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Clin Med - Cardio I > Patho - cardiovascular dz > Flashcards

Patho - cardiovascular dz Flashcards

1
Q

etiology of valvular heart dz

A
  1. acute vs chronic
  2. acquired vs congenital
  3. susceptibility to infective endocardiits
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2
Q

what valvular heart dz represents 2/3 of all valve dz

A

acquired stenosis of aortic or mitral valve

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3
Q

pathogenesis of rheumatic heart dz

A

M protein on GABS looks like proteins on heart valve
-triggers immune to attack the heart

= valvular heart dz

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4
Q

Acute Rheumatic fever jones criteria

A

PECCS

  1. Migratory Polyarthritis
  2. Erythema marginatum
  3. Acute carditis
  4. chorea
  5. subcutaneous nodules (used to be sedrate)
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5
Q

acute valvular dz vs chronic valvular dz

A
  1. acute - swollen, red, multisystem (rashes, joint pain, minimal lung involvement), M>F, aortic and mitral valve involvement, rarely just aortic involvement
  2. chronic - leaflets get fused together, also the chordae tendinae thicken, mitral valve especially, F>M
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6
Q

what is the most common cause of aortic stenosis

A

calcific aortic stenosis

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7
Q

acquired vs congenital calcific aortic stenosis

A
  1. acquired - develops in normal valve = later in life, leaflets stiff, but remains unfused, angina pectoris,syncope
  2. congenital - bicuspid instead of tricuspid, occrs earlier in life (40s-50s) more susceptible to calcification

tx - valve replacement - w/o tx mortality w/i 2 years

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8
Q

what is myxomatous degeneration of the mitral valve

A

aka mitral valve prolapse

  • MC cause of mitral valve regurg
  • usually involves posterior leaflet
  • peak age 20-40
  • W>M
  • associated with Marfan’s syndrome
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9
Q

what is infective endocarditis

A

vegetation/infective lesion on valve

  • usually bacterial
  • acute rapid developing high virulence (staph) doesn’t matter if valves are normal or abnormal
  • subacute/lower virulence = hemolytic strep = usually abnormal valves; occurs after dental/resp/acne disruption
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10
Q

what is the cause of R endocarditis

A

IV drug abuse until proven different

-goes into veins and first part of heart it reaches is the right side

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11
Q

2 broad classifications of valve replacement

A
  1. mechanical - no tissue componenet, clots occur more

2. bioprosthetic - human/pig tissue, clots can occur but not as much

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12
Q

what is the most common cause of myocarditis

A

viral

  • sudden unexpected death
  • coxsackie A&B
  • will induce direct myocardial injury
  • immune mediated damage adds to heart injury
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13
Q

how often is bacterial myocarditis seen

A

not much

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14
Q

3 types of myocarditis

A
  1. viral
  2. eosinophilic
  3. bacterial
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15
Q

3 types of cardiomyopathies

A
  1. dilated
  2. hypertrophic
  3. restrictive
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16
Q

cardiomyopathies can lead to

A

heart failure or arrthymias that lead to sudden death

17
Q

what can cause cardiomyopathies

A
  • alcohol abuse
  • occupational exposure
  • 3rd trimester/postpartum dilated cardiomyopathy
18
Q

an EF of what will need a heart transplant

A

25% or less

19
Q

dilated cardiomyopathies

A
  • usually idiopathic

- could be genetic link

20
Q

hypertrophic cardiomyopathy

A
  • IHSS - septum is assymetrically involved in hypertrophy
  • autosomal dominant - variable penetrance = everyone that has it wont be affected the same = 50% chance of having normal heart even with bad gene
  • point mutation - should code for sarcomeres of heart muscles = uncontrolled hypertrophy = insufficiency
21
Q

why can’t the ventricle pump efficiently in hypertrophy vs dilated ventricle

A

hypertrophy - can’t fill adequately

dilated - can’t contract (flabby)

22
Q

restrictive cardiomyopathy

A

doesnt change morphology of heart but something resists contactility of heart

  • genetic
  • endomyocardial fibroelastosis = poor contractions
  • electrical conduction interrrupted
23
Q

three types of congenital heart dz

A
  1. left to right shunt = acyanotic at presentation
  2. right to left shunt = cyanotic at or near time of birth (pulm HTN); blood not getting oxygenated and then pumped to body
  3. coarctation of aorta = pre-ductal, post-ductal
24
Q

what is the most common pediatric condition

A

congenital heart dz

-ranges in severity

25
Q

which type of congenital heart dz is most common

A

left to right shunt - abnormal connection bw LA and RA may have to be patched

26
Q

right to left shunt

A
  • blue baby
  • needs surgical repair
  • at risk for infective endocarditis
  • kids squat to increase venous return (instinct)
27
Q

what is tetrology of flow

A

5% of all congenital heart dz

-MC of all blue baby issues

28
Q

4 abnormalities of tetrology of flow

A
  1. VSD
  2. ventricular outflow obstruction on right
  3. move to right aortic arch
  4. RV hypertrophy
29
Q

what is transposition of the great vessels

A

backwards connection of great vessels

can be surgical repair

30
Q

what is coarctation of the aorta

A

narrowing of aorta

  • newborns: may be preductal
  • later in life: postductal
  • weaker femoral pulse
  • bounding axillary pulse
31
Q

what is included in pericardial dz

A
  1. pericarditis

2. pericardial effusion - serous, sero-sanguinous, hemopericardium

32
Q

what is a hemopericardium

A

blood in the pericardium

-ex. ruptured MI

33
Q

types of cardiac tumors

A
  1. metastatic = liposarcomas
  2. primary =
    - atrial myxoma (not seen alot)
    - rhabdomyoma - associated with tuberous sclerosis; spider cells
34
Q

valvular heart dz can be caused by what

A

stenosis
regurg
or both

Clin Med - Cardio I (7 decks)

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