heart 2 Flashcards
What are the large vessels type of vasculitis ?
Giant cell arteritis - old age
Takayasu - early age
giant cell arteritis is a large vessel vasculitis charechterised by …
chronic granulomatous reaction → granulomas in lumens of SEGMENTS of arteries in the Head such as temporal ,vertebral , ophthalmic →ischemia
-t-cell mediated response against vessel wall antigen
affects old ages - *take large biopsy*
Takayasu large vessel vasculitis is charactarised by…
“Pulseless disease”-in asian noodle motherfuckers
- intimal hyperplasia and thickening of vessel wall
- collagenous scarring → reduced BP ,weaker pulse in upper extremities
-in early ages unlike giant cell arteritis
the medium sized vasculitis include …
PAN
KAWASAKI
Polyarteritis Nodoa (PAN) is charachterized by …
-affects **many vessels EXCEPT THE LUNG
-30%**
of patients hepatitis B as antigen
2 forms
acute - segmental transmural necrotizing inflammation → thrombosis/aneurysm/rupture
chronic - necrotizing inflammation → fibrosis → ischemia
kidney failure
MI
small skin hemorrhages
Kawasaki is a medium sized vasculitis characterized by …
Acute, febrile, self‐limited disease in infant/children
antibodies against endothelial cells especially → coronary arteries → aneurysm/thrombus/rupture/**AMI
“CRASH”
C**
onjunctivits
Rash
Adenopathy
Strawberry tongue
Hands+feet edema+rash
types of small vessels vasculitis include …
Microscopic Polyangiitis
wegner granulomatosis
Buerger disease
Microscopic Polyangiitis aka “leukocytoclastic vasculitis” is characterized by PMNI infiltration with fragmented nuclei as well as …
Hypersensitivity reaction to antibiotics, microorganisms or tumor - affects small vessels.
- no granulomas , P-ANCA in 70% of cases
90% of patients have :
- necrotizing glomerulonephritis → hematuria,proteinuria
- pulmonary capillaries→hemoptysis
Wegener granulomatosis is characterized by …
C-ANCA
Granulomas and Vasculitis of small vessels in the lungs and upper respiratory tract → hemorrhage and hemoptysis.
Chronic sinusitis
Glomerulonephritis
Buerger disease is characterized by …
develops before age 35.
Strongly associated with smoking tobacco which is toxic to endothel
small microabscesses in vessel wall may result in gangrene of the extremities.
Raynaud phenomenon
infectious vasculitis is usually caused by bacteria and fungi , particulary … which can cause…
Aspergillus
can cause mycotic aneurysm→thrombosis→infarct
Isolated pericardial disease is uncommon. thats meaning …
pericardial diseases are almost always associated with disease in other parts of the heart
pericarditis can be caused by …
primary pericarditis → viral infection
secondary pericarditis →
- after AMI
- Uremia
- SLE , RF
- Surgery
what are the fates of pericarditis ?
immediate hemodynamic sequences
resolve
progress to chronic fibrotic process
morphology of pericarditis comes in 2 forms
Acute pericarditis
- Virus/Uremia →“Bread-Butter” fibrinous exudate
- Bacteria → fibrino-purulent exudate
- Malignancy → Bloody effusion
Chronic pericarditis
delicate adhesions →fibrotic scars →contrictive pericarditis
normally , serous fluid in the pericardial sac measures for about 30-50 ml. pericardial effusions exceeding these volumes occur in the following forms …
Serous → CHF, hypoalbuminemia
Seroanguinous (serous+blood) → ruptured MI , Trauma , aortic dissection , malignancy
Chylous → lymphatic obstruction
a patient previously diagnosed with pericarditis is complaining about atypical chest and dyspnea. his blood pressure was measured and was found to be low. atempts to stabilize his blood pressure with medications failed. this patient may have developed…
cardiac tamponade due to fluid accumulation
aneurysm is a …
abnormal dilation of blood vessel
aneurysm are classified as …
true aneurysm →involves all 3 layers
false/pseudo aneurysm →breach in vascular wall→hematoma
aneurysm can come in two shapes , namely
saccular / fusiform
name 3 types of aneurysms
1) Abdominal Aortic Aneurysm -“AAA”
2) Syphilitic aneurysm
3) Berry aneurysm
what are the causes of AAA and where does it usually arise ?
Atherosclerosis →compress→necrosis→dilation
Genetic polymorphism in →MMP/ MMPi / inflammatory infiltration
arises between renal arteries above iliac bifurcation
what are the 2 types of AAA and my be the consequences of such aneurysms ?
Mycotic →bacteria infects atherosclerotic lesions
inflammatory → periaortic fibrosis + inf.inf.
consequences :
thrombosis → ischemia
rupture
embolism
compression on ureter
syphilitic aneurysms are caused by which type of spirochaete bacterium?
Treponema pallidum →syphillis STD
disease affects vasa vasorum → ischemia of aortic root media→ scaring →dilation
valvular insufficiency → L.V.H
Berry aneurysms are most commonly found in the …and are due to …
branching points of arteries in circle of willis
develops due to
congenital malformation + hypertension
if ruptures →intracranial pressure increases
treatment clip it ! or insert spiral metal inside it !
aortic dissection is a …
intimal tear allows blood to flow to space between intima and media so they separate.
what are the causes of aortic dissection ?
1) hypertension →old ages
2) atherosclerosis
3) C.T. disorders →young ages → Marfan syndrome
how are aortic dissections classified ? what are the consequences of such dissections ?
A
Type 1/2 → proximal in ascending aorta
- type 1 - extensive, ascending +descending
- type 2 - focal, in ascending
B
- type 3 → distal, in descending aorta
consequences :
1) narrow orifices of blood vessels
2) rupture and bleeding inside body cavities →cardiac tamponade
3) sometimes new channels are formed allowing
* *re-entry** of blood to lumen of aorta →chronic dissection
