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CVM > Path slide set 3 > Flashcards

Path slide set 3 Flashcards

1
Q

Transient, often recurrent chest pain induced by myocardial ischemia insufficient to induce myocardial infarction

A

Angina pectoris

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2
Q

describe the pulmonary congestion of primary right sided heart failure

A

minimal

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3
Q

Vascular changes of the heart from aging

A
  • coronary atherosclerosis

- stiffening of the aorta

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4
Q

Half of all MI deaths occur within 1 hour of onset and are usually secondary to what?

A

arrhythmia

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5
Q

what are 2 situations that can cause asymptomatic heart attacks?

A
  • diabetics

- heart transplant patients can be denervated

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6
Q

What can cause isolated right sided heart failure?

A

anything that causes pulmonary hypertension

  • parenchymal lung diseases (emphysema)
  • primary pulmonary HTN
  • pulmonary vasoconstriction
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7
Q

-episodic coronary ARTERY SPASM relieved by vasodilaters

A

Prinzmetal variant angina

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8
Q

Where does a ventricular aneurysm most frequently seen

A

apex and pops out during systole

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9
Q

Classic presentation of a myocardial infarction

A
  • PROLONGED CHEST PAIN (>30 min)
  • -crushing, stabbing, squeezing, tightness
  • -radiating down left arm, or to left jaw
  • DIAPHORESIS
  • dyspnea
  • Nausea-vomiting
  • up to 25% are asymptomatic
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10
Q

What will not help in determining if there was an MI after a car wreck?

A

CK-Mb because of muscle damage

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11
Q

Most common arteries that cause ischemia to heart?

A
  • LAD
  • left circumflex
  • right coronary
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12
Q

what are the risk factors for a myocardial rupture

A
  • age
  • large transmural ANTERIOR MI
  • FIRST MI
  • absence of LV hypertrophy
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13
Q

what is a complication of an MI due to the inflammatory process of neutrophils coming in

A

fibrinous pericarditis

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14
Q
  • Pain, increasing in frequency, duration, and severity, eventually at rest
  • usually RUPTURE of a plaque, with a partial thrombus
  • 50% may have evidence of myocardial necrosis
A

Unstable (or “crescendo”) angina

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15
Q
  • STENOTIC OCCLUSON of coronary artery
  • “squeezing” or burning sensation relieved by rest or vasodilators
  • symptoms come on with exercise or effort
A

Stable angina

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16
Q

in the setting of volume overload, describe the hypertrophy

A

myocytes elongate and ventricular dilation is seen

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17
Q

Morphology of MI 3-4 days

A

neutrophils

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18
Q

Morphology of MI 24 hours

A

coagulative necrosis

19
Q

Morphology of MI 2 months

A

dense collagen

20
Q

What is the best measure of hypertrophy?

A

heart weight

21
Q

When does a myocarcial rupture occur

A

2-4 days post MI when inflammation and necrosis have weakened the wall

22
Q

what is the most common cause of right sided heart failure?

A

left sided heart failure

23
Q

Describe the venous system in primary right sided heart failure

A

markedly congested:

  • lever congestion (nutmeg liver)
  • splenic congestion (splenomegaly)
  • effusions of peritoneal, pleural, and pericardial spaces (ascites)
  • renal congestion
  • edema, especially in dependent areas (ankles)
24
Q

left sided heart failure is most commonly a result of what 4 things?

A
  • myocardial ischemia
  • HTN
  • left-sided valve disease
  • primary myocardial disease
25
Q

Concentric hypertrophy causes what dysfunction?

Dilated?

A

diastolic

systolic

26
Q

What morphological feature can be found in dead myocytes that are repurfused and why?

A

necrosis with contraction bands because dead myocytes are able to contract because of influx of calcium from repurfusion

27
Q

a myocardial rupture after an MI typically requires what?

A

transmural infarct

28
Q

What will stain normal cells red because they contain lactate dehydrogenase and will leave lysed or death cells pale or white?

A

triphenyltetrazolium chloride

29
Q

What occlusion more commonly causes an arrythmia after MI

A

RCA

30
Q

Left ventricular dysfunction can lead to left atrial dilation which can then lead to what?

A
  • atrial fibrillation
  • stasis
  • thrombus
31
Q

causes of myocardial infarction

A
  • nearly 90% to atheromatous plaque
  • embolus
  • vasospasm (cocaine)
  • ischemia secondary to vasculitis, shock, hematologic abnormality (sickly cell)
32
Q

left sided heart failure leading to Decreased ejection fraction may result in decreased glomerular perfusion which will cause what?

A
  • stimulation of renin and increased volume

- Prerenal Azotemia

33
Q

how long does it take a zone of necrosis during an MI to become transmural

A

6-24 hours

34
Q

Pressure overload from systemic HTN gives what kind of hypertrophy

A

myocytes become thicker and the left ventricular wall thickness increases concentrically

35
Q

What are the clinical effects of left sided heart failure due to?

A
  • congestion in pulmonary circulation

- decreased tissue perfusion

36
Q

What usually precipitates sudden cardiac death

A

coronary artery disease. could be subclinical

37
Q

morphology of MI 7-10 days

A

macrophages

38
Q

Valve changes with aging

A
  • Aortic and mitral valve annular calcification
  • fibrous thickening
  • mitral valve leaflets buckling towards left atrium-> increased left atrium size
  • LAMBLE EXCRESCENCES
39
Q

Morphology of MI 10-14 days

A

early granulation tissue. some collagen

40
Q

when do troponins peak

A

24 hours

41
Q

myocardium and chamber changes of the heart with aging

A
  • Decreased LV size
  • increased epicardial fat
  • Myocardial lipofuscin and basophilic degeneration
  • fewer myocytes and increased collagen in myocardium
42
Q

best lab test for MI

A

troponins I and T most specific for cardiac myocyte

43
Q

Leading cause of death in U.S.

A

ischemic heart disease

44
Q

what situations cause cardiac myocytes to become hypertrophic?

A
  • sustained pressure or volume overload

- sustained trophic signals (B-adrenergic stimulation)

CVM (6 decks)

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