Pathology of Cardiovascular System Flashcards
List the common and important diseases affecting the heart and vascular tree (6)
• Ischaemic heart disease • Hypertensive heart disease • Congenital heart disease • Valvular heart disease • Infective endocarditis • Rhythm disturbances – Based on ECG ➢ Idiopathic long QT syndrome ➢ Coronary Acute Syndrome – ST segment change
What is the disease associated with the symptom - chest pain
Ischaemic heart disease, pericarditis – inflammation of
the pericardium, aortic dissection – tear in aorta,
respiratory, GI, muscular
What is the disease associated with the symptom - Breathlessness – Shortness of breath on exertion,
orthopnoea, paroxysmal nocturnal dyspnoea, wheeze
Heart failure, ischaemia, respiratory
What is the disease associated with the symptom - palpitations
Rhythm disorders, functional problem – hypertrophies,
anaemia – causing ↓ blood O2, hyperthyroidism
What is the disease associated with the symptom - Syncope
Rhythm disorders, valvular disease, vasovagal, postural
hypotension, neurological
What is the disease associated with the symptom - fatigue
Heart failure
What is the disease associated with the symptom - Oedema, organomegaly
Heart failure, valvular disease
What is the disease associated with the symptom - cyanosis
Congenital heart disease, left heart failure
What is in the general examination for CVD (5)
General Face Hands Pulse Precordium Peripheral Vascular status
What are you looking for in the GENERAL examination for CVD
❖ Age & sex, rich/poor ❖ Cared/Uncared for ❖ Obesity/Cachexia ❖ Pallor/Cyanosis/Jaundice sclera ❖ Comfort/Breathlessness
What are you looking for in the FACE examination for CVD
❖ Pale/Plethoric – Red faced
▪ MALAR FLUSH is the redness of cheeks seen in MITRAL STENOSIS – causes CO2 RETENTION & VASODILATION
❖ ARCUS SENILIS
▪ Lipid deposits that occur due to hypercholseterolemia
▪ Pale ring at the periphery of the iris
❖ XANTHALESMA
▪ Yellow plaques at inner part of the eye
▪ Can be an indication of hyperlipidemia, but not always
❖ Mouth breathing
▪ Due to apnoea
What are you looking for in the HAND examination for CVD
❖ Cold/Warm
❖ Finger clubbing
▪ ↑ in soft tissue around the ends of fingers & toes causing nail base to become convex
▪ Occurs in cyanotic CHD, right to left shunts, bacterial endocarditis
❖ Palmar creases
▪ Pale indicate anaemia
❖ Splinter haemorrhages
▪ Indication of thromboembolic phenomenon, trauma, bacterial endocarditis
❖ Tobacco staining
▪ Indicates high risk of atherosclerosis
What are you looking for in the PULSE examination for CVD
❖ ARTERIAL pulse obtained at right radial artery
❖ Rate
▪ Beats/minute (BPM) – should be an EVEN number
❖ Rhythm
▪ Regular or irregular? Regularly irregular?
► Seen in sinus arrhythmia, second degree heart block
o Irregularly irregular
► Seen in atrial fibrillation
What are the investigations used for CVD (6)
• Blood pressure
➢ Measure SYSTEMIC BP & JUGULAR VENOUS PRESSURE
➢ ↑ JVP indicates RIGHT HEART FAILURE
• Auscultation
➢ Listen to RATE and any NEW/CHANGING MURMURS
• Chest X-ray
➢ Identify SIZE of heart and CALCIFICATION (normally on valves)
• Fluoroscopy
➢ Identify ARTERIES (stenosis) & PATENCY
• ECG
• Echocardiography
➢ Observe blood FLOW & DYNAMICS
What are the macroscopic changes in ischemic heart disease?
➢ Infarcted area becomes PALE
➢ 12 months post MI (assuming survival):
▪ Infarcted area replaced with fibrous tissue is thinner as does NOT CONTRACT – not bulky
▪ DILATION of ventricle due to inefficient pumping
