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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
Q

tetralogy of fallot

A

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
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26
Q

what are the main side effects of tetralogy of follot?

A

digital clubbing

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27
Q

Most common cause of cyanotic congenital heart disease

A

Tetralogy of fallot

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28
Q

Transposition of great arteries

A

Right to left- Congenital Heart Disease

emryonic lethal in absence of shunt

R ventricle is attached to aorta (should be attached to pumonary)

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29
Q

Coarctation

A

Aortic coarctation -congenital Heart disease

  1. Narrowing of aorta
  2. Causes cyanosis and low BP sytemically
  3. Size matter
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30
Q

Ischemic Heart Disease

(4)

A
  1. Angia pectoris
  2. Acute MI (myocardial infarction)
  3. Chronic IHD
  4. Sudden cardiac death
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31
Q

what is the ischemic heart disease

A

myocardial perfusion can’t meet demand

Usually a result of reduced coronary artery blood flow

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32
Q

thrombus

embolism

A

thrombus- cloat forms and stays where it is

embolism- forms and then moves

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33
Q

Angina pectoris

A

intermittent chest pain

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34
Q

Angina pectoris

stable

A

Intermittent chest pain

Most common

pain on exertion

fixed narrowing of CA

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35
Q

Angina Pectoris

Prinzmetal (variant)

A

intermittent chest pain

pain at rest

Coronary artery spasm

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36
Q

Angina Pectoris

Unstable (pre-infraction)

A

unpredictable pain

plaque disruption and thrombosis

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37
Q

What is Acute MI?

A

necrosis of myocardium from ischemia

38
Q

Acute MI is due to ____

can slavage if _____

A

Most due to CA thrombosis (20-30) minutes

salvage myocardium

39
Q

Acute MI

clinical feature

A

sever crushing chest pain

not relieved by nittoglycerin

sweating

nausea

40
Q

what can you detect in the blood when you have an Acute MI

A

CK-MB increases in 2-4 hours

normal in 72 hours

41
Q

nitroglycerin

A

converted to NO

expands the blood vessels

42
Q

Gross changes of Acute MI

A

Mottling-

Yellow infrarct center

yellow center, red borders

scar

43
Q

Mottling

A

coagulation
necrosis
neutrophils come in

44
Q

yellow infract center

A

neutrophils dies
macrophages eat dead cells

45
Q

yellow center, red borders

A

granulation tissue

46
Q

scar

A

collagen

47
Q

Acute MI

types

A

Subendocardial infarction

transmural infaraction

48
Q

Subendocardial Infarction

A

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
Q

Transmural infarction

A

Acute MI

infarction affects more than 1/2 of the heart wall

more serious

50
Q

Chronic IHD

A

Ischemic Heart Disease (IHD)

accumulation of small ischemic insults leads to mechanical failure

51
Q

Sudden cardiac death

A

often a result of a lethal arrythmia without myocyte

necrosis

52
Q

Hypertensive Heart Disease

A

Can affect L or R ventricle

53
Q

Cor pulmonale

A

hypertensive heart disease

RV enlargement due to pulmonary hypertension

(PH from primary lung disorder)

54
Q

Valvular Heart Disease can be a cause of

A

murmurs

angina

CHF

fainting

55
Q

Stenosis

A

failure to open

Valvular Heart Disease

56
Q

Insufficiency

A

failure to close

Regurgitation

Valvular Heart Disease

57
Q

Valvular Heart Diseases (5)

A
  1. Valvular stenosis
  2. Valvular regurgitation
  3. Rheumatic Valvular disease
  4. Mitral valve prolapse syndrome
  5. Infective endocarditis
58
Q

valvular stenosis

A

narowing of valves

aortic stenosis

mitral stenosis

59
Q

Valvular regurgitation

A

leakage of valvs

aortic regurgitation

mitral regurgitation

60
Q

Phonocardiogram

sounds

A

Sounds

1 – AV valves close

2 – Semilunar valves close

3 – “Slushing” of blood

61
Q

Aortic Valve Stenosis

A

Stiffening and narrowing of the aortic vavle

  • blood has difficulty exiting the heart
  • prolonged ejection sound
62
Q

aortic valve stenosis

clinical manifestations

A
  • Crescendo-decrescendo systolic heart sound
  • Decrease in stroke volume
  • Increased LV pressure
  • Decreased systolic blood pressure
  • Hypertrophy of left ventricle
63
Q

