Heart Pathology

Question 1

Heart Failure Compensations

Answer 1

• Catecholamines
  
  • help pick up slack (epineprine)
• Frank-Staling
• Hypertrophy

Question 2

Where does blood pool with right heart failure

Answer 2

• Below body
• Peripheral edema- legs
• Ascites (testes)
• Splenomegaly
• Hepatomegaly

Question 3

Where does blood pool during left heart failure

Answer 3

• Pulmonary edema
• Cyanosis

Question 4

Common Causes of Left Heart Failure

Answer 4

• Systemic hypertension- high BP
• Mitral or aortic valve disease
• Primary heart diseases

Question 5

Left heart changes during failure

Answer 5

• LV hypertrophy
• LV dialation
• LA may be enlarged

Question 6

Left heart failure consequences

Answer 6

• Dyspnea (pnea=lungs) hard time breathing
• Orthopnea
• Enlarged heart, inc heart rate
• Rales- crackling bubbling in lungs
• Mitral regurgitation, systolic mumur

Question 7

Right Heart Failure common causes

Answer 7

• Cor Pulmonale- lung problem causing right failulre
• Congenital heart diseases
  *

Question 8

Right heart changes due to heart failure

Answer 8

RV hypertrophy

RV Dilation

RA may be enlarged

Question 9

Right heart failure consequences

Answer 9

• Peripheral edema- not able to get blood from systemic back
• Enlarged liver (hepatomegaly)
• Enlarged Spleen (splenomegaly)

Question 10

Congenital heart diseases Left to right

Answer 10

ASD

VSD- most common

PDA

Question 11

Congenital heart diseases Right to Left

Answer 11

Tetralogy of Fallot

Transposition of great arteries

Question 12

Congenital heart disease Coarction

Answer 12

Coarction- narrow area in aorta

Aortic Coarction

Question 13

Atrial Septal Defect ASD

Answer 13

• 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

Question 14

Ventricular Septal Defect

Answer 14

• 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

Question 15

Patent Ductus Arteriosus (PDA)

Answer 15

• 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

Question 16

Tetralogy of Fallot

Answer 16

• 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
  *

Question 17

Transposition of great arteries

Answer 17

• Right to left disease
• RV and LV are switched
• Absolutely lethal without a shunt

Question 18

Coarction

Answer 18

• Narrowing of aorta
• Causes cyanosis and low BP systemically
• Size matters
• Hard for LV to get blood out, hypotension

Question 19

Ischemic Heart Disease

4 syndromes

Answer 19

• 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

Question 20

Angina Pectoris

Answer 20

• 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

Question 21

Acute MIin Ischemic Heart Disease

Answer 21

• 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