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Pathology > Heart and Blood Vessels > Flashcards

Heart and Blood Vessels Flashcards

1
Q

Cardiac Failure

A

Heart unable to pump blood at rate required for normal functioning
Initially the heart ‘Compensates’
Leads to cardiac hypertrophy and/or dilatation, and eventual inability to maintain normal

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2
Q

What happens when the heart does not pump as effectively as it should?

A

Oedema – pulmonary and peripheral

Tiredness

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3
Q

Signs/Symptoms of Cardiac failure

A

Shortness of breath (SOB)
Fatigue
Fluid in lungs (Pulmonary Oedema)
All-over, excessive, fluid-filled veins (Systemic Venous Congestion & Oedema)

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4
Q

Valvular Heart Disease - Mechanisms

A

Stenosis - Failure to open completely, impeding forward flow
Incompetence/Regurgitation - Failure to close, allowing reverse flow
Vegetations – abnormal tissue growth on valve (fibrin, platelets & bacteria)

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5
Q

Valvular Heart Disease – Underlying Causes

A 
Infection – Endocarditis/Rheumatic disease 
Calcific aortic valve disease 
Age-related degeneration
Carcinoid Syndrome
Fibrosis & muscle rupture after MI
Heart failure
Hypertension
Congenital 
Prosthetic Heart Valves
Connective Tissue Disorders 
IV Drug use
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6
Q

Symptoms/Consequences of Valvular disease

A 
Differ with the site/type lesion
Stroke 
Arrythmias
Ventricular hypertrophy
Angina (Chest pain)
Syncope (Fainting)
Heart failure
Infarcts to kidneys and spleen
Poor prognosis once symptoms
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7
Q

Infective Endocarditis

A

Endocardium is the inner lining of the heart and its valves.
Endocarditis is when this lining becomes infected/inflamed
Infection occurs on the edge of heart valves
Vegetation is a mass of bacteria, fibrin, platelets
Right-sided in IV drug use
Left-sided in others
Colonization of the heart valves or mural endocardium usually by bacteria
Streptococci (α haemolytic) affects abnormal valves usually after dental extraction / cleaning / bronchoscopy / tonsillectomy
Staph aureus affects previously normal valves, usually IV drug abusers

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8
Q

PROPHYLAXIS

A

Imperative to give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia

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9
Q

Pericarditis & Myocarditis Causes

A 
Viral
Bacterial
Parasitic
TB
Uraemia (urine products in blood)
Carcinoma
MI
Post surgery
Drugs
Connective tissue disease
Radiation
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10
Q

Pericarditis &Myocarditis Types

A

Acute

Chronic

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11
Q

Pericarditis & Myocarditis Symptoms and Signs

A

Chest Pain

Cardiac Failure

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12
Q

Pericarditis & Myocarditis Treatment

A

Anti-inflammatory Drugs

Surgical Excision of the Pericardium

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13
Q

Unusual Cardiac Diseases

A 
Cardiomyopathy
Multisystem Diseases – like Sarcoidosis & Amyloidosis
Thyrotoxicosis
Myxoedema
Alcoholism
Pregnancy
Iatrogenic (drug-induced) disease
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14
Q

Cardiomyopathy

A

Disease of the heart muscle

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15
Q

Hypertrophic Cardiomyopathy

A 
Heavy, muscular, hypercontracting
Abnormal diastolic filling
1/3 have intermittent left ventricular outflow obstruction
End stage dilatation can occur
Myocardial hypertrophy, disarray
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16
Q

Clinical Features of Hypertrophic cardiomyopathy

A

SOB, chest pain, palpitations, black-out
Sudden death
Atrial fibrillation

50% Familial, autosomal dominant with variable expression
Genetic defect in 1 of 4 genes that encode cardiac contractile elements

17
Q

Aneurysms

A

Localised, permanent, abnormal dilatation of a blood vessel

18
Q

Types of Aneurysm

A 
Atherosclerotic
Aortic Dissection
Berry
Micro-Aneurysms
Syphilitic
Mycotic (infective)
19
Q

Hypertension

A

BP is recorded as two numbers—the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats)
Measured in millimeters of mercury - mmHg
eg 120/80 mm Hg
120/80mmHg or lower is classed as normal BP
No universal definition of what exactly is high
BP 140/90 offered 24hr ambulatory monitoring
Categories:
Mild: diastolic 95 – 104mmHg
Moderate: 105 – 114mmHg
Severe: >115mmHg

20
Q

Benign Hypertension

A

Most remain stable over many years
live a relatively normal life
until/unless complications arise

21
Q

Malignant Hypertension

A

Accelerated Hypertensive disease
5% of cases
Rapidly rising blood pressure
90% die in the first year!

22
Q

Complications of Hypertension: Blood Vessels

A

Large Blood Vessel disease (Macroangiopathy)
Atherosclerosis
Small Blood Vessel disease (Microangiopathy)
Arteriolosclerosis
Increased risk of rupture
and dissection, & MI

23
Q

Complications of Hypertension: Heart

A

Heart disease:
Left ventricular hypertrophy
Cardiac Failure
Myocardial Infarction

24
Q

Complications of Hypertension: Kidney

A

Benign nephrosclerosis

Renal failure

25
Q

Complications of Hypertension: Eyes (Retina)

A

Hypertensive retinopathy
Retinopathy Grades:
Grade I Thickening of arterioles

Grade II Arteriolar spasms

Grade III Hemorrhages

Grade IV Papilloedema (seen in Malignant Hypertension)

26
Q

Complications of Hypertension: Brain

A

Cerebral haemorrhage

Cerebral infarction

27
Q

Factors Indicating Adverse Prognosis in Hypertension

A 
Male
Young
Black Ethnicity
Smoker
Persistent  diastolic BP > 115 mm Hg
Diabetes  
Hypercholesterolemia 
Obesity 
Excess  alcohol 
Organ  damage:  Heart, Kidney, Eyes, Brain
28
Q

Diabetic Vascular Disease

A 
Damage to Vessels Generally - Atherosclerosis
Damage to Kidneys 
Damage to Nerves 
Damage to Retinas
Complications such as: 
Gangrene
Renal failure 
Blindness
Effective control of Diabetes reduces disease!
29
Q

Venous Thrombosis

eg DVT

A

When normal venous return is impeded, predisposes to Thrombosis

30
Q

Varicosities

A 
Common Problem
Tortuous and Distended veins
Cause 
Incompetent valves in legs
Impaired venous return 
stasis 
oedema  
fibrin deposits around veins
Often associated Ulceration – ankles and lower legs
31
Q

Congenital Cardiovascular Disease – Commonest Types

A

Septal defects - Atrial or Ventricular
Failure of blood vessel closure at birth - Patent Ductus Arteriosus
Narrowed Aorta - Coarctation of the Aorta
Valvular Abnormalities
Vessels the wrong-way round - Transposition of the great vessels
Coronary artery defects
Multiple defects - Fallot’s Tetralogy

32
Q

Causes of aneurysms

A

Causes: Age, Atherosclerosis, Ischaemia, Hypertension, Inflammation, Diabetes, Autoimmune diseases, Bacteria, Bacterial Endocarditis, Fungus, Marfan’s Syndrome, Syphilis

33
Q

Treatment of Aneurysms

A

Treatment: Stents, Surgery, reducing arterial pressure

34
Q

Causes of Venous Thrombosis

DVT

A 
Causes: 
Immobility
Malignancy 
Pregnancy & Childbirth 
Oestrogens 
Haematological disorders 
IV cannulas
Danger of PE

Pathology (22 decks)

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