Other disorders Flashcards
Coarctation of aorta
Bicuspid aortic valve
Associated with turner syndrome
Hypertension of upper extremities
Weak, delayed pulse in lower extremities
Brachiofemoral delay
Notched appearance on CXR
HF, ⬆️risk cerebral hemorrhage (berry aneurysm), aortic rupture and possible endocarditis
Essential Hypertension
⬆️CO
⬆️TPR
Renovascular secondary htn
1- fibromuscular dysplasia : String of beads appearance of renal artery
2- atherosclerotic renal artery stenosis
3-hyperaldostronism
Dilated cardiomyopathy
Eccentric hypertrophy
Cause: alcohol,beriberi,cocaine, chagas, coxaci B viral myocarditis, doxorubicin, hemochromatosis, sarcoidosis, thyrotoxicosis, peripartum cardiomyopathy.
Findings: HF, S3, regurgitant murmur systolic, balloon shape on cxr
Tx: Na restriction, ACEI, betablocker, diuretic, digixin, ICD, heart transplant
Tokotsobu cardiomyopathy
Dilated cardiomyopathy
Broken heart syndrome
Ventricular apical ballooning due to increased sympathetic stimulation
Young athlete sudden death
Hypertrophic cardiomyopathy
Hypertrophic obstructive cardiomyopathy (HOCM)
Concentric hypertrophy
Cause sudden death in athletes due to V arrhythmia
Syncope during exercise (asymmetric septal hypertrophy and systolic anterior motion of mitral»outflow obstruction»dyspnea and syncope)
S4
Systolic murmur
MR
Tx: CCB (verapamil), Beta blocker, ICD
Concentric LVH
HTN chronic
Friedreich ataxia
HOCM
Restrictive infiltrative cardiomyopathy
Low coltage ecg
Post radiation fibrosis, hemochromatosis,amyloidosis, sarcoidosis, loffler endocarditis (hyper eosiniofilic syndrome)
Rheumatic fever
Rheumatic heart disease
Pharyngeal infection with group A betahemolytic streptococci
Mitarl>Aortic»tricuspid involvement
Early : MR Late: MS
Aschoff bodies : granuloma with giant cells
Anitschkow cells : enlarge macrophage with ovoid, wavy, rod-like nucleus
⬆️ASO titer
Immune mediated - type II hypersensitivity
Tx : penicillin
JONES CRITERIA
Jones criteria for rheumatic fever
Migratory poly arthritis (Joints) Carditis Subcutaneous nodules in skin Erythema marginatum Syndenham chorea
Pericarditis
Sharp pain Inspiration: ⬆️pain Sitting up and leaning forward: ⬇️pain Complication : pleural effusion Friction rub, Widespread ST elevation PR depression
Tx : NSAIDs, colchicine, glucocorticoids
Causes of pericardity
Confirmed infection (coxsakievirus B) Neoplasia Autoimmune (SLE, RA) Uremia Cardiovasculr ( dressler and STMEI) radiation therapy Idiopathic
Lymphocytic infiltration + focal necrosis
Viral myocarditis Adeno Parco Coxsakie Hiv Hhv
Myocarditis
SCD <40 Dyspnea, chest pain, fever, arrhythmia Persistent tachycardia not proported to fever Cause : viral Parasite (trypanozome, toxo) Bac (m. Pneumoniae, B. Bergdorfi) Toxin (CO, blck widow venom) Rheumatic fever Drugs (cocaine, doxorubicine) Autoimmune (kawasaki, sarcoidosis, SLE, polymyositos
Complications: SCD, arrhythmia herat block, dilated cardiomyopathy, Hf, mural thrombus with systemic emboli