Heart II Flashcards
Left vs. Right Hypertensive Disease Morphology
Left Sided shows concentrically thickened LV hypertrophy
Right Sided shows RV dilation with no hypertrophy
Arrhythmia
General and Specific (4) Causes
Caused by ischemia leading to:
Sick Sinus Syndrome: SA node damage (bradycardia)
Atrial Fibrillation: Irregularly irregular beats
Heart Block: dysfunctional AV node
Channelopathies: Long QT Syndrome (K+ and Na+)
Heart Block Types with Descriptions (3)
1st Degree: Prolonged PR interval
2nd Degree: intermittent transmission
3rd Degree: complete failure
Sudden Cardiac Death
General and Specific Causes (5)
Fatal arrhythmia from ischemia-induced myocardial irritability
Mainly 75%+ stenosis of Coronary As.
Also: Cardiomyopathies, Myocarditis, Conduction Defects, Hypertrophy
Calcific Aortic Stenosis Risk Factors (5), Location and Complications (4)
Age (60-80), Chronic HTN, Hyperlipidemia, Inflammation
Congenital bicuspid aortic valve
Calcifications on cusps
Angina
LVH
CHF
Syncope
Mitral Annular Calcification Risk Factors (3), Location and Complications (5)
Female over 60 years old
Mitral valve prolapse
Calcifications on fibrous annulus
Regurgitation Stenosis Arrhythmias Thrombus Infectious Endocarditis
Mitral Valve Prolapse
Pathogenesis (3), Morphology, Complications (4)
Marfan Syndrome fibrillin defect makes floppy valve Proteoglycan deposition (myxomatous degeneration) and elastin disruption thicken leaflets
Interchordal ballooning of mitral leaflets
Mostly asymptomatic but can lead to:
Endocarditis, Thrombus, Insufficiency, Arrhythmias
Rheumatic Fever
Pathogenesis, Morphology (4) and Complications (5)
Immune cross reaction between Strep A M proteins and cardiac self-Ags
Aschoff Bodies (T cells)
Anitschkow cells (macrophages)
Fibrinoid Necrosis
Verrucae
Pancarditis Migratory Polyarthritis Subcutaneous Nodules Erythema Nodosa Sydenham Chorea
Rheumatic Heart Disease
Pathogenesis, Morphology and Complications (5)
Chronic rheumatic fever
Mitral valve stenosis
LA Dilation Thromboembolism Atrial Fibrillation RV Hypertrophy Infective Endocarditis
Infective Endocarditis
Types (2) with Descriptions and Treatments
Acute: Rapid destruction of previously normal valve
Treat with surgery and antibiotics
Subacute: Slow infection of previously deformed valve
Treat with antibiotics
Infective Endocarditis Morphology (5)
Friable, bulky valves
Destructive valvular vegetations
Septic emboli
Right side infected in IVDU’s
Infective Endocarditis Presentation (5)
Murmurs present if lesion on Left Side
Subungual/Splinter hemorrhages
Janeway lesions
Roth spots
Osler nodes
Non-Bacterial Thrombotic Endocarditis
Description, Association and Complication
Sterile thrombi along line of valve closure
Associated with mucin producing adenocarcinomas
Emboli
Libman-Sacks Endocarditis (SLE)
Description
Mitral and Aortic valvulitis with eosinophilic granular vegetations
Carcinoid Heart Syndrome
Presentation (5) and Complication
Flushing Diarrhea Dermatitis Bronchoconstriction High serotonin levels
Right sided carcinoid heart disease (left protected)
Prosthetic Valve Complications (3)
Thomboembolism
Infective Endocarditis
Anticoagulant Hemorrhage
Dilated Cardiomyopathy Risk Factors (4), Morphology (3) and Complications (3)
Genetics
Alcohol abuse
Myocarditis
Hemochromatosis
Dilation
Myocyte Hypertrophy
Interstitial fibrosis
CHF
Mural Thrombi -> embolism
Arrhythmias
Hypertrophic Cardiomyopathy
Morphology (3) and Complications (5)
Beta myosin heavy chain mutations
Septal Hypertrophy
Myocyte Disarray
Harsh systolic murmur Ischemia LA dilation Mural Thrombi Arrhythmias
Takotsubo Cardiomyopathy
Cause and Morphology
Extreme stress causing massive catecholamine release in mostly women
Apical LV ballooning
Arrhythmogenic R. Ventricular Cardiomyopathy (ARVC)
Morphology and Presentation (2)
Myocytes replaced with adipose and fibrosis
Ventricular Tachycardia or Fibrillation
Naxos Syndrome: hyperkeratosis of plakoglobin on palms and soles
Restrictive Cardiomyopathy
Causes (2) and Diagnosis
Caused by amyloidosis or radiation exposure (fibrosis)
Apple green birefringence on congo red stain
Myocarditis Causes
Infectious (3) and Non-Infectious (3)
Coxsackie A and B Chagas Disease (Trypanosoma cruzi)
Rheumatic Fever
SLE
Drug Hypersensitivity
Pericardial Effusions
Causes (2) Types (2) and Presentation (2)
Postinfarction, Uremia
Fibrinous
Serofibrinous (hemopericardium)
Hear loud pericardial friction rub
Rapid accumulation caused cardiac tamponade
Pericarditis
Types (5) and Morphology
Serous Purulent Hemorrhagic Caseous Constrictive
Shaggy fibrinous exudate
Cardiac Tumors
Types (5) with Complications and Morphology
Myxoma: ball-valve obstruction, hear tumor plop
Globular hard mass, mottled, translucent, papillary/villous with gelatinous appearance
Lipoma: localized and well circumscribed
Papillary Fibroelastoma: Lambl excrescences
Rhabdomyoma: frequent in pediatrics
Angiosarcoma: malignant, affects older adults
Cardiac Transplant Complications (3)
Main complication is allograft rejection
Allograft Arteriopathy: stenosing intimal proliferation
Happens to all transplants by 10 years
EBV associated B cell lymphoma (immunosuppression)
