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1. Cardiovascular > Non Ischaemic Heart Disease > Flashcards

Non Ischaemic Heart Disease Flashcards

1
Q

Define Cardiomyopathy

A

any disease of the cardiac muscle that often results in changes in the size of the heart chambers

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2
Q

What are the three classifications of cardiomyopathy?

A

dilated, hypertrophic, restrictive

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3
Q

What are the characteristics of hypertrophic cardiomyopathy?

A

thickened left ventricle, big solid heart

diastolic dysfunction, heart can contract but cannot relax as well as it should so eventually causes outflow obstruction

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4
Q

What is a cause of sudden death in young athletes?

A

hypertropic cardiomyopathy

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5
Q

What does hypertrophic cardiomyopathy cause?

A

arrhythmias because the hearts normal function is altered

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6
Q

What is the histological appearance of hypertrophic cardiomyopathy?

A

disorganised myofibrils

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7
Q

What are the causes of hypertrophic cardiomyopathy?

A

genetic – myosin binding to protein C, beta myosin heavy chain, alpha tropomyosin

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8
Q

What are the characteristics of dilated cardiomyopathy?

A

weak, floppy and flabby heart

2-3 times normal weight

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9
Q

What are the causes of dilated cardiomyopathy?

A

genetic cause - genes that encode heart muscle proteins alcohol – toxic effect of ethanol on the myocardium, people who have undergone toxic chemotherapy.
Rare causes – cardiac infection and pregnancy

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10
Q

What are the clinical features of dilated cardiomyopathy?

A
  • general picture of heart failure
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11
Q

What are the characteristics of restrictive cardiomyopathy?

A
  • lack of compliance (relaxation of the heart during diastole)
  • rigid, stiff heart so it doesn’t fill with blood well so creates a diastolic dysfunction
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12
Q

What are the causes of restrictive cardiomyopathy?

A
  • deposition of something in the myocardium
  • metabolic byproducts (iron)
  • amyloidosis
  • sarcoidosis
  • tumours
  • fibrosis
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13
Q

What do you see in restrictive cardiomyopathy and why?

A

bilateral dilatation as a result of pressure

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14
Q

What is the histological appearance of restrictive cardiomyopathy?

A

waxy pink material – green apple birefringence, stains positively for congo red
abnormal deposition of an abnormal protein (amyloid)
AMYLOID IS PANSYSTEMIC

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15
Q

What is Arrythmogenic right ventricular dysplasia?

A

abnormality of the right ventricle and atrium due to accumulation of abnormal adipose tissue within the myocardium

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16
Q

What is myocarditis?

A

Inflammation of the heart

17
Q

What is infectious myocarditis due to?

A

viral, bacterial, fungal, protozoal and helminthic
– echo virus and caxackie A and B
MOST COMMONLY INFECTIOUS

18
Q

What is non infectious myocarditis due to?

A

immune mediated hypersensitivity disorders (rheumatic fever)

19
Q

What is Rheumatic fever and what is is histological appearance?

A

mitral stenosis, with thickening and fusion to heart valve leaflets (short thick chordae tendonae).
Histoloicaly – aschoff bodies

20
Q

What is pericarditis?

A

Inflammation of pericardial layers

21
Q

What causes pericarditis?

A 
infection
immune mediated (rheumatic fever)
idiopathic
uraemic (renal failure)
post M.I (dressler’s syndrome)
connective tissue disease
22
Q

What causes infectious endocarditis? And where is it caused?

A

occurs on normal valves but normally abnormal

- requires a very virulent organism, bacterial or fungal – IV drugs abuse and septicaemia

23
Q

What causes infectious pericarditis?

A 
Esp ECHO virus
bacterial (extend from elsewhere – pneumonia, purulent effusions)
fungi (immunosuppressed pts
post transplant
produce purulent effusions
tuberculosis (caseous material in sac)
24
Q

What are the complications of pericarditis?

A 
pericardial effusions
tamponade
constrictive pericarditis
cardiac failure
death
25
Q

What is endocarditis?

A

Inflammation of the inside of the heart (generally refers to inflammation of the valves)

26
Q

What is the pathology of endocarditis?

A

Aggregates of organism on heart valves called vegetations

Appear to erode the heart valve

27
Q

What are the causes of non infectious endocarditis?

A

non bacterial thrombotic endocarditis (don’t destroy the valves they just get smaller, associated with cancer)
Lupus – small sterile emboli, often asymptomatic

28
Q

What are the cardiac complications of endocarditis?

A

acute valvular incompetence

high output cardiac failure

29
Q

What are the characteristics of Carcinoid Heart disease?

A

neoplasms, high amounts of 5HIAA, secreted from the tumour, affects the right side of the heart

30
Q

What is the most common cardiac tumour?

A

atrial myxoma - usually left atrium, will cause an obstruction and may cause endocarditis, systemic fever and malaise

1. Cardiovascular (30 decks)

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