CVS

Question 1

Pathogenesis of atherosclerosis

Answer 1

Endothelial injury increasing permeability, causing leukocyte adhesion and macrophage activation
Lipid deposition in damaged intima, phagocytosed by macrophages (foam cells) which form fatty streaks (early plaque)
Macrophages release cytokines and growth factors, causing ECM synthesis
Collagen synthesis forms a dense fibrous cap over plaque, white and hard (established atherosclerosis)
Collagenisation affects the tunica media, disrupting elastic lamina and weakening the arterial wall, ulcerating and causing platelet aggregation and thrombosis (complicated atherosclerosis)
Small size + large lipid core + thin fibrous cap = more likely to rupture

Question 2

How does MI cause pulmonary and ankle oedema

Answer 2

Death of cardiac muscle leads to LV pump failure
Backward failure leads to LA dilation, pulmonary hypertension and congestion and edema
Left side failure may lead to right ventricular failure, causing systemic and portal congestion and ankle edema

Question 3

MI complications

Answer 3

Myocardial rupture
Congestive heart failure
Fibrosis
Aneurysm
Thrombus
Pericarditis
Ruptured papillary muscle
Arrhythmia
Contractile dysfunction

Question 4

Risk factors for MI

Answer 4

Modifiable: Hyperlipidemia, hypertension, diabetes, smoking
Non-modifiable: age, gender (male), family history, genetics

Question 5

What is infective endocarditis

Answer 5

Infection of valves forming vegetation and destroying tissue
Causes fever, chills, heart murmurs

Question 6

What is rheumatic heart disease

Answer 6

Abnormal immune response to group A strep
Inflammation and damage to valves causing stenosis and regurgitation
Rheumatic valvulitis: fibrous thickening and fusion of chordae tendinae