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DMD 5247 > Heart Pathology-Bickmen > Flashcards

Heart Pathology-Bickmen Flashcards

1
Q

heart failure

A

heart cannot pump blood suffiecent to meet body’s needs

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2
Q

in early stages of heart failure certain compensations occur

A

catecholamines (epi)

Frank-Starling mechanism (fills more contracts more)

Hypertrophy

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3
Q

heart failure eventually leads to

A

Ischemia

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4
Q

heart failure generally occurs on

A

one side

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5
Q

Where does blood pool with right heart failure?

*

A

pools in the body

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6
Q

where does blood pool with left heart failure?

A

pool in the lungs

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7
Q

right heart failure causes

A
  1. hepatomegaly
  2. splenomegaly
  3. ascites
  4. peripheral edema
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8
Q

left heart failure leads to

A

cyanosis

pulmonary edema

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9
Q

Left Heart failure common cause

A
  • Systemic hypertension
  • Mitral or aortic valve disease
  • Primary heart diseases (e.g., amyloidosis)
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10
Q

left heart failure consequences

A
  1. Dyspnea- difficulty breathing
  2. Orthopnea- difficulty breathing in certain postions
  3. Enlarged heart, increased heart rate
  4. Rales-hear bubble cracking, fluid in lungs
  5. Mitral regurgitation, systolic murmur
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11
Q

Heart changes

left heart failure

A

LV hypertrophy

LV dilation

LA may be enlarged

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12
Q

Right heart failure common causes

A
  • cor pulmonale- lung problem thats starts to give problems with right side of the heart (COPD)
  • some congenital heart diseases
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13
Q

Right heart failure consequences

A 
Peripheral edema
Enlarged liver (hepatomegaly)
Enlarged spleen (splenomegaly)
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14
Q

right heart failure heart changes

A

RV hypertrophy

RV dilation

RA may be enlarged

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15
Q

Right heart failure

A

Hepatomegaly

Spleenegaly

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16
Q

congential heart diseases cause

A

90% unknow

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17
Q

left to right congenital heart disease

A

ASD
VSD
PDA

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18
Q

Right to left congential heart diseases

A

tetralogy of fallot

transposition of great arteries

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19
Q

coarctation congenital heart disease

A

aortic coarctation

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20
Q

which congenital heart disease is the most common?

A

VSD

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21
Q

ASD

A

Left to right

Atrial septal defect

my cause pulmonary hypertension

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22
Q

VSD

A

ventricular septal defect

left to right

  • Most common
  • most close spontaneously
  • Better to have it towards the bottom because the contraction goes from the bottom to the top. So if the septal defect is at the bottom then you close the hole are at the start of the contraction
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23
Q

PDA

A

congential heart disease

patent ductus arteriosus

left to right

  • In the fetus, allows flow from PA to aorta
  • Generally closes by day 2 of life
  • Size matters
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24
Q

ASD

VSD

PDA

all have in common?

