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Pathology > Heart & Blood vessels > Flashcards

Heart & Blood vessels Flashcards

1
Q

How would you describe cardiac disease and give 4 examples?

A

Disease of the heart.

1) Heart Failure
2) Valvular heart disease (wide/narrow)
3) Pericarditis, myocarditis and endocarditis (infections)
4) Cardiomyopathy (intrinsic disease)

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2
Q

How would you describe vascular disease and give 4 examples?

A

Disease of the blood vessels.

1) Aneurysms (dilation)
2) Hypertension
3) Diabetic vascular disease
4) Venous disease (e.g. DVT, viscose)

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3
Q

How would you describe congenital heart disease?

A

Disease present from birth

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4
Q

Definition of heart failure?

A

A condition whereby the body is unable to pump the blood around the body that is required for normal functioning

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5
Q

How can you detect heart failure radiologically?

A

Using an echocardiogram - this can detect ejection fraction (the % of blood which is ejected from the ventricles) If below 40% = heart failure

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6
Q

What causes heart failure?

A 
Anything that reduces the supply and/or increases the demand on the heart. (think: CO = HR X SV)
Reducing supply:
1) Ischaemic heart disease
2) Congenital heart disease
3) Cardiomyopathy
4) Arrhythmias
Increasing demand:
1) Hypertension
2) Anaemia
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7
Q

Explain what causes the different symptoms of heart failure?

A

In order for the heart to cope with the demands of the body, the myocytes in the heart will increase in size (hypertrophy). However, there is only a certain amount of blood that can to be pumped. So, the blood starts to back up into: 1) Pulmonary circuit 2) Peritoneal cavity and 3) Peripheral veins

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8
Q

What symptom and sign is caused from the blood backing up into the pulmonary circuit?

A

Symp: Pulmonary oedema
Sign: Breathlessness, increased respiratory effort and crackles in chest (indicating fluid)

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9
Q

What sign is caused from the blood backing up into the peritoneal cavity?

A

Sign: Asites (swelling of the abdomen)

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10
Q

What symptom and sign is caused from the blood backing up into the peripheral veins?

A

Symp: Peripheral oedema
Sign: ankle swelling

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11
Q

What are the 3 different classifications of heart failure?

A

1) Chronic (needs treating) Vs. Acute (treated in the community)
2) Left (lungs) Vs. Right (ankles)
3) Severity

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12
Q

Treatment for heart failure?

A

Treat the underlying cause. However, you couldn’t do this with acute heart failure. This needs to be treated with O2 or diuretics

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13
Q

What are the names of the different valves in the heart?

A

Right: Tricuspid & Pulmonary valve
Left: Bicuspid & Aortic valve

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14
Q

What 3 conditions occur in vascular heart disease and their definition?

A

Stenosis: When the valves narrow which impedes on their forward flow
Regurgitation: When the valves don’t close up properly so blood flows backwards and forwards
Vegetation: Abnormal growth on the tissue

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15
Q

What causes stenosis?

A

1) Vegetation
2) People can be born with an abnormality - in which they don’t appear to have all of the chordae which would normally hold the valves in place
(this is a chronic process)

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16
Q

What causes regurgitation?

A

1) Vegetation
2) Damage to the supporting structures (i.e. chordae or the papillary muscles - attached to the chordae)
(this can be a chronic or an acute process)

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17
Q

What causes vegetation?

A

1) Bacteria
2) Inflammation
3) Clot

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18
Q

What is known as the ‘The Cardiac Staircase’?

A

When 1 valve is affected, this puts pressure on the other valves and so this can then affect other valves

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19
Q

What are the symptoms for vascular heart disease?

A

Same as heart failure (pulmonary oedema, peripheral oedema, asites)

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20
Q

What are the specific symptoms for aortic stenosis?

A

THE CLASSIC TRIAD:

1) Angina
2) Shortness of breath
3) Collapse

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21
Q

What are the signs for vascular heart disease?

A

Same as heart failure (breathlessness, crackles, ankle swelling, abdominal swelling)
PLUS:
Murmurs (not the normal ‘lub-dub’ sound)

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22
Q

What are pericarditis, myocarditis and endocarditis?

A

Diseases of a specific layer of the heart

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23
Q

Pericardium:

A

Outer layer of the heart

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24
Q

Myocardium:

A

Muscle layer

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25
Q

Endocardium:

A

Inside layer of the heart and its valves

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26
Q

Explain the differences between right and left sided endocardium?

A 
Left sided: Most common 
Right sided: Common with IV drug users
Left sided: Streptococci
Right sided: Staphaureus 
Left sided: Affects abnormal valves
Right sided: Affects normal valves
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27
Q

Describe what is meant by Prophlaxis?

A

Giving patients that are at risk of endocarditis antibiotics before they undertake any procedures that are likely to introduce any other kind of bacteria into their body

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28
Q

What are the symptoms of endocarditis?

A 
(same as heart failure and sepsis) 
PLUS:
- fever
- malaise 
- weight loss
29
Q

What are the signs of endocarditis?

A 
(same as heart failure)
PLUS:
- splinter haemorrhage
- finger clubbing
- Osler's nodes (hands)
- Roth's spots (eyes)
30
Q

What is the classification of endocarditis and describe?

A

Acute (sweating - needs medical attention) and sub acute (where the vegetation will be growing slowly on the endocardium)

31
Q

What are the causes for both pericarditis and myocarditis?

A

1) Infection (viral/bacteria)
2) Carcinoma
3) Uraemia (when the kidneys don’t filter the waste products our of the blood correctly)
4) Myocardial Infarction

32
Q

What are the symptoms for both pericarditis and myocarditis?

