Random Cardio Path HY Flashcards by Alegra Mendez

heart originates from which germ cell layer

mesoderm

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heartbeat established when during gestation?

3th wk

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changes occurring at birth in baby

lungs expand –> inc BF, dec R, higher partial P of O2

inc SVR (removal of placenta)

inc systemic BP

inc LVP

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tissue that becomes infolding of muscular roof of common atrium, and door of foramen ovale

septum secundum

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origin of aorticopulmonary septum

neural crest cells

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trisomy 21

associated disorders

endocardial cushion defects (common AV canal), VSD, ASD, PDA

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Turner syndrome

associated disorders

coarctation of aorta

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trisomy 18

associated disorders

VSD

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LV hypOplasia

associated disorders

aortic stenosis

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persistent trucus arteriosus

associated disorders

aortic and pulmonic outflow tract

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portion of atrial septum adjacent to AV valves is developed from

endocardial cushion tissue

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secundum ASD

patent foramen ovale (most common ASD)

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muscular VSD

harsh, pan systolic murmur

little functional disturbances

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paramembranous VSD

most common form VSD

involves the membranous septum

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TOF mechanism

abnormal endocardial cushion development of conotruncus

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@ which level does mixing occur w/ untreated D-TGA

ASD or VSD

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T/F

D-TGA –> mixing of blood occurs at ductus arteriosus level

false

BUT keeping DA open does inc VR to LA and improve mixing at atrial level

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hypOplastic left heart can lead to

MS/atresia
AS/atresia
RVH
coarctation of aorta

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___ aneurysms most commonly involve aortic arch, abd aorta, iliac a.

fusiform aneurysms

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aortic aneurysms predisposing condn

ATHEROSCLEROSIS
cystic medial degeneration
other (trauma/congenital defects/vasculitis/infections)

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AAA rarely develop before age

AAA rarely develop before age 50

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AAA usual location

below renal a., above bifurcation of aorta

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AAA freq contains a

laminated mural thrombus

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T. palladium

syphilitic aneurysm

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condition leading to obliterative endarteritis (freq. involv vasovasorum)

syphilitic aneurysm --> results in ischemic medial injury --> aneurysmal dilatation of the aorta and aortic annulus

Homan sign

pain w/ dorsiflexion of foot poss DVT

myxomas

primary cardiac tumor benign most in LA "ball in valve" (MS sx, syncope, sudden death)

myxoma histo

mesenchymal cells | abundant ground substance (gelatinous appearance --> myxoid, fibrous, slender cells)

rhabdomyoma

most comm primary tumor in infants/children benign hamartoma valvular obstruction TUBEROUS SCLEROSIS

rhabdomyoma histo

large round polygonal myocytes w/ glycogen-rich vacuoles (CLEAR cytoplasm) (spider-cells)

tuberous sclerosis

AD, mut TSC1 (hamartin) or TSC2 (tuberin) mostly TSC2: more severe --> seizures, ash leaf spots, facial skin spots (angiofibromas), mental retardation

Kaposi sarcoma

caused by Kaposi sarcoma herpesvirus (HHV-8) most common HIV-related malignancy often involves lymph nodes and disseminates widely to viscera early in course

Kaposi sarcoma histo

dilated, irregular, not well-formed vascular channels w/ extravasated erythrocytes, hemosiderin-laden macrophages

mutations in sarcolemma and nuclear membrane proteins

dilated cardiomyopathy

mutations in b-myosin heavy chain sarcomeric protein

HCM

global LV systolic dysfunction inc LV cavity diameter absence of HTN, valve disease, significant CAD

DCM

inc weight of heart, may be 3x four chamber dilatation flabby, pale myocardium w/ subendocardial scars

DCM

anthracycline toxicity

DCM

pregnancy/peripartum --> _CM

DCM

HCM clinical features

``` sudden cardiac death (arrhythmia) syncope (LVOT obstruction) mitral regurgitation (LVOT tugs MV) ```

asymmetric bulging of lg inter ventricular septum into LV chamber

HCM

microfiber disarray, especially in interventricular septum

HCM disarray via xs branching--> block beneath AV, can't get blood across --> syncope during exercise

_____ may mimic constrictive pericarditis

RESTRICTIVE CM may mimic constrictive pericarditis

R sided sx | cardiomegaly w/ thickened myocardial wall, dec contractility

amyloidosis (systemic senile amyloidosis) --> RCM apple green birefringence, Congo red, pink amorphous material

causes of myocarditis

influenza rocky mounted spotted fever Chagas drug rxns (penicillin, sulfonamide)

Coxsackie B

viral myocarditis

URI hx w/ + throat culture for specific virus most pts recover, few die of congestive HF/arrhythmias unusually severe in preg women/children

viral myocarditis

patchy/diffuse interstitial infiltrate of T lymphocytes, macrophages, rare giant cells, focal myocyte necrosis

viral myocarditis

T. Cruzi

chagas disease pseudocyst in myocardial fiber --> MYOCARDITIS

flabby/dilated heart

giant cell myocarditis rare, unkown cause (seen w/ SLE, hypERthyroidism, thymoma) young/mid age pts histo: chronic inflamm w/ many giant cells

most pericarditis are acute or chronic?

acute

post-MI (Dressler's) can lead to

pericarditis

most viral causes of acute pericarditis

likely coxsackie virus

hyperemic border (red) around infarct age of infarct?

3-7 d

2-4 d post MI

PMNs interstitial edema, hemorrhage, necrotic myocytes (nuclei disappear)

5-7 d post MI

macrophages disintegration of dead myofibers

2-8 wks post MI

well-stab granulation tissue new blood vessels increased collagen dec dec cellularity

MVP

mid systolic click

rheumatic fever dx criteria

2 major | or 1 major, 2 minor Jones criteria

minor jones

fever arthralgia acute phase reactants

___ occurs as pancarditis

acute rheumatic carditis

caterpillar cells

anitschkow cells | acute rheumatic carditis

Aschoff body

focus of fibrinoid necrosis surr by inflamm cells (plasma cells, lymphocytes, anitschkow cells, Aschoff giant cells)

acute rheumatic endocarditis

vegetations on closure line of cusps

``` infective endocarditis (subacute) ``` most come organism

strep viridans usu w/ predisposing factor (MVP etc)

``` infective endocarditis (acute) ``` most come organism

staph aureus high virulence, can occur w/o predisposing factor

infective endocarditis

bulky, friable, destructive vegetations anywhere in valve vegetations = fibrin, inflamm cells, bacteria ....later... fibrosis calcification

Which form of AV block may be physiologic?

mobitz I Wenckebach

cardiogenesis is completed by

6th week

cardiogenesis weeks of gestation

3-6 wk

closes archway of septum secundum, becomes valve of foramen ovale

remainder of septum primum

T/F EtOH abuse contributes to risk of intracranial aneurysm

True

DCM is associated with which viruses

likely caused by AI attack on myocardium (viral myocarditis)

Is HCM a common cause of CM?

Restrictive CM usually presents with R or L sided sx?

most comm cause of acute pericarditis in immunocompromised

CMV

causes of fibrinous pericarditis

``` MI uremia chest radiation rheumatic fever lupus trauma ```

2-4 d post MI

mottling w/ yellow-tan softening risk for arrythmia