Heart Flashcards
Under 6 hours MI
Normal by histology
CK MB normal
6-24 hours post MI
Loss of nuclei
Homogenous cytoplasm
Necrotic cell death
1-4 days
Infiltration of polymorphs then macrophages (clears up debris)
5-10 days post MI
Removal of debris by macrophages
1-2 weeks post MI
Granulation tissue
New blood vessels
Myofibroblasts
Collagen synthesis
Weeks to months post MI
Strengthening
Decellularising scar tissue
Causes of dilated cardiomyopathy Metabolic Inflammation Endocrinology Heart
Idiopathic Alcohol Peripartum Genetic Sarcoidosis Chemo Haemochromatosis Viral myocarditis Hormonal (thyroid/DM)
Causes of hypertrophic cardiomyopathy
Genetic (autosomal dominant)
Storage disease
Causes of restrictive cardiomyopathy
Sarcoidosis
Amyloidosis
Radiation induced fibrosis
Most common mutation associated with HOCM
Autosomal dominant
Beta HMC gene
(MYBO-C and Trop-T gene also common)
Histology of HCM
Myocyte disarray
Which HOCM mutation has high risk of sudden cardiac death?
Tropinin T mutation
Peak age of rheumatic fever
5-15 years
What does rheumatic fever affect
Heart
CNS
joints
Skin
Heart manifestation of rheumatic fever
Endocarditis
Myocarditis
Pericarditis
Skin manifestation of rheumatic fever
Erythema marginatum
Subcutaneous nodules
Joint manifestation of rheumatic fever
Arthritis
Synovitis
CNS manifestation of rheumatic fever
Sydenham’s chorea
Encephalopathy
When does acute rheumatic fever begin
2-4 weeks following strep throat infection
Diagnostic criteria for rheumatic fever
Positive for group A strep
1 major and 2 minor criteria
JONES Major criteria for major rheumatic fever?
CASES
Carditis Arthritis Sydenham’s chorea Erythema marginatum Subcutaneous nodules
Valve commonly affected by rheumatic fever
Mortal valve
25% affect both mitral and aortic
Main pathogen of rheumatic fever?
Lance field group A strep
Antigen mimicry
Histology of rheumatic fever
Beady fibrous vegetation’s
Aschoff bodies
Anitschkov myocytes
What are Aschoff bodies
Small giant cell granulomas
Found in histology of rheumatic fever
What are anitschkov myocytes
Regenerating myocytes
Found in histology of rheumatic fever
Tx of rheumatic fever
Benzylpenicillin
Erythromycin if allergic to pen
5 types of inflammation of pericardium (I.e 5 causes)
Fat pigs get horny fast
Fibrinous Purulent Granulomatous Haemorrhagic Fibrous
Causes of fibrinous pericarditis
MI
uraemia
Causes of purulent pericarditis
Staphylococcus
Causes of granulomatous pericarditis
TB
CAuses of haemorrhagic pericarditis
Tumour
Tb
Uraemia
Causes of fibrous pericarditis
MI Uraemia Staphylococcus TB Tumour
