Lecture 9 Heart and Blood Vessels Flashcards
Define congenital cardiovascular disease
Heart disease present from birth
Define congenital cardiovascular disease
Heart disease present from birth
Define cardiac failure
How does heart compensate and what results?
Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.
Signs/symptoms of CV disease?
All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).
Define stenosis (valvular heart disease).
Failure to completely open.
What are the three ways for valvular heart disease?
Stenosis, incompetence/regurgitation and vegetations
What does incompetence/regurgitation mean for valvular heart disease?
Failure to close, allowing reversible flow
What does vegitation mean for valvular heart disease?
Abnormal tissue growth on valve (fibrin, platelets and bacteria)
What is the most common valvular disease?
Stenosis of aortic and mitral valves. (2/3rd of
What is valvular stenosis mainly due to?
Primary valve cusp abnormality
Why do vegetations form?
From infective endocarditis & rheumatic fever
What is the clinical presentation of vegetations?
Sepsis, heart failure, new murmur.
As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?
Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use
What is the pathological cause for mitral stenosis?
Rheumatic fever
What is the pathological cause for mitral incompetence?
Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps
What is the pathological cause for aortic stenosis?
Rheumatic fever, calcific degerneration
What is the pathological cause for aortic incompetence?
Rheumatic fever, dilation of aortic root, rheumatological disorders.
Ehst is the pathological cause for endocarditis?
Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves
What are the clinical features of mitral stenosis?
Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.
What are the clinical features of mitral incompetence?
Murmur. Variable haemodynamic effect
What are the clinical features of aortic stenosis?
Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.
What are the clinical features of aortic incompetence?
Murmur. Collapsing pulse. Angina. L vent failure/ sudden death
What are the clinical features of endocarditis?
Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,
Define endocardium?
inner lining of the heart and its valves
Where does infection occur in the endocardium?
Edge of heart valves
What does endocarditis on the R side mean?
IV drug use
What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?
Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys
What affects previously normal valves?
IV drug abusers
When considering prophylaxis and endocarditis?
MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.
Define preicardium
Heart sac
What causes pericarditis and mycarditis?
TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,
Name some unusual cardiac diseases?
Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.
Name dilated cardiac diseases
Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid
Name hypertrophic cardiac diseases
Idiopathic, genetic, storage disease
Name restrictive cardiac diseases?
Idiopathic, amyloidosis, radiation induced, chemo related
What can hypertrophic cardiomyopathy led to?
end stage dilation
a 1/3rd of hypertrophic cardiomyopathy have?
intermittent left ventricular outflow obstruction
Clinical features of HCM?
Black outs, SOB, chest pain, palpitations, atrial fib,
What causes HCM?
50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements
What I didn’t know that could cause aneurysms?
Autoimmune diseases, bacteria, fungus, syphilis
Aneurysm treatments?
Stents, surgery, reducing arterial pressure
Where are atherosclerotic aneuryms found?
Lower abdominal aorta and iliac arteries
Where are aortic dissections found?
Aorta and major branches
Where are berry aneurysms found?
circle of willis
Where are micro aneurysms found?
intracerebral vapillaries
Where are syphilitic aneurysms found?
ascending & arch of aorta
Where are mycotic (infective) aneurysms found?
Root or aorta and and vessel
What are the clinical effects of atherosclerotic aneurysms
Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage
What are the clinical effects of aortic dissection?
Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta
What are the clinical effects of micro-aneurysms?
Intracerebral haemorrhage (hypertension)
What are the clinical effects of syphilitie aneurysms?
Aortic incompetence
What is the circle of willis?
Circle of vessels around the base of the brain
What is the circle of willis?
Circle of vessels around the base of the brain
Define cardiac failure
heart unable to pump blood at rate required for normal functioning
How does heart compensate and what results?
Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.
Signs/symptoms of CV disease?
All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).
Define stenosis (valvular heart disease).
Failure to completely open.
What are the three ways for valvular heart disease?
Stenosis, incompetence/regurgitation and vegetations
What does incompetence/regurgitation mean for valvular heart disease?
Failure to close, allowing reversible flow
What does vegitation mean for valvular heart disease?
Abnormal tissue growth on valve (fibrin, platelets and bacteria)
What is the most common valvular disease?
Stenosis of aortic and mitral valves. (2/3rd of
What is valvular stenosis mainly due to?
Primary valve cusp abnormality
Why do vegetations form?
From infective endocarditis & rheumatic fever
What is the clinical presentation of vegetations?
Sepsis, heart failure, new murmur.
As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?
Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use
What is the pathological cause for mitral stenosis?
Rheumatic fever
What is the pathological cause for mitral incompetence?
Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps
What is the pathological cause for aortic stenosis?
Rheumatic fever, calcific degerneration
What is the pathological cause for aortic incompetence?
Rheumatic fever, dilation of aortic root, rheumatological disorders.
