Hypertensive Heart Diseases Flashcards
In systemic hypertensive heart disease, heart weight can exceed …. and thickness can exceed….
500 g
2 cm
Define Cor-pulmomale
Right ventricular hypertrophy amd diltation frequently accompanied by right heart failure caused by pulmonary HTN attributable to primary disorders of the lung parenchyma or pulmonary vasculature.
Acute cor-pulmonale follows ….
Massive pulmonary embolism
Mention feautre of cor-pulmonale
Right atrium and ventricle are commonly dilated
The pulmonary arteries often contain atheromatous plaques
GR,MI is a common comp of HTN
Mention another association
Due to depriving the thickened myocardium of essential oxygen
Coronary atherosclerosis
Mention gross features and association of brown atrophy of heart
Associated with wasting disease amlnd olf age
The heart is small with wrinkled surface and loss of epicardial fat, the coronaries are tortuous. Muscles are brown and friable.
Mention gross features and association of cloudy swelling of heart
Associated with infections and toxic states as typhoid, diphtheria, influenza.
The heart is soft and pale with friable myocardium.
Mention features and association of fatty heart
Obesity due to increased epicardial fat
Fatty change with accumulation of fat in myocardial fibers.
Mention features of glycogen infiltration in heart
Von Geirke’s disease
Glycogen accumulates in myocardial fibers
With enlargement of heart and disturbance of function.
Define HTN
Permenant elevation BP above 140 mmHg systolic and 90 mmHg diastolic.
Classify HTN
According to cause, primary and secondary
According to severity, benign and malignant
Mention hypertensive changes in large and medium sized arts
HTN accelerates atherogenesis
HTN causes degenerative changes in the vessel walls that can lead to aortic dissection & cerebrovascular hemorrhage.
Mention organs affected by HTN & the affection
Heart, concentric hypertrophy in left ventricle and atrium in response to elevated BP
Kidney, arteriosclerotic kidney, benign nephrosclerosis, primary contracted kidney
Small arteries & arterioles, homogenous pink hyaline thickening of arteriolar walls with loss of underlying structural details & luminal narrowing.
Mention causes of death in benign HTN
CHF
Coronary insuffiency or MI
Cerebrovascular accindents mainly cerebral hemorrhage
Renal failure
Mention symptoms of malignant HTN
Severe headache
Eye changes, retinal hemorrhages, exudates & papilloedema
Severe impairment of renal function with albuminuria
Mention causes of death in malignant HTN
Renal failure
Cerebrovascular accidents mainly cerebral hemorrhage
Coronary insufficiency
Heart failure
Mention changes in small arteries and arterioles in malignant HTN
Hyperplastic arteriolosclerosis, vessels have onion-skin concentric laminated thickening if arteriolar wall and luminal narrowing. Laminations consist of muscle cells and thickened reduplicated BM.
Necrotizing arteriolitis the vessel wall shows fibrinoid deposits & vessel wall necrosis.
Mention the congenital anomalies of BVs
Developmental or berry aneurysms (cerebral arteries)
Anteriovenous fistulas
Fibromuscular dysplasias
Define true aneurysm
Its wall is composed of all the layers of the artery (intima, media & adventitia) or attenuated wall of heart (ventricukar aneurysm) following transmural MI.
Mention types of true aneurysm
Saccular and fusiform
Mention effects of congenital aneurysm
If rupture, they cause fatal intracerebral hemorrhage
Atheromatous aneurysms are …., while syphilitic aneurysms are …..
Fusiform
Saccular
Mention effects of atheromatous aneurysms
- Pressure on surrounding organs
- Rupture with fatal hemorrhage
- Thrombosis & aneurysm
Mention effects of syphilitic aneurysms
- Pressure on trachea and esophagus
- Erosion of the sternum by pressure necrosis with production if SC pulsatile swelling
- Rupture with fatal hemorrhage
- Thrombosis & embolization