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Cardiovascular (Annie) > Non-ischaemic Heart disease > Flashcards

Non-ischaemic Heart disease Flashcards

1
Q

what is cardiomyopathy?

A

any disease of the cardiac muscle

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2
Q

what does cardiomyopathy odten result in?

A

changes in SIZE of heart chambers and THICKNESS of heart

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3
Q

what are the 3 types of cardiomyopathy?

A

1) dilated
2) hypertrophic
3) restrictive

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4
Q

what is dilate cardiomyopathy?

A

= heart is expanded and therefore cannot pump blood effectively as it becomes weaker

  • big heart = 2 or 3 times normal
  • heart is flabby & floppy
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5
Q

what are the causes of dilated cardiomyopathy?

A

1) genetics
2) toxins
3) alcohol
4) chemotherapy agents
e. g. doxorubicin

Rarer;

5) cardiac infection
6) pregnancy

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6
Q

what are 4 features of dilated cardiomyopathy?

A

1) general picture of heart failure
2) shortness of breath
3) poor exercise tolerance
4) low ejection fraction ( low CO)

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7
Q

what is hypertrophic cardiomyopathy?

A

= big solid hearts.
= portion of the heart becomes thickened
= hypertrophic and strong contractions (doesn’t dilate, it gets bigger - very thick left ventricle)

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8
Q

what can hypertrophic cardiomyopathy result in?

A

diastolic dysfunction
= as the heart cannot relax
= eventually causing outflow obstruction
= sudden death in athletes

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9
Q

Yes or No.

In hypertrophic cardiomyopathy, is systolic contraction affected?

A

no - systolic contraction is fine, it is only diastolic dysfunction

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10
Q

what causes hypertrophic myopathy?

A
  • majority is genetic
    e.g. genes that create actin and myosin
    = beta myosin heavy chain
    = myosin binding protein C
    = alpha tropomyosin
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11
Q

what are 3 features of hypertrophic cardiomyopathy?

A

1) building inter ventricular septum
2) LV luminal reduction
3) outflow tract obstruction

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12
Q

in hypertrophic cardiomyopahty, what would you see on a microscope of the myofibrils?

A

disorganised myo-fibres

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13
Q

what does restrictive cardiomyopathy cause?

A
  • a LACK OF COMPLIANCE causes a STIFF HEART so the heart doesn’t relax during systole
  • therefore, heart doesn’t fit well so diastolic dysfunction
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14
Q

Yes or No.

Can the heart appear normal in restrictive cardiomyopathy?

A

yes.

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15
Q

what causes restrictive cardiomyopathy?

A 
= deposition of something in myocardium
Examples; 
- metabolic byproducts, iron.
- amyloid. 
- sarcoid = multi system granulomatous disorder. 
- tumours.
- fibrosis
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16
Q

what is amyloidosis?

A

abnormal deposition of an abnormal protein

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17
Q

in amyloid, what is the tendency of the abnormal depositions to form?

A

tendency to form beta pleated sheets

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18
Q

what are the 6 classifications of amyloid?

A

1) AA
- relates to chronic diseases e.g. rheumatoid

2) AL
- light chains, abnormal immunoglobulin

3) haemo-dialysis associated beta 2 micro globulin
4) familial forms
5) diabetes
6) Alzheimer’s

19
Q

under a microscope, what would an amyloid look like?

A
  • waxy pink material
  • stains positively for Congo red
  • exhibits apple green birefringence
20
Q

what does amyloid resemble?

A

restrictive cardiomyopathy

21
Q

what is arrhythmogenic right ventricular dysplasia?

A

= genetic disease

- when fat replaces the right ventricle - prone to arrhythmias and therefore sudden death.

22
Q

what is myocarditis?

A

inflammation of heart that can be infectious or non-infectious

23
Q

what is infectious myocarditis most commonly caused by?

A
  • viruses
    e
    = coxsackie A&B
    = ECHO virus
  • bacterial
  • fungal
  • protozoal
  • helminntthic
24
Q

in infectious myocarditis, what happens to the myocardium?

A

it is thickened

25
Q

what is non-infectious myocarditis caused by?

A

= immune mediated hypersensitivity reactions

e. g. hypersensitivity to infection, rheumatoid fever after strep sore throat
e. g. hypersensitivity to drugs, eosinophils myocarditis
e. g. systemic lupus erythematosus (SLE)

26
Q

what is rheumatoid fever classically indicated by?

A
  • mitral stenos with thickening and fusion of valve leaflets
  • short thick chordae tensile
  • myocardium is patchily inflamed
27
Q

what is pericarditis?

A

= inflammation of pericardial layers

28
Q

what causes pericarditis?

What does tuberculous pericarditis produce?

A
  • infection
  • immune mediated (rheumatoid fever)
  • idiopathic
  • uraemia (renal failure)
  • post MI
  • connective tissue disease

= produces constrictive pericarditis

29
Q

what are 5 possible complications of pericarditis?

A

1) pericardial effusion
2) tamponade
3) constrictive pericarditis
4) cardiac failure
5) death

30
Q

what is endocarditis?

A

= affects heart lining but refers to INFLAMMATION OF VALVES

31
Q

who is at risk of getting infectious endocarditis?

A
  • IV drug abusers

- individuals with septicaemia

32
Q

what 5 organisms can be the cause of endocarditis?
and

what 2 organisms can be the cause of endocarditis in IV drugs users?

A

HACEK

  • haemophilia
  • actinobacillus
  • cardiobacteria
  • eikenella
  • kingella

IV drug users;

  • candida
  • staph aureus
33
Q

what are 5 cardiac complications?

A

1) acute valvular incompetence
2) high output cardiac failure
3) abscess
4) fistula
5) pericarditis

34
Q

what is non-bacterial thrombotic endocarditis?

A
  • non- invasive
  • doesn’t destroy valves
  • Can cause embolic disease
  • Assoc with cancer
  • associated with mucinous adenocarinomas
35
Q

what is lupus?

A

= long-term autoimmune disease in which the body’s immune system becomes hyperactive and attacks normal, healthy tissue.

36
Q

what is carcinomas heart disease?

A

= carcinoid tumours, neoplasms of neuroendocrine cells found in any mucosa

37
Q

when does carcinoid syndrome occurs?

A

occurs when tumour has spread to liver, metastases

38
Q

what does carcinoid heart disease & carcinoid syndrome produce as a result of the tumour?

what are the symptoms of carcinoid heart disease & carcinoid syndrome?

A
  • 5HIAA
  • serotonin
  • histamine
  • bradykinin
  • flushing of skin
  • nausea
  • vomiting
  • diarrhoea
  • systemic fever
  • malaise
39
Q

what does carcinoid heart disease produce?

A

= right sided cardiac valve disease affecting tricuspid and pulmonary valves.

40
Q

are primary tumour in heart common?

A

NO - very rare

41
Q

what type of differentiation are cardiac muscle cells?

A

end differentiated

42
Q

what is atrial myxoma?

A

cancer in the atria

43
Q

what can atrial myxoma cause?

A

= ball/valve obstruction
= tumour emboli
= develop endocarditis

Cardiovascular (Annie) (36 decks)

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