Pericardium and Congenital Diseases

Question 1

Give cause of hemopericardium and Pus in pericardial space

Answer 1

Myocardial Infract

Pericarditis

Question 2

Whats so bad about Cardiac Tamponade

Whats so bad about chronic healed pericarditis

Answer 2

Compression of the heart - prevent ventricles from expanding fully

Question 3

Pathological Types of Pericarditis [5]

Answer 3

Fibrinous
- post MI, Rheumatic HD, uremic (metabolic toxin), radiation, SLE, trauma; bread and butter

Suppurative/Purulent
- infection

Hemorrhagic involves blood mixing w fibrinous or suppurative
- from TB, Neoplastic invasion, severe bacteria

TB forms caseous pericarditis

Serous Pericarditis (non infective)

Question 4

Gimme Acyanotic and Cyanotic Congenital HD

Answer 4

Acyanotic

• Left to right shunt - ASD, VSD
• PDA
• Aortic Coarctation

Cyanotic

• Tetralogy of Fallot
• Transposition of Great Vessels
• Truncus Arteriosus (single trunk out of both ventricles)

Question 5

Whats the big deal w Left to Right shunt since is Acyanotic?

Answer 5

Eisenmenger Syndrome

• Left to right shunt
• Pulmonary Hypertension, more BP, volume
• • Pulmonary arterioles react w Vasoconstriction and Medial Hypertrophy
• Pulmonary vascular damage, fibrosis
• RVH, increases Pulmonary vascular resistance reaching systemic levels
• Right to Left shunt
• Deoxygenated blood going into systemic circulation - cyanotic

Question 6

Give 2 causes of Pulmonary arteriole vasoconstriction

Answer 6

Hypoxia - divert blood to better-oxygenated places

Hypertension

Question 7

Tetralogy of Fallot

Answer 7

Pulmonary Stenosis
RVH
VSD
Overriding Aorta - both LV and RV opens into Aorta

Question 8

What’s paradoxical embolism and why can ToF cause it

Answer 8

When clot goes from venous to artery wo being filtered and stuck at the lungs which is supposed to; goes to brain

Question 9

Coarctation of Aorta

Answer 9

Narrowing after giving off branches to upper limb and brain

• Lower BP at lower limbs
• RAAS activated, higher BP for upper, normal to lower for lower

Note PDA w this can maintain BP, but lower limb cyanosis;

Clinical: pulse diff upper and lower;

Question 10

MI histology

Answer 10

Eosinophilia, loss of nuclei;
Neutrophil infiltrate between myocardial fibers
- Coagulative necrosis

Question 11

What is a key feature of Rheumatic myocarditis from Rheumatic Heart Disease

Answer 11

Aschoff bodies: granulomatous inflammation, giant cells, caterpillar macrophages; central necrosis

Note pancarditis occurs in ARF

Question 12

How does MI lead to aneurysm

Answer 12

Healing, fibrosis, aneurysm - thrombi, emboli

Question 13

What is a pericardial sac Cx for IHD

Answer 13

Necrosis - Hemopericardium w tamponade

- 1 week before healing