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DEN303 - IHD > Pathology Ischaemic Heart Disease and Hypertension > Flashcards

Pathology Ischaemic Heart Disease and Hypertension Flashcards

1
Q

Virchow’s triad

A

Change in vessel wall structure
Change in blood flow
Change in blood constituents

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2
Q

Laminar flow maintains

A

healthy movement of blood through vessels

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3
Q

Collagen formation on endothelia occurs after
Allows
This leads to
Fibrinogen is

A

Damage by cholesterol
Platelet attachment
Further platelet aggregation and release of clotting factors
Polymerised into fibrin –> blood clot –> thrombus formation

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4
Q

Causes of ischaemic heart disease

A

Lack of blood supply
Atherosclerosis
Myocardial hypertrophy
Small vessel disease

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5
Q

Ischaemic heart disease

A

Disease involving narrowing of vessels supplying blood to heart muscle due to accumulation of fatty plaque

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6
Q

Risk factors of atherosclerosis and explain

A 
High salt+fat diet
Sedentary lifestyle
Smoking
High BP - shearing of endothelial cells
Poorly controlled diabetes 
Hyperlipidaemia - abnormally high concentration of fats or lipids in blood 
High blood sugar and lipids 
Continuing damage to endothelium
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7
Q

Characteristics of atherosclerosis

A

Bleeding within plaque build up due to collapse of new fragile vessels
Slow
Consistent damage over time
Death of heart muscle results

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8
Q

Myocardial hypertrophy

Affects

A

Left ventricle

LV has to work harder to pump blood due to increased thickness of heart muscle

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9
Q

Small vessel disease
Occurs at
Involves

A

Arteriolar level
Inappropriate vasoconstriction
Reduced production of nitric oxide and increased destruction of nitric oxide

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10
Q

Types of IHD

A

Regional transmural MI
Subendocardial MI
Chronic ischaemia

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11
Q

Regional transmural MI

A

Supply to certain region cut off due to blockage of after
Acute occluding event in one of 3 CAs
Lack of collateral circulation from other vessels

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12
Q

Subendocardial MI

A

Supply cut off inside of cardiac structure e.g LV
Severe coronary artery atherosclerosis in all 3 main CAs
Sudden reduction in blood flow e.g hypotension during surgery

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13
Q

Chronic ischaemia

A 
Fixed atherosclerotic lesions
Angina
Myocardial fibrosis
Hibernating myocardium
Stunned myocardium
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14
Q

Complications of MI

A 
Sudden death
Arrhythmias 
Cardiac failure
Mitral incompetence 
Pericarditis
Cardiac rupture
Mural thrombosis
Ventricular aneurysm 
Pulmonary emboli
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15
Q

Sudden death explanation

A

Inadequate blood flow

Arrhythmias e.g ventricular fibrillation

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16
Q

Cardiac failure explanation

A

Arrhythmia

Loss of myocardium - reduced pump fx

17
Q

Mitral incompetence cause

A

Rupture/necrosis of papillary muscles

Pan systolic murmur

18
Q

Cardiac rupture explanation

Occurs when

A

Weakening of wall due to muscle necrosis and acute inflammation
3-7 days after infarction
Rupture in pericardial sac
Rupture of inter ventricular septum

19
Q

Mural thrombosis
When does it occur
What does it lead to

A

Thrombosis on normal endothelial surface post infraction
7-14 days after infarction
embolisation to any arterial site

20
Q

Ventricular aneurysm
When does it occur
Associated with?
May contain?

A

Stretching of newly formed collagenous scar tissue
4 weeks post infarction
Cardiac failure
Thrombus

21
Q

Hypertension
At 20 y/o
At 50 y/o

A

Abnormally high BP
>140 mmHg systolic and <90 diastolic
>159 mmHg systolic and <95 diastolic

22
Q

Clinical importance of hypertension

A

Most common cause of heart failure
Major risk factor for atherosclerosis
Major risk factor for cerebral haemorrhage

23
Q

Classification of hypertension and define

A

Primary - no definitely identified cause

Secondary - identifiable cause

24
Q

3 factors involved in primary hypertension

A

Adrenaline
Sodium control
Renin angiotensin aldosterone - RAAS

25
Q

Causes of secondary hypertension

A

Renal
Endocrine
Coarctation of aorta
Drug therapy

26
Q

Coarctation of aorta

A

Narrowing of aorta

27
Q

Causes of secondary hypertension - renal

A

Salt and water overload

Renin dependent

28
Q

Causes of secondary hypertension - endocrine

A

Cushing’s, Conn’s, phaeochromocytoma (rare tumour of adrenal glands)

29
Q

Phaeochromocytoma

A

Tumour on adrenal glands

Overproduction of catecholamines –> sweating, racing heart, hypertension

30
Q

Causes of secondary hypertension - drug therapy

A

NSAIDs, corticosteroids

31
Q

Clinicopathological classifications - two

A

Benign

Malignant

32
Q

Clinicopathological classifications - benign

A

Long asymptomatic period

Increased frequency of complications later on

33
Q

Clinicopathological classifications - malignant

A

Significantly raised diastolic BP
Symptomatic
Rapidly fatal if untreated

34
Q

Effects of hypertension - vessel

A

Microaneurysms and haemorrhages
Accelerated atherosclerosis
Athersclerosis of other smaller vessels

35
Q

Effects of hypertension - organ

A

Heart failure
Kidney failure
Cerebral haemorrhages aka strokes

DEN303 - IHD (58 decks)

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