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CVS Pathology > Hypertensive Heart Diseases > Flashcards

Hypertensive Heart Diseases Flashcards

1
Q

In systemic hypertensive heart disease, heart weight can exceed …. and thickness can exceed….

A

500 g

2 cm

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2
Q

Define Cor-pulmomale

A

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.

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3
Q

Acute cor-pulmonale follows ….

A

Massive pulmonary embolism

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4
Q

Mention feautre of cor-pulmonale

A

Right atrium and ventricle are commonly dilated

The pulmonary arteries often contain atheromatous plaques

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5
Q

GR,MI is a common comp of HTN

Mention another association

A

Due to depriving the thickened myocardium of essential oxygen
Coronary atherosclerosis

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6
Q

Mention gross features and association of brown atrophy of heart

A

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.

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7
Q

Mention gross features and association of cloudy swelling of heart

A

Associated with infections and toxic states as typhoid, diphtheria, influenza.
The heart is soft and pale with friable myocardium.

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8
Q

Mention features and association of fatty heart

A

Obesity due to increased epicardial fat

Fatty change with accumulation of fat in myocardial fibers.

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9
Q

Mention features of glycogen infiltration in heart

A

Von Geirke’s disease
Glycogen accumulates in myocardial fibers
With enlargement of heart and disturbance of function.

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10
Q

Define HTN

A

Permenant elevation BP above 140 mmHg systolic and 90 mmHg diastolic.

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11
Q

Classify HTN

A

According to cause, primary and secondary

According to severity, benign and malignant

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12
Q

Mention hypertensive changes in large and medium sized arts

A

HTN accelerates atherogenesis

HTN causes degenerative changes in the vessel walls that can lead to aortic dissection & cerebrovascular hemorrhage.

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13
Q

Mention organs affected by HTN & the affection

A

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.

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14
Q

Mention causes of death in benign HTN

A

CHF
Coronary insuffiency or MI
Cerebrovascular accindents mainly cerebral hemorrhage
Renal failure

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15
Q

Mention symptoms of malignant HTN

A

Severe headache
Eye changes, retinal hemorrhages, exudates & papilloedema
Severe impairment of renal function with albuminuria

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16
Q

Mention causes of death in malignant HTN

A

Renal failure
Cerebrovascular accidents mainly cerebral hemorrhage
Coronary insufficiency
Heart failure

17
Q

Mention changes in small arteries and arterioles in malignant HTN

A

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.

18
Q

Mention the congenital anomalies of BVs

A

Developmental or berry aneurysms (cerebral arteries)
Anteriovenous fistulas
Fibromuscular dysplasias

19
Q

Define true aneurysm

A

Its wall is composed of all the layers of the artery (intima, media & adventitia) or attenuated wall of heart (ventricukar aneurysm) following transmural MI.

20
Q

Mention types of true aneurysm

A

Saccular and fusiform

21
Q

Mention effects of congenital aneurysm

A

If rupture, they cause fatal intracerebral hemorrhage

22
Q

Atheromatous aneurysms are …., while syphilitic aneurysms are …..

A

Fusiform

Saccular

23
Q

Mention effects of atheromatous aneurysms

A
  1. Pressure on surrounding organs
  2. Rupture with fatal hemorrhage
  3. Thrombosis & aneurysm
24
Q

Mention effects of syphilitic aneurysms

A
  1. Pressure on trachea and esophagus
  2. Erosion of the sternum by pressure necrosis with production if SC pulsatile swelling
  3. Rupture with fatal hemorrhage
  4. Thrombosis & embolization
25
Q

Mention causes of mycotic aneurysms

A
  1. Embolization of a septic embolus
  2. Extension of adjacent suppurative process
  3. Direct infection pf artery by circukating organisms
26
Q

Mention causes of aneurysm

A
  1. Inadquate or abnormal ECM synthesis (Marfan)
  2. Excessive degradation of ECM due to inc MMP or dec TIMP
  3. Disorders leading to SM cells loss or cahnge in synthetic phenotype
    A. Genetic disorders (Marfan) or metabolic (scurvy)
    B. Ischemia (atherosclerosis & HTN) resulting SM cell loss & medial degeneartve changes as fibrosis, inadequate ECM synthesis, cystic medial degeneration.
27
Q

Mention types of false aneurysm

A 
Pulsating hematoma (walls of hematoma are formed by the compressed adjacent structures (eg. Muscle & fascia)
Arteriovenous fistula
28
Q

Mention complications of AV anastomosis

A

High-output cardiac failure may occur in karge AV fistulas due to shunting if blood from arterial to venous circulation.

29
Q

Define aortic dissection

A

It occurs when blood passes into diseased media dividing it into inner part (intima & part of media) and outer part (part of media & adventitia).

30
Q

Mention causes of aortic dissection

A

HTN, compression of vasa vasorum & hypoxic medial damage
Non-HTN, Disorders of connective tissue (aquired or hereditary)
Iatrogenic complicating arterial cannulation

31
Q

Mention clinical symptoms of aortic dissection

A

Sudden onset of stabbing pain in ant chest radiating to back and moving downwards
Cardiac involvemnet include tamponade, aortic insufficiency & MI

32
Q

Mention effects of aortic dissection

A 
The fakse lumen could rupture internally recommunucating with true lumen or externally keadung to:
Cardiac tamponade
Mediastinal hemorrhage 
Haemothorax
Abdominal hemorrhage

CVS Pathology (5 decks)

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