Heart Pathology Flashcards
Heart Failure Compensations
- Catecholamines
- help pick up slack (epineprine)
- Frank-Staling
- Hypertrophy
Where does blood pool with right heart failure
- Below body
- Peripheral edema- legs
- Ascites (testes)
- Splenomegaly
- Hepatomegaly
Where does blood pool during left heart failure
- Pulmonary edema
- Cyanosis
Common Causes of Left Heart Failure
- Systemic hypertension- high BP
- Mitral or aortic valve disease
- Primary heart diseases
Left heart changes during failure
- LV hypertrophy
- LV dialation
- LA may be enlarged
Left heart failure consequences
- Dyspnea (pnea=lungs) hard time breathing
- Orthopnea
- Enlarged heart, inc heart rate
- Rales- crackling bubbling in lungs
- Mitral regurgitation, systolic mumur
Right Heart Failure common causes
- Cor Pulmonale- lung problem causing right failulre
- Congenital heart diseases
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Right heart changes due to heart failure
RV hypertrophy
RV Dilation
RA may be enlarged
Right heart failure consequences
- Peripheral edema- not able to get blood from systemic back
- Enlarged liver (hepatomegaly)
- Enlarged Spleen (splenomegaly)
Congenital heart diseases Left to right
ASD
VSD- most common
PDA
Congenital heart diseases Right to Left
Tetralogy of Fallot
Transposition of great arteries
Congenital heart disease Coarction
Coarction- narrow area in aorta
Aortic Coarction
Atrial Septal Defect ASD
- Left to right disease
- Blood flows between l and r atria
- Interartrial septum absent or defective
- Allows oxygen rich blood from LA to mix with RA
- May cause pulmonary hypertension, bc sending too much blood to lungs
Ventricular Septal Defect
- L to R disease
- Common, mst close spontaneously
- Size and location matters
- If hole is in the lower half of septum, better outcome
- When heart contracts the hole will be sealed
Patent Ductus Arteriosus (PDA)
- L to R disease
- In fetus, allows blood to flow from pulmonary artery to aorta
- Should close after birth
- Size matters
- Keeps returning blood from aorta to lungs
Tetralogy of Fallot
- Right to left disease
- 4 problems
- VSD
- Pulmonary Stenosis- RV has a hard time getting blood into pulmonary valves and arteries
- Overriding Aorta
- RV hypertrophy
- Digital clubbing
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Transposition of great arteries
- Right to left disease
- RV and LV are switched
- Absolutely lethal without a shunt
Coarction
- Narrowing of aorta
- Causes cyanosis and low BP systemically
- Size matters
- Hard for LV to get blood out, hypotension
Ischemic Heart Disease
4 syndromes
- Myocardial perfusion cant meet demand
- Due to reduced coronary artery blood flow, like a thrombus
- 4 syndromes
- Angina pectoris
- Acute MI
- Chronic IHD
- Sudden cardiac death
Angina Pectoris
- Stable
- Most common
- Pain on exertion
- Fixed narrowing of CA
- Prinxmetal (variant)
- Pain at rest
- Coronary Artery Spasm
- Unstable (pre-infarction)
- Unpredictable pain
- Plaque disruption and thrombosis
Acute MIin Ischemic Heart Disease
- Necrosis of myocardium from ischemia
- Most due to coronary artery thrombosis
- Prompt reperfusion can slavage myocardium
- Clinical features (how you explain heart attack)
- Severe crushing chest pain
- Not relieved by nitroglycerin (vessel dialator)
- Sweating nausea
- Creatin-Myoglobin increase due to myocytes lysing and releasing their contents
