CVS patho Flashcards
Shunts in patients with intracardiac fistulas are detected and quantified by?
Echocardiography with doppler
TOF is Caused by :
anterosuperior displacement of the infundibular septum
differential cyanosis seen in? caused by?
Uncorrected PDA→ can eventually result in late cyanosis in the lower extremities, clubbing without pulse and BP discrepancy
PDA closure:
Physiologic
Anatomic
Physiologic at 18-24 h
Anatomical: days to weeks
Left to right intracardiac shunts can be identified by?
bubble study with echocaediography
Complications of Coarctation of aorta include
- HF,
- ↑ risk of cerebral hemorrhage (berry aneurysms)
- aortic rupture
- possible endocarditis
Williams syndrome Congenital heart defect
Supravalvular aortic stenosis
22q 11 syndromes Congenital heart defect
- Truncus arteriosus,
2. tetralogy of Fallot
Marfan syndrome Congenital heart defect
- MVP,
- thoracic aortic aneurysm and dissection,
- aortic regurgitation
Young age, alternating areas of fibrotic web and aneurysmal dilation + lack of intima:
Fibromuscular dysplasia
Isolated systolic HTN in which conditions?
- Age
- Aortic regurgitation
- Anemia
- Hyperhyroidism
HTN nephrosclerosis will cause ↑ EPO or ↓ EPO production?
↓ EPO → Anemia
What is use of Diuretic in chronic lymphedema?
Contraindicated as it cause intravascular volume depletion which is already depleted → AKI
Needle shaped clefts in arterioles:
organs affected?
Atheroembolization
GIT, SKIN, CNS, Renal
Total coronary artery Ca content correlates with:
Ca scoring by cardiac CT scan is used to ____
total atherosclerotic plaque burden
estimate the severity of coronary artery disease
Abdominal aortic aneurysm underlying pathology:
↑ inflammatory infilterates and ROS formation by smoke:
- Transmural inflammation of aortic wall
- Apoptosis of vascular smooth muscles
- Degradation of extracellular matrix proteins (elastin and collagen) by metalloproteinases
Painful pulsatile mass + Systemic signs (fever, malaise)
Mycotic aneurysm : Septic emboli or bacteremic seeding
Aortic dissection trigger:
Associations:
Longitudinal intimal tear
(HTN, bicuspid aortic valve, Marfan syndrome)→ Risk factors of TAA
SCD can be prevented by
Implantable cardioverter-defibrillator
Lightening strike ► Death within 1 hours due to?
1.
2.
Type of burn
ANS damage leads to
- Cardiac arrythmias
- Respiratory failure
Superficial burn
Fixed dilated pupil
Skin lesion in lightening strike
Lichtenberg figure (erythmatous cutaneous marks in a fern-leaf pattern)
Stable angina pharmacotherapy used for stress test?
Results?
Dobutamine
Supply demand mismatch → transient ↓ in contractility → ↓EF
Loss of cardiac myocytes contractility occurs with in ______ after total ischemia
60sec
After 30 mins half of ____ stores are depleted and complete deletion of _______
Adenosine
Myocardial glycogen
Histology
1-3 days after MI
3-14 days
1-3 days: neutrophils
3-7 days Macrophages
10-12 days prominent granulation tissue with neovascularization
Normally R>S waves seen by lead ____
Poor R wave progression is seen in _____
V3
Anterior ischemia
Transmural ischemia of septum (V1 V2) results in
Infranodal (mobitz type 2) 2nd degree heart block or 3rd degree heart block. But sinus bradycardia donot occur
Gold standard for MI diagnosis in first 6 hours
More specific
Reinfarction
ECG
Troponin I 4. 24. 7-10 days
CK-MB 6-12. 16-24. 48h
Drugs avoided in inferior wall MI
Beta blocker
nitrates
myocardial infarction complication with time
1-3 pericarditis 2-7 papillary muscle rupture 3-5 septum 5-14 free wall 3-14 pseudo aneu >14 true aneu
Dilated cardiomyopathy treatment
ABDD
Na+ restriction, ACE inhibitors, ~-blockers, diuretics, digoxin, ICD, heart transplant.
Physiology of HOCM-
asymmetric septaI hypertrophy
and
systolic anterior motion of mitral valve
peripartum cardiomyopathy (during last month of pregnancy and 5 months after delivery) related to impaired function of______
angiogenic growth factor (VEGF) during peripartum period
Cardiac amyloidosis is impaired diastolic filling due to_______ rather than _______
stiffening……….thickening
only slight increase in thickness but LV cavity size remains normal
Familial DCM: truncating mutation in _____ gene which encode for cardiac_____
TTN…………..sacromere protein TITIN
Ventricular Hypertrophy ECG:
High voltage ECG
large S wave in V1 V2 and large R wave in V5, V6
Endocardial fibroelastosis
(thick fibroelastic tissue in endocardium of young children),
Restrictive/infiltrative cardiomyopathy
Loffler endocarditis-
associated with hypereosinophilic syndrome; histology shows eosinophilic infiltrates in myocardium
A patient with HF also has renal failure/ ↑K+, which drug should be avoided?
Mineralocorticoid receptor antagonist
HFrEF contraindicated drug?
Non-DHP CCB
Drugs improving mortality in HFrEF
HI-ABDs Sacubitril-valsartan
Moderate to severe hypothermia (<32’C) can produce hypotension due to
bradycardia
Of all the congenital heart defects _____ is not associated with ↑ risk of Infective endocarditis
ASD
Isotonic fluids
Crystalloid: 0.9% N/S, R/L
Colloid: Albumin (5% or 25%) → treatment of SBP, HRS
Infective endoarditis cause which type of glomerulonephritis?
Diffuse proliferative glomerulonephritis
Causes of nonbacterial (marantic/thrombotic) endocarditis:
malignancy (mucinous adenocarcinoma), hypercoagulable state, or lupus.
less common causes: Burns, Antiphospholipid syndrome, DIC
Infective endocarditis is rarely caused by _______ organisms
gram -ve, endotoxin producing
Pericardial knock is heard in:
early diastole just after S2, even earlier than S3
