Pathology Flashcards
Pathogenesis of Atheroma stages(4)
Primary Endothelial Injury
Accumulation of lipids and macrophages
Migration of smooth muscle cells
Increase in size
Atheromatous plaque types and indication (4)
Fatty streak
Fibrofatty plaque
Complicated plague with overlying thrombus
Progression is associated with further loss of luminal patency and arterial wall weakness
Atheromatous narrowing of an artery is likely to produce critical disease if (3)
It is the only artery supplying an organ - No collateral circulation
Artery diameter is small
Overall blood flow decreases
Atheroma complications (5)
Stenosis Thrombosis Aneurysm Dissection Embolism
Arterial stenosis (3)
The narrowing of arterial lumen
Decreases elasticity and flow in systole
Causes tissue ischaemia
Clinical effects of cardiac ischaemia (5)
Reduced exercise tolerance => Stable angina => Unstable angina => MI => Cardiac failure
Cardiac fibrosis indication and effects (2)
Loss of cardiac myocytes is replaced by collagen and fibrocytes
Causes contractility loss, decreased elasticity and filling
Main arteries affected by arterial stenosis and consequence (4)
Coronary
Carotid - TIA, stroke
Renal - Hypertension, renal failure
Peripheral - Claudication, leg ischaemia
Aneurysm definition (2)
Abnormal persistent dilation of arteries due to elastic degeneration in tunica media
Most common in abdominal aorta
Aneurysm complications (5)
Rupture (>6 cm) Thrombosis Embolism Pressure erosion to adjacent structures Infection
Arterial dissection (3)
Splitting within media by flowing blood where false lumen forms filled with blood within the media
Common in middle age with/without atheroma
Causes sudden collapse with high mortality
Associations with aortic dissection (6)
Atheroma Hypertension Trauma Coarctation Marfan's syndrome Pregnancy
Embolism (2)
Caused by superadded thrombus and plaque breaking off
Causes cerebral, renal and lower limb infarct
Dilated Cardiomyopathy (4)
Big, flabby and floppy
Histology features not specific
Caused by genes mutations encoding heart muscle proteins, toxins, alcohol, infection, pregnancy
Clinical features - SOB, low ejection fraction, poor exercise tolerance
Hypertrophic Cardiomyopathy (5)
Big solid heart
Diastolic dysfunction - Heart cant relax
Outflow tract obstruction occurs
Causes are genetic - Beta myosin heavy chain, myosin binding protein C
Features are bulging interventricular septum, LV luminal reduction
Restrictive Cardiomyopathy (3)
Cause is lack of compliance - Stiff heart (Poor diastolic function)
Biatrial dilatation from back pressure
Requires biopsy as looks normal - Identifies iron, amyloid, sarcoid, tumours and fibrosis
Amyloid (5)
Abnormal deposition of abnormal protein
Tendency to form beta pleated sheets - Body cant get rid of it
Caused by chronic inflammation responses
Looks like waxy pink material with apple green birefringence or Congo red
Resembles restrictive cardiomyopathy
Arrhythmogenic Right Ventricular Dysplasia (3)
Rarest cardiomyopathy type
Genetic disease causing syncope, arrhythmias and sudden death
RV largely replaced by fat - Big and floppy
Infective Myocarditis characteristics (2)
Thickened ‘beefy’ myocardium
Lymphocytic infiltration from immune response
Non-infective Myocarditis features (3)
Mitral stenosis with thickening and fusion of valve leaflets
Short thick chordae tendinae
Myocardium patchily inflammed
Purulent pericarditis features (4)
Heart encaged in caseous necrosis - TB
Wavy peeling butter effect - Uraemic
Damaged heart muscle and immune response - Post MI
Dressler’s Syndrome
Infectious endocarditis feature
Rheumatic fever - Aschoff bodies (Vegetations)
Non infectious endocarditis (2)
Causes are rheumatic fever, SLE, non-bacterial thrombotic endocarditis
Small, multiple vegetation causing embolic and hypercoaguable states
Heart tumours (2)
Atrial myxoma is most common
Primary tumours very rare - Myocytes end differentiated
Atrial Myxoma (3)
90% in atria and usually left
Causes tumour emboli, endocarditis
Associated with systemic fever and malaise - Due to IL-6 secretion
Lupus in heart diseases (3)
Sacks endocarditis
Forms small sterile emboli on under-surface of valves or chords
Often small asymptomatic deposits or significant valvulitis occurs
