✅Patho-Heart Flashcards
Natriuretic peptide in the ventricles
Type B and C
Sound that corresponds to the closure of the semilunar valves
S2
S3 is due to
Sudden rush of blood in overloaded ventricles
s3 is physiologic in
Children and young adults
S3 is pathologic for people
40 and above
S4 is due to
Noncompliant ventricles
Heart sounds that is always pathologic
S4
Earliest symptom in left sided heart failure
Dyspnea
Perihilar congestion in Left sided HF
Bat wing configuration
Prominent heart sound in left sided heart failure
Prominent left sided S3
Nutmeg liver is found in
R sided HF
Causes of high output failure
Beriberi
Anemia
Hyperthyroidism
AV Fistula
Most important in determining the severity of TOF
Pulmonic stenosis
Percent of all childbirths with Congenital heart disease
1%
Most common genetic risk for CHD
Down syndrome
Most common cyanotic CHD
TOF
2 forms of TOF
As determined by the degree of subpulmonic stenosis
Mild form - Pink TOF
Sever form - Classic TOF
TGA is associated with offsprings of
Diabetic mothers
Cyanotic heart disease with VSD as primary shunts
Truncus 1
Tetralogy 4
TGA but only 35 percent
ASD/PFO/ PDA shunt in cyanotic heart diseases
TGA but have vsd in 35 %
Tricuspid atresia 3
TAPVR 5
Most common variant of TAPVR
Supracardiac variant that drains to brachiocephalic vein
ASD associated with downs
Primum
3 types of ASD
Secundum 90%
Primum 5%
Sinus venosus 5%
Most common adult CHD
ASD
Most common CHD
VSD
Multiple VSDs maye be seen in the _______ and is called
Muscular septum
Swiss cheese septum
Types of VSD
Which one is most common?
Membranous 90%
Infundibular
Ventricular septum
Percentage of VSDs that will close spontaneously
50
Surgicl correction of VSD should be done at
1 year of age
2 forms of AVSD
Partial
Complete
2 types of coarctation of the aorta
Infantile
Adult
Turner’s syndrome is associated with which CHD
Infantile coarctation of the aorta
CHD in congenital rubella syndrome
PDA
Cardiac defects in marfan
MVP
Aortic dissection
Prinzmetal angina is caused by
Vasoconstriction due to TXA2 or increased endothelin
Other name for unstable angina
CRESCENDO angina
Primary pharmacologic drug for prinzmetal angina
CCB
Sudden cardiac death is defined as
Death within 1 hr of cardiac symptoms
Sudden cardiac death is due to
Arrythmia
Sudden cardiac death usually occurs at what time of the day
Early morning (highest level of stress hormones)
Inherited long QT syndrome that can cause sudden cardiac death
Romano ward syndrome
What medications are contraindicated in
Inferior wall MI
Pain med usually given in MI
Morphine
Types of MI
Q wave infarction/ST elevation
Non Q wave infarction/ ST depression
Heart layers involved in ST elevation MI
Transmural
Heart layers involved in st depression MI
Subendocardial/partial thickness
MI affects which top 3 blood vessels
LAD
RCA
LCX
Gross changes in MI
Mottling 4 hrs
Bright yellow 1 week
Surrounding red granulation tissue 2 weeks
Gray white scar 2 months
Coagulation necrosis in MI happen in how many hrs?
4-12 hrs
Changes during coag necrosis in MI
Wavy fibers
Myctolysis
Gross changes in MI can be seen after
12 hrs
Acute inflammation (neutrophils is most prominent at
Day 1-day 3
Macrophage invasion and the day where the heart is softest is on
Day 3
Granulation tissue in MI can be seen in
1-2 weeks
What time frame are the ff events in MI reperfusion seen?
Completely salvageable
Partially salvageable
No reduction in MI size
Before 20 mins
3-6 hrs after
More than 6 hrs
Myocardial rupture in MI usually happens to those with
Virgin MI
What drugs are given in MI to affect ventricular remodeling?
Ace inhibitors
Secondary form of pericarditis that occurs after MI
Dressler syndrome
Triad of dressler’s syndrome
Fever
Pleuritic pain
Pericarditis/pericardial effusion
Cardiac enzyme that can diagnose reinfarction
CKMB
Weight of the heart
300-350g (50g less in females)
Failure to open completely and prevents forward flow
Stenosis
Failure to close completely and allows reversed flow
Regurgitation
Opening snap, RHD, diastolic rumble, AF, accentuated S2, diastolic rumble
Mitral stenosis
Murmur associated with pulmonary regurgitation? Aortic regurgitation?
Graham steel murmur
Austin flint murmur
Pulsating nail bed with elevation of the nail
Quincke’s pulse
Systolic pulsation of the uvula
Mueller’s sign
Femoral retrograde bruits
Durosier’s sign
Pistol shot femorals
Traube’s sign
BP LE> BP UE
Hill’s sign
Onset of symptoms in RF after infection
2-3 weeks
Major manifestations in Jones criteria
Migratory polyarthritis Carditis Subcutaneous nodules Erythema marginatum Sydenham chorea
Minor manifestations in RF
Fever, arthralgia, elevated acute phase reactants
What valvular disease is seen in RF as compared to RHD?
Rf mitral regurgitation
Rhd mitral stenosis
Dx of RF based on criteria
2 major
1 major 2 minor
Morphology of RF and RHD
Aschoff bodies found in ALL layers
Anitschow cells
What are anitschow cells
Macrophages or histiocytes containing abundant cytoplasm, round nuclei with slender, wavy ribbons of chromatin found in RHD
Irregular thickenings of the endocardium in RHD
Maccallum plaques
Usual bacteria in IE
S viridans
Etiology of IE in IV drug users
S aureus
Etiology of IE in people with prosthetic cardiac valves
S epidermidis
Etiology of IE in people with GI or GU surgery
S bovis
Most common sx in IE
Fever
Most common lab finding in IE
Anemia
Other name for nonbacterial theombotic endocarditis
Marantic endocarditis
Septic emboli that lodged in extremities in IE. Painless
Janeway lesions
Findings in IE
Bacteria FROM JANE
Fever Roth spots Osler nodes Murmur Janeway lesions Anemia Nail bed hemorrhage Emboli
vegetation assoc with SLE
Libman sacks disease
Vegetation in libman sacks may contain
Hematoxylin bodies
Small warty vegetations along the lines of closure of valve leaflets usually assoc with
Rhd
Large irregular masses on valve cusps that can extend to the chordaw is found in
IE
Cardiomyopathy is diagnosed using a
Bioptome
Causes of dilated cardiomyopathy
Abcccd
Alcohol Beriberi Chagas Coxsackie B Cocoaine Doxorubicin
Most common infectious cause of myocarditis
Coxsackie B
Transient apical ballooning usually stress induced also known as gebrochenes herz syndrome
Takotsubo cardiomyopathy
Microbes involved in myocarditis
Coxsackieviruses
T. Cruzi
Borrelia burgderfori
Define electrical alternans
QRS complexes alternate in amplitude
Most common finding in cardiac tamponade
Pulsus paradoxus - drop in BP of 15mmHG with inhalation
What are the ecg changes seen in pericarditis
Diffuse ST elevation of all leads except AVR AVF V1
PR depression
A type of chronic pericarditis that follows suppurative or caseous pericarditis, previous cardiac surgery or irradiation to the mediastinum.
Adhsive mediastinopericarditis
Most common heart tumor
Metastasis
Most common primary heart tumor in children
Rhabdomyosarcoma
Most common site of metastasis in the heart
Pericardium
