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Cardiovascular > Non-ischaemic Heart Disease > Flashcards

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
Q

Name six causes of pericarditis

A
  • infection
  • immune mediated
  • idiopathic
  • uraemic
  • post MI
  • connective tissue disease
26
Q

Give an example of a connective tissue disease

A

Lupus

27
Q

What viruses cause infective pericarditis?

A

ECHO

28
Q

How does bacteria cause infectious pericarditis?

A

As an extension from elsewhere e.g. pneumonia

29
Q

Who is usually infected by fungi causing pericarditis?

A

Immunosuppressed & Post transplant

30
Q

How does tuberculous cause pericarditis?

A

Caseous material in the sac produces constrictive percaridits

31
Q

How can pericarditis occur post MI?

A

damaged heart muscle releases previously un-encountered material that stimulates an immune response

32
Q

Usually the inflammation occurs a few days post MI what is the exception to this?

A

Dresslers Syndrome

33
Q

Name five complications of post MI pericarditis

A
  • pericardial effusion
  • tamponade
  • constrictive pericarditis
  • cardiac failure
  • death
34
Q

How does endocarditis affect the heart?

A

It affects the heart lining but it is mainly inflammation of the valves

35
Q

Describe infectious endocarditis

A

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
Q

Who is predisposed to endocarditis?

A

patients with

  • rheumatic heart disease
  • prosthetic valves
  • congenital defects
  • MV prolapse
  • calcific disease
37
Q

Name five organisms that cause endocarditis

A
  1. Haemophilus
  2. Actinobacillus
  3. Cardiobacteria
  4. Eikenella
  5. Kingella.
38
Q

What organisms cause endocarditis in IV drug users?

A
  • Candida

- Staph aureus

39
Q

What organisms cause endocarditis in patients with prosthetic valves?

A

S. epidermidis

40
Q

Describe the. pathology of infectious endocarditis

A

Vegetations, bacteria excites acute inflammation cell products digest the valve leaflets

41
Q

What is vegetation?

A

Aggregates of organisms on heart valves

42
Q

What are the complications of infectious endocarditis? (will never remember them all)

A
  • Acute valvular incompetence
  • High output cardiac failure
  • Abscess, fistula, pericarditis
  • osters nodes
  • janeway lesions
  • roth spots
  • splinter haemorrhages
  • septicaemia
  • septic emboli
  • mycotic aneurysms
43
Q

Name four causes of non-infectious endocarditis

A
  • rheumatic fever
  • SLE
  • Non-bacterial thrombotic endocarditis
  • Carcinoid heart disease
44
Q

Describe non-bacterial thrombotic endocarditis

A

small, multipl vegetations that are non-invasice & can cause embolic disease

45
Q

What is non-bacterial thrombotic endocarditis associated with?

A
  • cancer

- hypercoaguable states

46
Q

What do excess hormones produced by tumours cause?

A

flushing of skin, D&V, nausea and ultimately right sided cardiac valve disease

47
Q

Are primary tumours of the heart common?

A

no - they are very rare

48
Q

What is the commonest tumour of the heart?

A

atrial myxoma

49
Q

Describe atrial myxoma

A

90% in atria & usually the left, may cause ball/valve obstruction, tumour, emboli or endocarditis

50
Q

What are atrial myxomas assoicated with?

A
  • systemic fever

- malaise

Cardiovascular (19 decks)

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