REVIEW 2 (cardiac) Flashcards
Are cardiac tumors usually benign or malignant?
They are usually benign and are pedunculated, (they have a stalk for easy remova)
What are the 3 types of cardiac tumors?
- Cardiac Myxomas (Adults)
- Rhabdomyomas (Kids)
- Metastatic Tumors
What is the most common primary cardiac tumor (35-50%)?
Cardiac Myxomas
Which primary cardiac tumor?
Most arise from the left atrium (75%), although they can occur in any chamber of the heart or on a valve.
Cardiac Myxomas
Which primary cardiac tumor?
- glistening, gelatinous, polypoid mass, usually 5-6 cms, with a short stalk
- Sometimes the tumor is sufficiently mobile as to obstruct the mitral valve orifice.
Cardiac myxoma
> 1/2 of the patients with cardiac myxomas of the left atrium have clinical evidence of __________
mitral valve dysfunction
1/3 of these pts with a cardiac myxoma of the left atrium or left ventricle die of what?
embolization of the tumor to the brain
Is surgical removal of cardiac myxomas usually successful?
Yes. surgical removal is successful in most cases
What is the most common primary cardiac tumor in infants and children and forms nodular masses in the myocardium.
Rhabdomyomas
Which primary cardiac tumor?
- Almost all are multiple
- involve both the left and right ventricles, and in 1/3 of cases, the atria as well.
- In 1/2 of cases, the tumor mass projects into the cardiac chamber.
Rhabdomyoma
Which primary cardiac tumor?
Grossly they are pale gray masses, up to several centimeters
Rhabdomyomas
What is the most feared complication of an aneurysm no matter the location?
-Rupture and death by exsanguination
-the jet of blood may also dissect through the wall of the aorta and form a periarterial second lumen called a Dissecting Aneurysm (this may also be from the root of the aorta)
What comes first in the pathogenesis of atherosclerosis:
Fatty streak
Atheroma
Plaque
Malignant plaque
1st- Fatty Streaks
2nd- Atheromas
3rd- Plaques
4th- Malignant plaques
The following is major or minor criteria for “Jones Criteria”? What is this used to dx?
- Pancarditis
- Polyarthritis
- Sydenhams Chorea
- Subcutaneous Nodules
- Erythema Marginatum
Major Criteria
Used to dx RHD
Clinical dx made when 2 major OR 1 major + 2 minor criteria are fulfilled
Major or minor “Jones Criteria? Used to dx what?
- h/o Rheumatic Fever
- Fever
- Arthragias
- EKG signs of heart damage
- Evidence of prior Strept infection (ASO titers, C-reactive protein, increased sed. rate)
Minor criteria
Used to dx RHD
*Clinical dx made when 2 major OR 1 major + 2 minor criteria are fulfilled
When is a clinical diagnosis of RHD made?
(how many major or minor criteria)
clinical dx made when:
2 major criteria
OR
1 major + 2 minor criteria are fulfilled
The following describes what histologic finding:
- Aggregates of lymphocytes and macrophages around a central zone of fibrinoid necrosis
- w/ time it assumes a granulomatous appearance and eventually is replaced by a scar
Aschoff Bodies
Seen in the myocardium of acute rheumatic myocarditis
What condition are Aschoff bodies seen in?
Acute Rheumatic Myocarditis
90% of the time, ______ (L or R) sided heart valves are involved in both RHD and Infective Endocarditis
Left sided heart valves
What is the only way you get right sided heart vegitation
??
What is Acute Bacterial Endocarditis (ABE) usually due to?
highly vurulent organisms like Staph auereus or the Gram negatives
What is Subacute Bacterial Endocarditis (SBE) usually due to?
Organisms of less virulence
Streptococcus viridans
Which organism is responsible for the most cases of Prosthetic Valve Endocarditis?
Staph epidermidis (majority)
other groups- Enterococci, Gram neg bacteria and fungi
What is the main organism associated with Endocarditis in IVDA’s?
St. aureus (50-60% of cases)
followed by Strept. species and candida (or any skin commensal)
RHD- what is responsible for the majority of deaths in the acute phase due to conduction system fibrosis?
Myocarditis
RHD:
The _______ is responsible for the most deaths after the acute phase
Endocarditis
