Lecture 11 - Heart Flashcards
1
Q
Ischemic Heart Disease
A
- one of the most common disease that causes death; requires significant fixed lesions.
- 70-75% stenosis (narrowing of vessel) leads to symptoms with increased demand for pumping blood
- 90% stenosis leads to symptoms at rest
2
Q
Acute Myocardial Infarction locations in coronary artery
A
- Left anterior descending= inclusions here leads to infarct in anterior left ventricle, anterior septum, apex circumferentially
- Right coronary – posterior left ventricle, posterior septum, right ventricular wall
- Left circumflex – lateral left ventricle
- Left ventricle affected most because it is thicker
3
Q
Pulmonary Hypertensive Heart Disease
A
- Cor Pulmonale => right ventricular hypertrophy
- Acute = pulmonary thromboemobolus (forms in leg but gets bigger as it moves closer to the heart); Acute Cor Pulmonale can lead to sudden death
- Chronic = pathologies of lung parenchyma or pulmonary vasculature
4
Q
Stenosis
A
- the first primary type of valvular disease
- narrowing of the valve / failure to open completely
- Left valves are subject more to stenosis because aortic ventricular valves are narrower
- Usually chronic – calcifications or scarring
- Usually causes hypertrophy of chamber proximal to valve
5
Q
Insufficiency
A
- the second primary type of valvular disease
- Failure of the valve to close completely causing leakage which allows or reverse flow
- Often primary valve defects of supporting structures
6
Q
Rheumatic Heart Disease
A
- inflammation
- Cardiac manifestation of rheumatic fever: due to antibody/bacteria complex from upper respiratory infection. (Multi-system disease from Group A Streptococcal Infection) = immunologically mediated
- Most common effects = valve disorders due to inflammatory lesions throughout the heart that leads to scarring
7
Q
Infective Endocarditis
A
- infection by microorganisms of heart valves or wall of heart.
- due to vegetations
- can be acute or subactue
8
Q
Vegetations
A
- develop on heart valves
- Consist of necrotic debris, thrombus and bacteria
- Can – embolize (become crumbly and break off easily), destroy valve annulus (walls)
9
Q
Acute infective endocarditis
A
- more virulent bacteria
- course of days
- Greater than 50% mortality
10
Q
Subacute infective endocarditis
A
- less virulent bacteria
- course of days to weeks
- indolent (little/no pain)
11
Q
Myocarditis
A
- primary inflammation of the middle/muscular layer of the heart (myocardium)
- Usually viral
- Effects = non-symptomatic => severe cardiomyopathy
12
Q
Pericarditis
A
- inflammation of the outer layers of the heart (epicardium and pericardium)
- anything that irritates pericardium = secondary disease
- can lead to tamponade (pericardial effusions) and/or constrictive pericarditis (due to stickyness of fibrin)
13
Q
Dialated Cardiomyopathy
A
- Progressive cardiac dilatation and systolic dysfunction (heart doesn’t pump efficiently)
- Results in enlarged (2-3X normal), flabby, dilated heart
- Causes: Genetic, myocarditis, chronic anemia, Adiramycin exposure, alcoholism, idiopathic
- Looks similar to that caused by ischemic heart disease, congestive heart failure
14
Q
Hypertrophic Cardiomyopathy
A
- idiopathic hypertrophic subaortic stenosis
- Myocardial hypertrophy, abnormal diastolic filling, sometimes ventricular outflow obstruction
- Gives marked left ventricular hypertrophy that reduces chamber size and impairs diastolic filling
- Causes are genetic
15
Q
Restrictive Cardiomyopathy
A
- Primary decrease in ventricular compliance; impaired diastolic filling
- Causes: amyloidosis, hemochromatosis, sarcoidosis, radiation-induced scarring
- looks like pericardial constriction
16
Q
Atrial Septal Defects
A
- type of congenital heart disease
- left-to-right shunt (cyanosis later in neonatal period)
- defect as a whole in atrial septum
- Ostium secundum = most common (defect of valve of foramen ovale)
- Ostium primum (defect of muscular wall/septum between ventricles)
17
Q
Ventricular Septal Defects
A
- type of congenital heart disease
- left-to-right shunt (cyanosis later in neonatal period)
- most common defect at birth
- can be Membranous = most common (defect = no seal of epicardium between left and right ventricles)
- can be Muscular (functional defect)
18
Q
Tetra logy of Fallot
A
- type of congenital heart disease
- right-to-left shunt (cyanosis at or near birth)
- 4 defects
1. Ventricular septal defect
2. Right ventricle with subpulmonic stenosis
3. Overiding aorta
4. Right ventricular hypertrophy - results from abnormal division of aortic/pulmonary root
19
Q
Transposition of Great Vessels
A
- type of congenital heart disease
- right-to-left shunt (cyanosis at or near birth)
- Aorta arises from the right ventricle and Pulmonary arises from the left ventricle (note: this is reversed fom normal)
- pumps deoxygenated blood to tissues = must be corrected soon after birth
- Infants with VSD are usually more stable
- Others will become unstable with closure of foramen and ductus
20
Q
Aortic Coarction
A
- obstructive leasion leads to focal narrowing of aorta
- Often exists with other defects
- Infantile = Hypoplasia of aortic arch proximal to ductus
- Adult = Discrete ridge just opposite the ligamentum
21
Q
Metastatic tumor
A
- most common tumor (neoplasm) of the heart because many tumors don’t arise from the heart
- tumor can come from: Lung, Lymphoma, Breast, Leukemia, Melanoma, Liver and colon.
- Note: Myxoma is the most common PRIMARY tumor (arises from heart)
