CV Path Flashcards
what is the definition of ischamic heart disease
genetic designation or a group of syndromes resulting from myocardial ischameia - an imbalance between oxygen supply and demand
what are 4 types of ischaemic heart disease syndromes
myocardial infarction - ischaemia causing myocardial cell death
angina pectoris - less severe ischameia with no death
chronic IHD - HF
sudden cardiac arrest
apart from IHD syndromes what other syndrome is associated with IHD
acute coronary syndrome
what are the risk factors of IHD
high total cholesterol to HDL ie higher LDL Conc, high BP, life factors ie smoking weight
what pathologically causes IHD
coronary atherosclerosis
what is the pathogenesis of IHD
atherosclerosis and endothelial dysfunction - vessel narrowing and abnormal vascular tone - imbalance of O2
what does narrowing of coronary arteries initially cause
stable angina
what are two types of thrombus that form in coronary arteries and what do they cause
mural thrombus - doesn’t complete block - unstable angina
occlusive angina - completely blocks - MI or sudden cardiac death
what are two types of tissue MI
transmural - full thickness of myocardium death
subendocardial - inner one third of the wall
what myocardial changes occur during MI
1-2 days = pale oedema and myocyte necrosis
3-4 days - yellow with haemorrhagic edges, necrosis and macrophages
1-3 weeks = pale, thin, granulation tissue, fibrosis
3-6 weeks - fibrous scars
what complications can occur due to MI
arrhythmia congestive heart failure thromboembolism ventricular aneurysm leading to cardiac tamponade cariogenic shock
what are the blood markers of IHD
troponins T&I - from damaged myocytes (HF, PE, myocarditis)
creatine kinase MB - myocardium and skeletal muscle
myoglobin - skeletal muscle
lactate dehydrogenase isoenzyme 1
aspartate transaminase - also present in the liver so not good specific marker
what level of sustained blood pressure increased would mean primary HT
140/90
what BP is classed as malignant hypertension
180/120 or greater - urgent treatment required before organ damage
what is the cause of 90% primary hypertension cases
idiopathic
multifactorial - genetics, obesity, alcohol, smoking, stress
what is the cause of secondary hypertension
caused by underlying condition
cushings - increased cortisol - stimulates sympathetic nervous system
conns - increased aldosterone - more na a fluid upstate
pheochromocytoma - increased catecholamine
coarctation of aorta
renal artery stenosis
what are the 4 main complications of having raised BP
renal disease - renal cortical scarring
cerebrovascular disease - subarachnoid haemorrhage secondary to berry anuyreusm
systemic heart disease - left sided heart disease
cor pulmonale - right sided heart disease due to hypertension in pulmonary vessels
what diseases can cause cor pulmonale
diseases of the pulmonary parenchyma
diseases of pulmonary vessels
disorders affecting chest movement
arterial compression
what is an aneurysm
a localised abnormal dilation of blood vessel or the wall of the heart
name 4 types of aneurysms
true aneurysm - all arterial wall dilates outward (tinuca adventitia, media and intima)
false - a breach in the vascular wall leading to extravascular haematoma that freely communicates with the intravascular space
arterial dissection - same as false bu haematoma dissects the layers
mycotic - infected aneurysm - can be secondary to infective endocarditis
what is the aetiology (cause) of aneurysm
atherosclerosis, cystic medial degernation (necrosis of tunica media of arteries), trauma, congenital defects, infections
which syndrome is assciated with necrosis of tunica media of arteries and aneurysm
marfan syndrome
what is obliterative endarteritis
inflammation of the intimacy vessels often caused by the tertiary stage of syphillis