A

Chest pain

33
Q

What are the signs for both pericarditis and myocarditis?

A

On ECG - ‘bucket-shaped’ S-T wave

34
Q

What treatment is used for pericarditis and myocardititis?

A

Anti-inflammatory drugs or leave it along to treat itself

35
Q

What are the 3 main types of cardiomyopathy?

A

1) Dilated cardiomyopathy
2) Hypertrophic cardiomyopathy
3) Restrictive cardiomyopathy

36
Q

How do you describe dilated cardiomyopathy?

A

All of the heart chambers will dilate. Resulting in a thin and floppy heart

37
Q

How do you describe hypertrophic cardiomyopathy?

A

The cells in the heart will increase in size, resulting in a large and muscular heart.

38
Q

What 2 problems occur from hypertrophic cardiomyopathy?

A

1) Abnormal diastolic filling
2) Intermittent obstruction to the left ventricular outflow - because the septum has increased in size and the bicuspid valve catches on it, which impedes on the outflow of blood through the aorta

39
Q

What is the main cause for all 3 types of cardiomypathy?

A

50% genetic

40
Q

What are the 3 other causes for dilated cardiomyopathy?

A

1) Alcohol
2) Pregnancy
3) Myocardititis

41
Q

What are the 3 other cause for restrictive cardiomyopathy?

A

1) Amyloidosis
2) Radiation
3) Chemotherapy

42
Q

What is the main cause for hypertrophic cardiomyopathy?

A

Genetic

43
Q

What are the 6 symptoms of cardiomyopathy?

A

1) Atrial Fibrillation
2) Palpitations
3) Shortness of breath
4) Chest pain
5) Syncope (temp loss of consciousness)
6) Sudden death

44
Q

What are the 2 classifications of hypertension and which is most common?

A 
Primary = don't know the cause (most common)
Secondary = there's an underlying cause
45
Q

Malignant hypertension

A

Rapid increase in blood pressure and its medical emergency because it prediposes to stroke

46
Q

What are the 5 risk factors for Primary Hypertension?

A

1) Genetic
2) Smoking
3) Alcohol
4) Stress
5) Obesity

47
Q

What are the causes for Secondary Hypertension?

A

1) Renal artery stenosis
2) Renal parenchymal disease
3) Physical obstruction to the blood flow
4) Endocrine cause
5) Neurogenic cause

48
Q

What are the complications of hypertension and the 5 organs affected?

A

1) BV - micro/macro angiopathy
2) Kidney - granular appearance due to scars
3) Heart - MI and heart failure
4) Eyes - Retinopathy
5) Brain - cerebral haemorrhage (damage)/ cerebral infarction (blockage) and depending on the area of the brain –> will depend on which limb is affected

49
Q

What are the 2 treatments for hypertension?

A

1) Lifestyle modifications

2) Anti-hypertensive drugs

50
Q

Definition of an Aneurysm?

A

An abnormal dilation of the blood vessels

51
Q

What is the main cause of an Aneurysm and how?

A

Caused by a weakening in the blood vessel wall due to:

1) Congenital
2) Atheroma
3) Pressure
4) Infection

52
Q

What are the 3 treatments for aneurysms?

A

1) Stents
2) Surgery
3) Using Anti-Hypertensives to lower BP

53
Q

Describe 5 different examples of aneurysms?

A

1) Berry Aneurysm - Dilation of the circle of Willis in the brain
2) Aortic Aneurysm - mainly in thoracic and abdominal aorta
3) Atherosclerostic Aneurysm - low abdominal aorta and iliac arteries
4) Micro-Aneurysm - the capillaries of the brain
5) Syphilitic Aneurysm - ascending and arch of the aorta

54
Q

What is diabetic vascular disease a consequence of?

A

Atheroscleosis (damage to the BV’s)

55
Q

What are the 3 complications of atherosclerosis and what are the signs?

A

1) Retinopathy - blindness
2) Peripheral neuropathy - gangrene
3) Nepropathy - kidney damage

56
Q

How do you reduce the likelihood of Diabetes Vascular disease?

A

By controlling the diabetes

57
Q

What are the 3 examples of Venous diseases?

A

1) DVT
2) Pulmonary embolism
3) Varicose veins

58
Q

What is DVT a consequence of ?

A

Venous return being impeded on or a change in blood components

59
Q

What are the 5 different causes for DVT?

A 
Venous return being impeded on:
1) Immobility
2) Pregnancy
A change in blood components:
1) Heamatological disease
2) Malignancies
3) Oestrogens
60
Q

Name 1 complication of DVT?

A

Pulmonary embolism

61
Q

What are the 5 symptoms of pulmonary embolism?

A

1) SOB
2) Chest pain
3) Calf swelling
4) Syncope
5) Sudden death

62
Q

How to treat pulmonary embolism?

A

Anti-coagulant medication

63
Q

Define varicose veins

A

Twisted superficial veins

64
Q

What causes varicose veins?

A

1) Impeded venous return

2) Valves in the legs are incompetant

65
Q

What are the 2 complications of varicose vein?

A

1) Ulceration

2) Skin irritations

66
Q

How common is congenital heart disease?

A

Rare

67
Q

Define congenital heart disease?

A

Septal deficit - hole in between the left and the right side of the heart

68
Q

What are the symptoms of congenital heart disease?

A

Can be asymptomatic

69
Q

What are the 4 complications of congenital heart disease?

A

1) Hypertension
2) Hypoxia
3) Embolism
4) Eisenmenger’s Syndrome: Blue face, drumstick-like fingers and curved nails

Pathology (9 decks)

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