Heart Path Lecture 1 Flashcards

1
Q

What 3 changes happen to the myocardium and chambers of the heart due to aging?

A
  1. ) Increase LV size
  2. ) Increased epicardial fat
  3. ) Lipofuscin and basophilic degeneration
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2
Q

What changes occur to the valves of the heart due to aging?

A
  1. ) aortic and mitral valve calcification
  2. ) fibrous thickening
  3. ) Mitral leaflets buckle towards LA, increasing the size of the left atrium
  4. ) Lambl excrescences (due to small thrombi)
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3
Q

The hypertrophied heart is vulnerable to what?

A

ischemia related decompensation

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4
Q

In the setting of pressure overload hypertrophy..? (HTN)

A

Myocytes become thicker (wider) and the LV increases concentrically

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5
Q

In the setting of volume overload hypertrophy..? (MI)

A

Myocytes elongate and ventricular dilation is seen

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6
Q

Left sided heart failure is most commonly a result of?

A
  1. ) MI
  2. ) HTN
  3. ) Left sided valve dz.
  4. ) Myocardial dz.
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7
Q

What results clinically as a result of left sided heart failure?

A

Congestion in pulmonary circulation and decreased systemic perfusion

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8
Q

What occurs morphologically as a result of left sided heart failure?

A
  1. ) LVH
  2. ) LA dilation -> a-fib, thrombus
  3. ) Decreased EF -> decreased glomerular perfusion
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9
Q

What are heart failure cells?

A

Hemosiderin laden macrophages

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10
Q

What is the most common cause of right sided heart failure?

A

Left sided heart failure

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11
Q

What happens to the liver as a result of right sided HF?

A

nutmeg liver

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12
Q

What happens to the spleen as a result of right sided CHF

A

splenomegaly

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13
Q

What is the most common cause of congenital heart dz?

A

Down syndrome. 40% of DS patients have a heart defect

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14
Q

What pathways are associated with congenital heart dz?

A
Notch 1 (bicuspid aortic valve)
Jag1 and Notch 2 (tetralogy of fallot)
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15
Q

When are ASD’s asymptomatic until?

A

> 30yo

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16
Q

90% os ASDs are?

A

ostium secundum

17
Q

Left to right shunting leads to?

A
  1. ) pulmonary HTN
  2. ) paradoxical embolus
  3. ) right sided CHF
18
Q

A PFO is what kind of defect?

A

ASD. R->L with increased pressure

19
Q

What can a PFO cause?

A

paradoxical embolus

20
Q

What is the most common cause of congenital heart dz?

21
Q

Large VSDs can lead to?

A
  1. ) RVH
  2. ) pulmonary HTN
  3. ) reversal and cyanosis
22
Q

90% of MI’s are caused by?

A

atheromatous plaques

23
Q

LAD infarction (40-50%)

A

Apex, LV anterior wall, anterior 2/3 of septum

24
Q

RCA infarction (30-40%)

A

RV free wall, LV posterior wall, posterior 1/3 of septum

25
LCX (15-20%)
LV lateral wall
26
Troponin T and I rises how many hours after an MI?
3-12
27
Troponin T peak somewhere between?
12-48 hrs post MI
28
Troponin I peak at?
24 hours post MI
29
CK MB rises?
3-12 hrs post MI
30
CK MB peaks?
24 hrs
31
CK MB normalizes?
48-72 hrs
32
Troponin I normalizes?
5-10 days after
33
Troponin T normalizes?
5-14 days after
34
When does a myocardial rupture occur?
2-4 days post MI
35
Which one peaks first?
myoglobin