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Cardiac PathoPhys > February 11th Lecture > Flashcards

February 11th Lecture Flashcards

1
Q

What is coronary heart disease (CHD) characterized by?

A

Insufficient delivery of oxygenated blood to the myocardium

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2
Q

What is coronary heart disease most commonly due to?

A

Coronary artery atherosclerosis

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3
Q

How many minutes can the myocardium survive with no oxygenated blood?

A

20 minutes

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4
Q

What are 3 other causes of CHD?

A

Abnormalities of blood oxygen content
Poor perfusion through coronary arteries
Abnormalities of microcirculation (genetic)

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5
Q

What is arteriosclerosis

A

Chronic disease of arterial system
Abnormal thickening and hardening of vessel walls
Gradual narrowing of arterial lumen

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6
Q

What is atherosclerosis

A

Form of arteriosclerosis
Caused by an accumulation of lipid-laden macrophages in arterial wall
Leads to plaque disease
Inflammatory disorder (not a single disease)

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7
Q

Stages of coronary atherosclerosis

A

Endothelial injury
Endothelial cells become inflamed
Inflammatory cytokines and growth factors released
Macrophages adhere to injured endothelium
Macrophages create oxidative stress

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8
Q

What are foam cells?

A

Macrophages fully of oxidized LDLs

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9
Q

What is a fatty streak?

A

Accumulation of foam cells; produce progressive wall damage

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10
Q

How does a fibrous plaque form?

A

When smooth muscle cells proliferate and migrate over a fatty streak

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11
Q

What is cardiac muscle replaced with when it dies?

A

Dense, irregular, connective tissue

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12
Q

What is CAD (coronary artery disease)?

A

Any vascular disorder that narrows or occludes coronary arteries
Can diminished blood supply enough to cause ischemia

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13
Q

What is myocardial ischemia?

A

Narrowing >50%

Impairs blood flow during exercise

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14
Q

How long does it take for a cardiac muscle cell to become ischemic?

A

10 seconds, lose contractibility after several minutes

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15
Q

What is angina pectoris?

A

Chest pain due to myocardial ischemia

No permanent change, or damage if blood flow is restored

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16
Q

What is Acute coronary syndrome?

A

Sudden obstruction due to thrombus formation of ruptured plaque

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17
Q

What is unstable angina?

A

Type of acute coronary syndrome

reversible myocardial ischemia

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18
Q

What is a myocardial infarction?

A

Type of acute coronary syndrome

Prolonged ischemia causing irreversible heart muscle damage

19
Q

What is sudden cardiac death?

A

Sudden arrest

Death from loss of heart function within 1 hour of onset of symptoms

20
Q

Chronic Ischemic Cardiomyopathy

A

Heart failure develop insidiously
Consequence of progressive ischemic myocardial damage
History of angina or MI
Consequence of slow, progressive apoptosis of myocytes
Poor prognosis- death of CHF

21
Q

Endocardial and valvular diseases are disorders of the

A

Endocardium

Damage heart valves

22
Q

Valvular Stenosis is when

A

Valve orifice is constricted and narrowed, impedes forward blood flow

23
Q

What does valvular stenosis lead to?

A

Myocardial hypertrophy

24
Q

What is valvular regurgitation?

A

Insufficiency or incompetence of a valve

Valve cusps fail to shut completely and blood flow is permitted when the valve is closed

25
Q

What is mitral stenosis?

A

Impairment of flow from left atria to left ventricle

26
Q

What are common causes of mitral stenosis?

A

Acute rheumatic fever or bacterial endocarditis

27
Q

What are some results of mitral stenosis

A

Narrowing as a result of inflammatory lesions
Incomplete atrial emptying- increased atrial pressure- dilation and hypertrophy
CO is decreased

28
Q

What is mitral regurgitation?

A

When blood flows back from the left ventricle to the left atria during ventricular systole

29
Q

Results of mitral regurgitation

A

Left ventricle becomes dilated and hypertrophied
Back flow volume increases- left atrium dilates
May lead to LV failure
Increases in atrial pressure, can lead to RV failure

30
Q

What is mitral valve prolapse

A 
Cusps of mitral valve billow upward 
Cusps are enlarged, thickened, scalloped
Chordae may be elongated
Leakage leads to regurgitation 
Minimal mortailty or morbidity
31
Q

Three common causes of aortic stenosis

A

Rheumatic heart disease
Congenital malformation
Degeneration thickening and calcification

32
Q

What happens with aortic stenosis

A

Diminished flow LV to aorta
Pressure increase in LV
Decreased SV, reduced systolic bp, narrowed pulse pressure, slow heart rate, faint pulse
Left ventricular hypertrophy to compensate

33
Q

Aortic Regurgitation

A

Causes volume overload in LV during diastole- increases EDV

LV increases SV to maintain CO

34
Q

What is rheumatic Heart Disease?

A

Diffuse inflammatory disease
Caused by delayed immune response to infection by A Beta- hemolytic streptococcus
Begins as carditis- all 3 layers affected

35
Q

What is the acute form of rheumatic heart disease?

A

Febrile illness with joint, skin, nervous system, and heart failure

36
Q

What can happen when rheumatic heart disease is untreated

A

Scarring and deformity of cardiac structures

37
Q

Where is the primary lesion in rheumatic heart disease?

A

Endocardium; Swelling of heart valve leaflets

38
Q

What are Aschoff bodies?

A

Fibrotic areas of myocardium surronded by areas of necrosis

Associated with rheumatic heart disease

39
Q

How does scarring occur with rheumatic heart disease?

A

Clots develop along valves and cordae- progressively adherent

40
Q

What happens if rheumatic heart disease is untreated?

A

Cardiomegaly and left heart failure

41
Q

What are specific symptoms associated with rheumatic heart disease?

A

Carditis
Acute migratory polyarthritis
Chorea
Erythema marginatum

42
Q

What is carditits?

A

A new heart murmur- mitral or aortic SL valve dysfunction

Chest pain from pericardial inflammation

43
Q

What is erythema marginatum

A

Truncal rash that accompanies rheumatic fever

Cardiac PathoPhys (4 decks)

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