Lec 1B: Pathology of Heart Wall disorders

Question 1

What is acute pericarditis?

Answer 1

(itis) - inflammation, tissue is damage.

- acute inflammation of the pericardium. (<2 weeks)

Question 2

Acute pericarditis as a result of what?

Answer 2

viral, bacterial or fungal (at origin)
autoimmune disease (Rhematic diseasem SLE (systemic lupus erythrmm…. )
-trauma
-drug toxicity

Question 3

Symptoms of pericarditis?

Answer 3

• Chest pain
• friction rub
• ECG changes

Question 4

What is pericardial effusion?

Answer 4

accumulation of excess fluid (exudate) in the pericardial sac
- this is bad because it’ll cause inflammation which then leads to heart wall compression.

Question 5

What determines the effect effusion has on cardiac function?

Answer 5

1) amount of fluid
2) rapidity in which it acculumates
3) elasticity of pericardium

Question 6

What can cause Serous pericarditis?

Answer 6

• SLE (systemic lupus erythematosus)
• Rheumatic fever
• viral infection

Question 7

What is serous pericarditis?

Answer 7

production of clear, straw-colored, protein-riche exudate containing small numbers of inflammatory cells.

Question 8

Fibrinous pericarditis?

Answer 8

fibrin-rich exudate. It may be caused by uremia, myocardial infarction or acute fheumatic fever.

Question 9

purulent pericarditis?

Answer 9

grossly cloudy exudate. It is almost always caused by bacterial infection.

Question 10

Hemorrhagic pericarditis?

Answer 10

bloody exudate. results from tumor invasion of pericardium, but can result from tuberculosis and other bacterial infections also.

Question 11

Cardiac temponade?

Answer 11

increase in pericardial sac pressure caused by accumulation of fluid or blood in pericardial sac. REsulting in reduced ventricular filling and subsequent hemodynamic compromise.

• medical emergency
• death depends on speed of diagnosis
• treatment provided

Question 12

Two approaches to getting rid of periocardiocentesis

Answer 12

1) Subxiphoid approach

2) parasternal approach.

Question 13

Myocardial disease?

Answer 13

originates within the myocardium. not from cardiovascular disease

Question 14

Two major forms of myocardial disease?

Answer 14

1) myocarditis

2) primary cardiomyopathies

Question 15

Myocarditis?

Answer 15

inflammation of heart muscle and conduction syste without evidence of myocardial infarction
-myocardium becomes thick and swollen

Question 16

Causese of myocaditis?

Answer 16

#1) Viral
. drug toxicity (cocaine)
autoimmune disease

Question 17

Biventricular heart failure?

Answer 17

myocaditis…. does not have any valvular, rheumatic and congenital heart disease.

Question 18

primary cardiomyopathies?

There are 3 types. what are they?

Answer 18

non-inflammatory

• silent onset.
• assymptomatic
• cardiomegaly and heart failure
• detected in athletes.
  1) Dilated, hypertrophic, and restrictive,

Question 19

Dilated cardiomyopathy?

Answer 19

most common form.

• progressive cardiac hypertrophy and dilation
• impaired pumping ability in one or both ventricles
• mural thrombi ( alcohol can cause this). may be a source of thromboemboli
• causes: idiopathic, infectious myocarditis, alcohol

Question 20

Hypertrophic cardiomyopathy?

Answer 20

• ventricular hypertrophy and impaired diastolic ventricular filling.
• autosomal dominant
• not sure how they get it
• Athletes get it.

Question 21

Restrictive cardiomyopathy?

Answer 21

least common of the primary cardiomyopathies.

• ventricular filliing is restrictive because of excessive regidity and stiffness of the ventricular walls.
• unknown cause.

Question 22

Bacterial endocarditis?

Answer 22

1) unknown
2) life-threatening condition.
3) includes heart valves.

Question 23

For infective endocarditis (bacterial endocarditis)? What two things must happen?

Answer 23

1) damaged endocardial surface (presence of valvular disease, prosthetic heart valves, congenital heart defects provide good environment for bacterial growth)
2) portal entry where organism gains access to vasculature (upper respiratory tract lesion, skin lesion)… STAPHYLOCOCCUS AUREUS.

Question 24

Bacterial endocarditis normally happens in what kind of people?

Answer 24

1) people with pre-existing heart lesions, also develop in normal hearts with IV drug abusers.

Question 25

Characteristic of an infective (bacterial) endocarditis?

Answer 25

-Large, soft, friable, easily detached vegetations consisting of fibrin and intermeshed inflammatory cells and bacteria.

Question 26

Bacterial endocariditis could eventually lead to what?

Answer 26

• ulceration
  -valve cusps
  rupture of one of the choae tendineae
  -mitral valve is most frequently involved

Question 27

Distal embolization occurs in where?

Answer 27

Bacterial endocarditis. can result to septic infarcts in brain or in other organs.