Lecture 14 (Quiz 3) Flashcards
What has retrosternal chest pain, dyspnea (short of breath), diaphoresis (sweating), nausea/vomiting, palpitations, anxiety. Can have any or several of these, but also can be asymptomatic or present as sudden death? Differential??? What are the criteria of this (2 things are required)?
- Myocardial Infarct
- Ischemic type chest pain >20 minutes, Acute EKG changes, Rising and Falling serum cardiac biomarkers (troponin and CK) and Documentation of an infarct at autopsy.
In Myocardial Infarcts there are several things of gross appearance that occur at different times. When does Pallor, Pallor and Hyperemia, Hyperemic boarder with central yellowing, Maximally yellow with soft vascular margins, and White fibrosis occur?
- Pallor: 18-24 hours
- Pallor and Hyperemia: 24-72 hours
- Hyperemic boarder with central yellowing: 3-7 days
- Maximally yellow with soft vascular margins: 10-21 days
- White fibrosis occur: 7 weeks and beyond
What has full thickness in the endocardium to epicardium of the heart, usually involves the Left Ventricle anterior and posterior free walls or septum with extension in the the Right Ventricle wall in 15-30% of cases, correlates with STEMI (ST segment elevation myocardial infarct on EKG), and is more severe?
- Transmural Infarct
What is due to Hypotension and Global ischemia, has multifocal/diffuse areas of necrosis is confined to the inner walls of the Left Ventricle, it is not necessarily in distribution of one coronary artery, it correlates with NSTEMI (non-ST segment elevation myocardial infarct) on EKG, is less severe but still potentially lethal?
- Subendocardial Infarct
What are the complications of Myocardial Infarctions? (8)
- Arrhythmias (75-95%)
- Congestive heart failure, pulmonary edema (60%)
- Pericarditis (50%)
- Mural thrombosis (40%)
- None (10-20%)
- Rupture of ventricle or papillary muscle (4-8%)
- Extension of Infarct
What is failure to open and presents forward flow of blood in the heart? What is failure to close, allows reverse flow? These are both examples of what? What two things cause Aortic Stenosis? What is a side-effect of this?
- Stenosis
- Regurgitation
- Valvular Heart Disease
- Senile Calcific Aortic Stenosis and Calcification of the bicuspid valve.
- Postinflammatory scarring (rheumatic heart disease)
What includes post infective endocarditis or rheumatic fever, is common in congenital bicuspid valves or normal valves of elderly people, is the fibrosis and calcification that obliterate sinuses of Valsalva and valve leaflets, and is overloaded pressure of the left ventricle?
- Calcific Aortic Valve Stenosis
Postinflammatory scarring, Syphilitic Aortitis, Ankylosing Spondylitis, Rheumatoid Arthritis and Marfan’s syndrome are all side effects of what?
- Aortic Regurgitation
What has excessively Large leaflets, Long chordae tendineae, or Myxomatous change within valve leaflets especially posterior leaflet, occurs in 2-3% of the general population, mostly women, and are susceptible to endocarditis? Etiology can be associated with what?
- Mitral Valve Prolapse
- Hereditary or Marfan’s syndrome
What has leaflets that have postinflammatory scarring, infective endocarditis, carcinoid disease. Is a rupture of papillary muscle or chordae tendineae and the Left Ventricle is dilated and has calcification of the mitral ring?
- Mitral Regurgitation
What has Polyarthritis of large joints, Carditis, Subcutaneous nodules, Erythema marginatum of skin, involves Sydenham’s chorea, and was once common but is now very uncommon due to antibiotic treatments for strep throat?
- Rheumatic Fever (Systemic Disease)
What involves Friable vegetations containing RBCs, fibrin, inflammatory cells and organisms, where fever and murmur are common, predisposing heart damage is present, and mortality can be has high as 70% if involves Staphylococcal bacteria? What is the highest site of involvement? What are the most common bacteria?
- Infective Endocarditis
- Aortic Valve and then the Mitral Valve.
- Staph. Aureus and Strep. Pseudomonas.
What has cardiac complications of coronary artery emboli, abscesses, erosion/perforation, of valve or chordae tendinae, and non-cardiac complications involving septic emboli, immune complex diseases in vessels/kidneys?
- Endocarditis
What are sterile small vegetations within fibrin and platelets along closure lines of aortic and mitral valves that have a hyper coagulable state and can become infected or a source of emboli?
- Nonbacterial Thrombotic Endocarditis
What are complications involved with having artificial valves?
- Thrombosis/Thromboembolism
- Anticoagulant hemorrhages
- Infective Endocarditis
- Structural/Biological deterioration.
- Nonstructural dysfunction