Ehst is the pathological cause for endocarditis?
Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves
What are the clinical features of mitral stenosis?
Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.
What are the clinical features of mitral incompetence?
Murmur. Variable haemodynamic effect
What are the clinical features of aortic stenosis?
Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.
What are the clinical features of aortic incompetence?
Murmur. Collapsing pulse. Angina. L vent failure/ sudden death
What are the clinical features of endocarditis?
Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,
Define endocardium?
inner lining of the heart and its valves
Where does infection occur in the endocardium?
Edge of heart valves
What does endocarditis on the R side mean?
IV drug use
What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?
Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys
What affects previously normal valves?
IV drug abusers
When considering prophylaxis and endocarditis?
MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.
Define preicardium
Heart sac
What causes pericarditis and mycarditis?
TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,
Name some unusual cardiac diseases?
Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.
Name dilated cardiac diseases
Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid
Name hypertrophic cardiac diseases
Idiopathic, genetic, storage disease
Name restrictive cardiac diseases?
Idiopathic, amyloidosis, radiation induced, chemo related
What can hypertrophic cardiomyopathy led to?
end stage dilation
a 1/3rd of hypertrophic cardiomyopathy have?
intermittent left ventricular outflow obstruction
Clinical features of HCM?
Black outs, SOB, chest pain, palpitations, atrial fib,
What causes HCM?
50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements
What I didn’t know that could cause aneurysms?
Autoimmune diseases, bacteria, fungus, syphilis
Aneurysm treatments?
Stents, surgery, reducing arterial pressure
Where are atherosclerotic aneuryms found?
Lower abdominal aorta and iliac arteries
Where are aortic dissections found?
Aorta and major branches
Where are berry aneurysms found?
circle of willis
Where are micro aneurysms found?
intracerebral vapillaries
Where are syphilitic aneurysms found?
ascending & arch of aorta
Where are mycotic (infective) aneurysms found?
Root or aorta and and vessel
What are the clinical effects of atherosclerotic aneurysms
Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage
What are the clinical effects of aortic dissection?
Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta
What are the clinical effects of micro-aneurysms?
Intracerebral haemorrhage (hypertension)
What are the clinical effects of syphilitie aneurysms?
Aortic incompetence
What are the clinical effects of mycotic (infective) aneurysms?
Thrombosis or rupture. Cerebral infarction of haemorrage.
What is the circle of willis?
Circle of vessels around the base of the brain
When is someone offered 24hr ambulatory monitoring?
When they have BP 140/90
What is mild diastolic bp between?
95-104mmHg
What is moderate diastolic bp between?
105-114mmHg
What is severe diastolic bp?
> 115mmHg
Primary hypertension is also known as?
Essential hypertension (95%)
Risk factors for essential hypertension?
(non-modifiable) Genes, family history. (Modifiable) diet, lifestyle weight, alcohol, smoking.
Causes of secondary hypertension?
Renal (polycystic kidney disease), Endocrine (thyrotoxicosis), vascular (raise IV volume), neurogenic (acute stress)
What is benign hypertension?
Remains stable, normal life until complications arise
What is malignant hypertension?
Accelerated hypertensive disease, 5% of cases. Rapid ^ BP 90% die in first year.
Hypertension can lead to what for blood vessels?
atherosclerosis, arteriosclerosis and ^risk of MI, rupture and dissection
Define sclerosis
Thickening/hardening of body tissue
Hypertension can lead to what for the heart?
Heart disease, left ventricular hypertrophy, cardiac failure and MI
Hypertension can lead to what for the kidney?
Benign nephrosclerosis and renal failure
Hypertension can lead to what for the eyes?
Hypertensive retinopathy,
What are retinopathy grades?
Grade I: thicking of arterioles. II: arteriolar spasms. III haemorrages. IV Papilloedema (seen in malignant hypertension)
Define adverse prognosis?
preventing success in outcomes
Factors indicating adverse prognosis in hypertension?
Male, young, black ethnicity, smoker, persistent diastolic BP > 115, diabetes, hypercholesterolemia, obesity, organ damage.
What can diabetic vascular disease cause?
Damage to vessels/ kidneys/ nerves/ retinas
Complications of diabetic vascular disease?
Gangrene, renal failure and blindness
Define gangrene
Localised death of tissue
How can diabetic vascular disease be improved?
effective diabetes control
What is deep vein thrombosis?
When normal venous return is impeded -> thrombosis.
What causes DVT?
immobility, malignancy, pregnancy, child birth, oestrogens, haematological disorders, IV cannulas.
What is varicosities?
Common problem. Torte and distended veins. Ulceration on ankles and lower legs.
What causes varicosities?
incompetent valves in legs, imparied venous return, stasis, oedema, fibrin deposits around veins.
Common congenital CV diseases?
Septal defects, patent ductus arteriosus, corarctation of aorta (narrowed), transposition of vessels, fallot’s tetralogy
