CV Path2 Flashcards
what is the definition of heart failure / congestive cardiac failure (CCF)
inability fo 4th heart to pump enough blood needed to meet the metabolic demands of tissue
what is the insidious / sudden effect of heart failure
I - chronic workoverlaod such as hypertension and valve disease
s - acute haemodynamic stress such as fluid overload and large MI
what are some common causes of heart failure
smoking, obesity, IHD, hypertension, diabetes, high cholesterol
what is the pathogenesis of heart failure
increased cardiac work - wall stress - cell stretch - hypertrophy or dilation via frank starling
what do the key clinical features of heart failure depend on
whether its left or right sided heart failure
what are the key clinical features of left sided heart failure
low CO and hypo perfusion
pulmonary congestion = pulmonary oedema, dysponea, PND, cyanosis
reduced kidney perfusion and RAAS activation
what are the key clinical features of right sided heart failure
engorgemont of portal and systemic venous return
liver and spleen congestion = oedema and ascites
systemic venous congestion - pleural and pericardial effusions
what are common examples of valvular heart diseases
rheumatic heart disease - aortic stenosis, disorders of valvular regurgitation
what is a problem with valvular opening called
stenosis
what is acquired aortic stenosis and what doe sit lead to
causes left ventricular hypertrophy (but not hypertension) and ischaemia - leads to cardiac decompensation, angina and CCF
what is the most common valvular abnormality and what causes it
calcific aortic stenosis
age related wear and tear
what causes acquired mitral stenosis
rheumatic heart disease
group a strep infection (pyogenes)
what are the clinical features of rheumatic heart disease
mitral valve stenosis with infective endocarditis and classic pancarditis
what is used to diagnosis rheumatic heart disease
the jones criteria
what would problems with closing chambers and valves in the heart lead to
regurgitation, incompetence and insufficiency
what are some causes of aortic regurgitation
RA
syphillis
marfans syndrome
what is a mitral valve prolapse, causes and clinical features
myxomatous degeneration of the mitral valve causing a floppy valve
idiopathic but associated with connective disorder such as marfans
murmur from regurgitation, dyspnoea, chest pain
what is the definition of congenital heart diseases
abnormalities of the heart and the great vessels present from birth - may not appear till later in life
what are some environmental / sporadic causes of congenital heart diseases
E - rubella, gestational diabetes, teratogens
s - downs syndrome, turners
between which weeks do congenital heart defects occur during gestation
faulty embryogenesis from week 3 -8
what are 4 examples of L - R shunts in congenital heart defects and what are two common effects
all have D’s in their name
no cyanosis so live longe r
pulmonary hypertension
atrial septal defect (ASD)
ventricular septal defect (VSD)
atrioventricular septum defect (AVSD)
patent ductus arteriosus (PDA)
describe an atrial septal defect and the prognosis ,which type is most common
abnormal atrial septum allowing communication of blood between the two atria (not patent foramen ovale)
secumdum - most common
asymp until adult hood - low mortality if treated
what is the most common (CHD) congenital heart disease
ventricular septal defect
which heart defect would you see swiss cheese septum
congenital heart defect
ventricular septal defect
how do yo remember congenital heart defects which shunt from R to L and what is the common feature
all have T’s in their name
cause cyanosis - deoxygenated blood bypasses the lungs into systemic circulation so less circulating O2
what are the main types of R - L shunting congenital diseases
tetralogy of fallout coarctation of aorta aortic stenosis pulmonary valve stenosis (atresias)
describe tetralogy of fallout - causes and key clinical features
transposition of great arteries, truncus arteriosus, total anomalous pulmonary venous connection, tricuspid atresia
VSD
sub-pulmonary stenosis
aorta overrides the VSD
RVH
caused by anterosuperior displacement of the infundibular septum during embryogenesis
who is affected more by coarctation of aorta
males - females 2:1 but females with turners frequently have it
what are the two forms of coarctation of aorta
infantile - (open PDA) cyanosis in lower half of the body
adult - closed ductus )no PDA) hypertension in upper extremities with hypotension in lower = claudication and coldness
what is collateral circulation caused by in coarctation of the aorta
intercostal and internal mammary arteries