Aortic Valve stenosis appears

A
  • calcification of valve
  • fish mouth valve
64
Q

Aortic Regurgitation

A

failure of the aortic valve to properly close

  • Blood leaks back into the ventricle after ventricular contraction
65
Q

Clinical manifestations

A
  • 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
Q

Mitral Stenosis

A
  • narrowing or stiffening of the mitral valve (left AV valve)
  • Tubulent blood flow during atrial filling and contraction
67
Q

Mitral Stenosis

clinical manifestations

A

​

  • Subtle crescendo diastolic murmur (rumbling)
  • Atrial dysrhythmias (fibrillation etc.)
  • Increases pulmonary blood pressure
  • Pulmonary edema
  • Right heart failure
68
Q

In Mitral Stenosis

left atrium clinical manifestations

A

Decreased blood flow from left atrium to left ventricle
Increased left atrial pressure
Hypertrophy and dilatation of left atrium

69
Q

***Mitral Stenosis is similar to ??

A
70
Q

Mitral regurgitation

A

failure of the mitral valve (left valve) to properly close

blood passing into atrium from ventricle during contraction

71
Q

Mitral regurgitaiton

clinical manifestations

A
  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
Q

gaint cells

A

multiple machrophages

73
Q

Rheumatic fever

A
  • 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
Q

If left untreated, rheumatic fever causes

A

rheumatic heart disease

75
Q

First Strep throat then after 3 weeks –>decades later

A

Strep→ Polyarthritis → Mitral Stenosis, Left Atrium enlargement

Aschoff body

76
Q

Mitral Valve Prolapse

A
  • Ballooning of mitral leaflets
  • Most patients asymptomatic
77
Q

Which genetic condition is associated with increased risk of valve proplase?

A

Marphans syndrome carries an increased risk of this

78
Q

Infective Endocarditis

A

microbial invasion of heart valves, endocardium

usually mitral and aortic valves

79
Q

Acute Infective Endocarditis

A
  • Highly virulent infection attacks normal valve (e.g., s. aureus)
  • 50% of patients die within weeks
  • Often requires surgery
80
Q

Subacute Infective Endocarditis

A
  • Low virulent infection colonizes abnormal valve
  • Long course, most recover
81
Q

Cardiomyopathies

A

diverse group of disorders in which myocardium dysfunctions

many causes some idiopathic

82
Q

Dialated Cardiomyopathy

traits

causes

A

congestive cardiomyopathy

  1. Ventricle can’t empty
  2. 70% die in 5 yrs
  3. causes
    • Viral
    • Alcohol/toxin
    • Genetic abnormality
83
Q

Hypertrophic cardiomyopathy

A
  • Ventricle can’t fill (heart too thick)
  • 4% die
  • causes
    • Hypertension
    • Sacrcomere mutation
84
Q

Hypertrophic Cardiomyopathy

treatment

A
  • beta blockers
  • drugs need to relax ventricles
85
Q

Restrictive Cardiomyopathy

A
  • Desposition of material in myocardium
  • Heart wall is stiff, can’t fill!
  • 70% of patients dead with 5yrs
86
Q

Restrictive Cardiomyopathy Cause

A

Idiopathic

Amyloidosis or sarcoidosis

87
Q

Amyloidosis

A

Desposition of material in myocardium

Insulin increases amyloid accrual

Plaque accumulation

88
Q

Pericardial Disease

Disorders of the pericardium

A

Disorders of the pericardium

  1. Acute pericarditis
  2. Pericardial Effusion
89
Q

Acute Pericarditis

A

Causes severe chest pain that worsens with respiratory movements and with lying down

Dangers: Tamponade, Chronic fibrosis

Pericardial Disease

90
Q

Pericardial Effusion

A

Accumulation of fluid within pericardium

Tamponade- phyical pressure compressess heart

Pericardial Disease

91
Q

Primary Tumors in the heart

A

very uncommon

most are benign (myxoma)

92
Q

Malignant heart tumors

A

caners of the heart are often metastasized from lung or lymphoma

more common

DMD 5247 (7 decks)

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