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Non-ischaemic Heart Disease Flashcards

1
Q

Name four non ischaemic heart diseases

A
  • cardiomyopathy
  • myocarditis
  • pericarditis
  • endocarditis
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2
Q

What is cardiomyopathy?

A

Any disease of the cardiac muscle often resulting in changes to the size and thickness of heart chambers

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3
Q

How can cardiomyopathy be classified?

A
  • Dilated
  • Hypertrophic
  • Restrictive
  • Arrhythmogenic right ventricular dysplasia
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4
Q

What is dilated cardiomyopathy?

A

Heart is 2/3 times bigger than normal and is floppy

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5
Q

State four causes of dilated cardiomyopathy

A
  • genetics
  • toxins
  • cardiac infection
  • pregnancy
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6
Q

What are the clinical features of cardiomyopathy?

A

Heart failure (SOB, poor exercise tolerance & low ejection fraction)

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7
Q

Describe the characteristics of hypertrophic cardiomyopathy

A

Big, solid heart. Strong contraction but cannot relax, eventually causes outflow obstruction usually in young people

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8
Q

What are the causes of hypertrophic cardiomyopathy?

A

Genetics (mutations in beta myosin heavy chain, myosin binding protein C & alpha tropomyosin)

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9
Q

Describe restrictive cardiomyopathy

A

stiff heart causes lack of compliance & diastolic dysfunction but the heart may appear normal

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10
Q

State six causes of restrictive cardiomyopathy

A
  • deposition of something in the myocardium
  • metabolic byproducts
  • amyloid
  • sarcoid
  • tumours
  • fibrosis
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11
Q

Define amyloid

A

abnormal deposition of an abnormal protein, tends to form beta pleated sheets that the body cannot get rid of

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12
Q

Name some diseases associated with amyloid

A
  • diabetes

- alzehiemers

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13
Q

What is the cause of ARVD?

A

It is a genetic disease

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14
Q

What is the consequence of ARVD?

A

Syncope & funny turns leading to arrhythmia & occasionally sudden death

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15
Q

What happens to the right ventricle in ARVD?

A

It gets replaced by fat

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16
Q

What does ARVD stand for?

A

Arrhythmogenic Right Ventricular Dysplasia

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17
Q

Define myocarditis

A

Inflammation of the heart

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18
Q

What are the two types of myocarditis?

A
  • infectious

- non-infectious

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19
Q

What causes most infectious carditis? Give examples

A

Viruses

  • ECHO virus
  • Lyme’s disease
  • Chaga’s disease
  • HIV
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20
Q

Myocarditis results in a thickened myocardium true or false?

A

True

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21
Q

What is non-infectious myocarditis due to?

A
  • immune mediated hypersensitivity reactions

- drugs

22
Q

Give an example of an immune mediated hypersensitivity reaction that causes myocarditis

A

Rheumatic fever after strep throat

23
Q

What type of myocarditis do drugs cause?

A

Eosinophilic

24
Q

Describe the signs of myocarditis as a result of rheumatic fever

A

classic mitral stenosis with thickening & fusion of leaflet valves. Short, thick chordea tendinae

25
Name six causes of pericarditis
- infection - immune mediated - idiopathic - uraemic - post MI - connective tissue disease
26
Give an example of a connective tissue disease
Lupus
27
What viruses cause infective pericarditis?
ECHO
28
How does bacteria cause infectious pericarditis?
As an extension from elsewhere e.g. pneumonia
29
Who is usually infected by fungi causing pericarditis?
Immunosuppressed & Post transplant
30
How does tuberculous cause pericarditis?
Caseous material in the sac produces constrictive percaridits
31
How can pericarditis occur post MI?
damaged heart muscle releases previously un-encountered material that stimulates an immune response
32
Usually the inflammation occurs a few days post MI what is the exception to this?
Dresslers Syndrome
33
Name five complications of post MI pericarditis
- pericardial effusion - tamponade - constrictive pericarditis - cardiac failure - death
34
How does endocarditis affect the heart?
It affects the heart lining but it is mainly inflammation of the valves
35
Describe infectious endocarditis
usually requires a very virulent organism it can occur on normal valves & can be bacterial or fungal caused by `iv drug absue of septicaemia
36
Who is predisposed to endocarditis?
patients with - rheumatic heart disease - prosthetic valves - congenital defects - MV prolapse - calcific disease
37
Name five organisms that cause endocarditis
1. Haemophilus 2. Actinobacillus 3. Cardiobacteria 4. Eikenella 5. Kingella.
38
What organisms cause endocarditis in IV drug users?
- Candida | - Staph aureus
39
What organisms cause endocarditis in patients with prosthetic valves?
S. epidermidis
40
Describe the. pathology of infectious endocarditis
Vegetations, bacteria excites acute inflammation cell products digest the valve leaflets
41
What is vegetation?
Aggregates of organisms on heart valves
42
What are the complications of infectious endocarditis? (will never remember them all)
- Acute valvular incompetence - High output cardiac failure - Abscess, fistula, pericarditis - osters nodes - janeway lesions - roth spots - splinter haemorrhages - septicaemia - septic emboli - mycotic aneurysms
43
Name four causes of non-infectious endocarditis
- rheumatic fever - SLE - Non-bacterial thrombotic endocarditis - Carcinoid heart disease
44
Describe non-bacterial thrombotic endocarditis
small, multipl vegetations that are non-invasice & can cause embolic disease
45
What is non-bacterial thrombotic endocarditis associated with?
- cancer | - hypercoaguable states
46
What do excess hormones produced by tumours cause?
flushing of skin, D&V, nausea and ultimately right sided cardiac valve disease
47
Are primary tumours of the heart common?
no - they are very rare
48
What is the commonest tumour of the heart?
atrial myxoma
49
Describe atrial myxoma
90% in atria & usually the left, may cause ball/valve obstruction, tumour, emboli or endocarditis
50
What are atrial myxomas assoicated with?
- systemic fever | - malaise

Cardiovascular (19 decks)

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