant angina

Cause

A

Coronary artery vasospasm (invoked usually by cocaine or smoking) that produces episodic pain at rest. It is a transmural ischemia

17
Q

Unstable (Crescendo) angina

Cause

A

Formation of non-occlusive thrombus in an area of coronary atherosclerosis (due to recurrent atherosclerotic plaque rupture)

18
Q 
Myocardial Infarction (MI)
(Cause)
A
  • Coronary artery atherosclerosis with plaque rupture and superimposed occlusive thrombus formation
  • Unrelieved coronary artery spasm
19
Q 
Myocardial Infarction (MI)
(Complications according to time line)
A
  • 0-24 hr: Cardiac arrhythmias especially VF [most common cause of death], HF and cardiogenic shock (> 40-50% myocardium is necrotic)
  • 1-3 days: Fibrinous pericarditis
  • 3-14 days: Free ventricular wall rupture –> cardiac tamponade, Interventricular septum rupture –> left to right shunt, Papillary muscle rupture –> mitral insufficiency
  • 2 weeks to several months: Congestive heart failure, Dressler syndrome, arrhythmias, true ventricular aneurysm ( risk of mural thrombus and thromboembolism)
20
Q

Sudden Cardiac Death

Causes

A
  • Fatal cardiac arrhythmias (usually VT) with 80% being coronary artery disease as the underlying cause
  • Hypertrophic and dilated cardiomyopathy
  • Mitral valve prolapse
  • Aortic valve stenosis
  • Congenital heart abnormalities
  • Hereditary ion channelopathies (e.g., long QT syndrome and Brugada syndrome)
  • Myocarditis
21
Q

Coronary Artery Disease (CAD)

Risk factors

A
  • Diabetes mellitus
  • Tobacco smoking
  • Hypertension
  • Hyperlipidemia
  • Abdominal obesity
  • Family history of premature CAD (under 55 in male and under 65 in women)
  • Age above 45 in men and above 55 in women
  • CAD risk equivalents are DM, symptomatic carotid artery disease, peripheral artery disease and abdominal aortic aneurysm
22
Q 
Myocardial Infarction (MI)
(Complications according to presentation)
A

All of them cause hypotension

  • Bradycardia: either sinus bradycardia (vascular insufficiency to SA node) or third degree AV block (cannon A waves). Rx: atropine first then pacemaker
  • Tachycardia:
  • RV infarction (associated with inferior MI [40%] and clear lungs). Dx: ST elevation in RV4. Rx: high volume fluid replacement and avoid nitroglycerin
  • Tamponade: “sudden loss of pulse” and clear lungs
  • VT and VF: also cause loss of pulse and should be diagnosed with ECG
  • Valve or septal rupture: both cause new onset murmur and pulmonary congestion (septal rupture cause step-up in oxygen saturation on entering RV)
  • Extension of infarction or reinfarction (inferior or anterior MI)
  • Aneurysm or mural thrombus: most aneurysms need no specific therapy while mural thrombi are treated with heparin followed by warfarin
23
Q

Dyslipidemia

Causes

A
  • Obesity
  • DM
  • Alcoholism
  • Hypothyroidism
  • Nephrotic syndrome
  • Hepatic disease
  • Cushing’s syndrome
  • OCP use
  • High dose diuretic use
  • Familial or hereditary
24
Q

Preductal Coarctation of aorta (infantile type)

Complications

A

Congestive heart failure

25
Q

Postductal Coarctation of aorta (adult type)

Complications

A
  • Congestive heart failure
  • Intracerebral hemorrhage
  • Dissecting aortic aneurysm
26
Q

Transposition of great arteries

Risk factors

A

Infants of diabetic mothers

27
Q

VSD

Complications

A
  • Eisenmenger complex (as all other left to right shunt defects)
  • Infectious endocarditis (small defect only due to jet stream that may damage the endocardium)
28
Q

ASD

Complications

A
  • Eisenmenger complex (as all other left to right shunt defects)
  • Paradoxical emboli (the most common cause is patent foramen ovale)
29
Q

PDA

Risk factors

A
  • Prematurity

- Congenital rubella infections

30
Q

Dilated Cardiomyopathy

Causes

A
  • Idiopathic
  • Alcoholism (B1 deficiency)
  • Wet Beriberi
  • Medications like doxorubicin and cocaine
  • Viruses like Coxsackievirus B and enteroviruses
  • Parasites like Chagas disease
  • Hemochromatosis
  • Sarcoidosis
  • Pregnancy (peripartum cardiomyopathy)
31
Q

Dilated Cardiomyopathy

Complications

A
  • Congestive heart failure (systolic)
  • Mural thrombi
  • Arrhythmias
32
Q

Hypertrophic Cardiomyopathy

Causes

A
  • Autosomal dominant (> 50% of cases, the most common mutation is beta-myosin heavy chain)
  • Idiopathic
  • Can be associated with Friedreich ataxia
33
Q

Restrictive Cardiomyopathy

Causes

A
  • Amyloidosis
  • Sarcoidosis
  • Post-radiation fibrosis
  • Endomyocardial fibroelastosis (thick fibroelastic tissue in endocardium of young children)
  • Loeffler endomyocarditis (fibrosis with prominent eosinophilic infiltration)
  • Hemochromatosis (although dilated cardiomyopathy is more common)

Cardiology (8 decks)

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