A

all three increase pressure to the lungs

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25
tetralogy of fallot
**Most common cause of cyanotic congenital heart disease** **right to left** 1. VSD- is now R to L here 2. pulmonary stenosis 3. Overriding aorta 4. RV hypertrophy
26
what are the main side effects of tetralogy of follot?
digital clubbing
27
Most common cause of cyanotic congenital heart disease
Tetralogy of fallot
28
Transposition of great arteries
***Right to left- Congenital Heart Disease*** emryonic lethal in absence of shunt *R ventricle is attached to aorta (should be attached to pumonary)*
29
Coarctation
***Aortic coarctation -congenital Heart disease*** 1. Narrowing of aorta 2. Causes cyanosis and low BP sytemically 3. Size matter
30
Ischemic Heart Disease (4)
1. Angia pectoris 2. Acute MI (myocardial infarction) 3. Chronic IHD 4. Sudden cardiac death
31
what is the ischemic heart disease
myocardial perfusion can't meet demand Usually a result of reduced coronary artery blood flow
32
thrombus embolism
thrombus- cloat forms and stays where it is embolism- forms and then moves
33
Angina pectoris
intermittent chest pain
34
Angina pectoris stable
***Intermittent chest pain*** Most common pain on exertion fixed narrowing of CA
35
Angina Pectoris Prinzmetal (variant)
*intermittent chest pain* pain at rest Coronary artery spasm
36
Angina Pectoris Unstable (pre-infraction)
unpredictable pain plaque disruption and thrombosis
37
What is Acute MI?
necrosis of myocardium from ischemia
38
Acute MI is due to \_\_\_\_ can slavage if \_\_\_\_\_
Most due to CA thrombosis (20-30) minutes salvage myocardium
39
Acute MI clinical feature
sever crushing chest pain not relieved by nittoglycerin sweating nausea
40
what can you detect in the blood when you have an Acute MI
CK-MB increases in 2-4 hours normal in 72 hours
41
nitroglycerin
converted to NO expands the blood vessels
42
Gross changes of Acute MI
## Footnote Mottling- Yellow infrarct center yellow center, red borders scar
43
Mottling
coagulation necrosis neutrophils come in
44
yellow infract center
neutrophils dies macrophages eat dead cells
45
yellow center, red borders
granulation tissue
46
scar
collagen
47
Acute MI types
Subendocardial infarction transmural infaraction
48
Subendocardial Infarction
Acute MI infarction affects only the inner 1/3 to 1/2 of heart wall inner wall more affected beacuse blood supply goes first to outer wall
49
Transmural infarction
Acute MI infarction affects more than 1/2 of the heart wall more serious
50
Chronic IHD
Ischemic Heart Disease (IHD) accumulation of small ischemic insults leads to mechanical failure
51
Sudden cardiac death
often a result of a lethal arrythmia without myocyte necrosis
52
Hypertensive Heart Disease
Can affect L or R ventricle
53
Cor pulmonale
hypertensive heart disease RV enlargement due to pulmonary hypertension (PH from primary lung disorder)
54
Valvular Heart Disease can be a cause of
murmurs angina CHF fainting
55
Stenosis
failure to open Valvular Heart Disease
56
Insufficiency
failure to close Regurgitation *Valvular Heart Disease*
57
Valvular Heart Diseases (5)
1. Valvular stenosis 2. Valvular regurgitation 3. Rheumatic Valvular disease 4. Mitral valve prolapse syndrome 5. Infective endocarditis
58
valvular stenosis
narowing of valves aortic stenosis mitral stenosis
59
Valvular regurgitation
leakage of valvs aortic regurgitation mitral regurgitation
60
Phonocardiogram sounds
Sounds 1 – AV valves close 2 – Semilunar valves close 3 – “Slushing” of blood
61
Aortic Valve Stenosis
Stiffening and narrowing of the aortic vavle * blood has difficulty exiting the heart * prolonged ejection sound
62
aortic valve stenosis clinical manifestations
* Crescendo-decrescendo systolic heart sound * Decrease in stroke volume * Increased LV pressure * Decreased systolic blood pressure * Hypertrophy of left ventricle
63
Aortic Valve stenosis appears
* calcification of valve * fish mouth valve
64
Aortic Regurgitation
failure of the aortic valve to properly close * Blood leaks back into the ventricle after ventricular contraction
65
Clinical manifestations
* Diastolic murmur (blowing sound) of high pitch over the left ventricle * Hypertrophy of left ventricle * LV failure * Doppler echocardigraphy reveals blood flow back through aortic valve
66
Mitral Stenosis
* narrowing or stiffening of the mitral valve (left AV valve) * Tubulent blood flow during atrial filling and contraction
67
Mitral Stenosis clinical manifestations
​ * Subtle crescendo diastolic murmur (rumbling) * Atrial dysrhythmias (fibrillation etc.) * **Increases pulmonary blood pressure** * **Pulmonary edema** * **Right heart failure**
68
In Mitral Stenosis left atrium clinical manifestations
Decreased blood flow from left atrium to left ventricle Increased left atrial pressure Hypertrophy and dilatation of left atrium
69
\*\*\*Mitral Stenosis is similar to ??
70
Mitral regurgitation
## Footnote failure of the mitral valve (left valve) to properly close blood passing into atrium from ventricle during contraction
71
Mitral regurgitaiton clinical manifestations
1. Systolic murmur 2. Hypertrophied left ventricle 3. Left heart failure 4. Pulmonary hypertension and edema 5. echocardiography= blood flow back through mitral valve
72
gaint cells
multiple machrophages
73
Rheumatic fever
* inflammatory disease * caused by immune response to infection by the group A β-hemolytic streptococci * Inflammation of the joints, skin, nervous system, and heart (Febrile illness)
74
If left untreated, rheumatic fever causes
rheumatic heart disease
75
First Strep throat then after 3 weeks --\>decades later
Strep→ Polyarthritis → Mitral Stenosis, Left Atrium enlargement **Aschoff body**
76
Mitral Valve Prolapse
* Ballooning of mitral leaflets * Most patients asymptomatic
77
Which genetic condition is associated with increased risk of valve proplase?
Marphans syndrome carries an increased risk of this
78
Infective Endocarditis
microbial invasion of heart valves, endocardium usually mitral and aortic valves
79
Acute Infective Endocarditis
* Highly virulent infection attacks normal valve (e.g., s. aureus) * 50% of patients die within weeks * Often requires surgery
80
Subacute Infective Endocarditis
* Low virulent infection colonizes abnormal valve * Long course, most recover
81
Cardiomyopathies
diverse group of disorders in which myocardium dysfunctions many causes some idiopathic
82
Dialated Cardiomyopathy traits causes
congestive cardiomyopathy 1. Ventricle can't empty 2. 70% die in 5 yrs 3. causes * Viral * Alcohol/toxin * Genetic abnormality
83
Hypertrophic cardiomyopathy
* **Ventricle can't fill (heart too thick)** * 4% die * causes * Hypertension * Sacrcomere mutation
84
Hypertrophic Cardiomyopathy treatment
* beta blockers * drugs need to relax ventricles
85
Restrictive Cardiomyopathy
* Desposition of material in myocardium * Heart wall is stiff, can't fill! * 70% of patients dead with 5yrs
86
Restrictive Cardiomyopathy Cause
Idiopathic Amyloidosis or sarcoidosis
87
Amyloidosis
**Desposition of material in myocardium** Insulin increases amyloid accrual Plaque accumulation
88
Pericardial Disease Disorders of the pericardium
Disorders of the pericardium 1. Acute pericarditis 2. Pericardial Effusion
89
Acute Pericarditis
Causes severe chest pain that worsens with respiratory movements and with lying down Dangers: Tamponade, Chronic fibrosis ***Pericardial Disease***
90
Pericardial Effusion
Accumulation of fluid within pericardium Tamponade- phyical pressure compressess heart ***_Pericardial Disease_***
91
Primary Tumors in the heart
very uncommon most are benign (myxoma)
92
Malignant heart tumors
caners of the heart are often metastasized from lung or lymphoma more common

DMD 5247 (7 decks)

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