Heart Path Lecture 1 Flashcards
What 3 changes happen to the myocardium and chambers of the heart due to aging?
- ) Increase LV size
- ) Increased epicardial fat
- ) Lipofuscin and basophilic degeneration
What changes occur to the valves of the heart due to aging?
- ) aortic and mitral valve calcification
- ) fibrous thickening
- ) Mitral leaflets buckle towards LA, increasing the size of the left atrium
- ) Lambl excrescences (due to small thrombi)
The hypertrophied heart is vulnerable to what?
ischemia related decompensation
In the setting of pressure overload hypertrophy..? (HTN)
Myocytes become thicker (wider) and the LV increases concentrically
In the setting of volume overload hypertrophy..? (MI)
Myocytes elongate and ventricular dilation is seen
Left sided heart failure is most commonly a result of?
- ) MI
- ) HTN
- ) Left sided valve dz.
- ) Myocardial dz.
What results clinically as a result of left sided heart failure?
Congestion in pulmonary circulation and decreased systemic perfusion
What occurs morphologically as a result of left sided heart failure?
- ) LVH
- ) LA dilation -> a-fib, thrombus
- ) Decreased EF -> decreased glomerular perfusion
What are heart failure cells?
Hemosiderin laden macrophages
What is the most common cause of right sided heart failure?
Left sided heart failure
What happens to the liver as a result of right sided HF?
nutmeg liver
What happens to the spleen as a result of right sided CHF
splenomegaly
What is the most common cause of congenital heart dz?
Down syndrome. 40% of DS patients have a heart defect
What pathways are associated with congenital heart dz?
Notch 1 (bicuspid aortic valve) Jag1 and Notch 2 (tetralogy of fallot)
When are ASD’s asymptomatic until?
> 30yo
90% os ASDs are?
ostium secundum
Left to right shunting leads to?
- ) pulmonary HTN
- ) paradoxical embolus
- ) right sided CHF
A PFO is what kind of defect?
ASD. R->L with increased pressure
What can a PFO cause?
paradoxical embolus
What is the most common cause of congenital heart dz?
VSD
Large VSDs can lead to?
- ) RVH
- ) pulmonary HTN
- ) reversal and cyanosis
90% of MI’s are caused by?
atheromatous plaques
LAD infarction (40-50%)
Apex, LV anterior wall, anterior 2/3 of septum
RCA infarction (30-40%)
RV free wall, LV posterior wall, posterior 1/3 of septum