rubins heart Flashcards
- Large VSDs initially characterized by
left-right shunt, with left ventricular dilation and CHF; if patient survives long enough, pulmonary HTN could cause reversal of the direction of the shunt and lead to CYANOSIS
- Endocardial fibroelastosis is
fibroelastotic thickening of the endocardium of the LV, which could also affect the valves (look for irregular gray-white patches of fibroelastotic thickening with degen of subendocard myocytes; look for something like aortic stenosis and coarctation of the aorta accompanying
- Hyperthyroidism may lead to
high-output heart failure (decreased peripheral resistance requires increased CO)
- Mural thrombi form on
endocardium, early after infarction, and over ventricular aneurysms (at site of healed, transmural myocardial infarct); thrombi are a source of systemic emboli
- Acute infarction often associated with
premature ventricular beats, v tachy, complete heart block, and v fib
- Myocardial rupture and hemorrhage into the _____ may occur
pericardial sac; at almost any time during the first 3 weeks following infarction, but most often b/w 1st and 4th days
- Nonbacterial thombotic endocarditis
known as marantic endocarditis, refers to the presence of sterile vegetations on apparently normal cardiac valves, usually in association with cancer or another wasting disease; maybe due to increased blood coag and immune-complex deposition…
- Three causes of calcific aortic stenosis are
- rheumatic disease
- senile calcific stenosis
- congenital bicuspid aortic stenosis
- Aschoff bodies consist of
foci of eosinophilic material surrounded by T lymphocytes, occasional plasma cells, and plump macrophages called “Anitschkow cells”
- Hypertrophic myocardial cells exhibit
increased diameter with enlarged, hyperchromatic, rectangular (“boxcar”) nuclei; if distance b/w interstitium and center of each myofiber is too great, supply of O2 to myofiber will be deficient
- Carcinoid heart disease typicaly affects
the right heart, causing changes in the pulmonary and tricuspid valves; associated with intestinal carcinoids metastasizing to the liver; with plaque-like deposits of dense fibrous tissue on tricuspid and pulmonary valves, you can get pulmonary stenosis and tricuspid insufficiency
- Cardiac amyloidosis causes
restrictive cardiomyopathy, characterized by reduced diastolic filling and right-sided heart failure; infiltration of the conduction system can result in arrhythmias or sudden cardiac death;
amyloid appears AMORPHOUS, GLASSY, EOSINOPHILIC
- Viral myocarditis can lead to
CHF showing biventricular dilation and hypokinesis; look on histo for patchy or diffuse interstitial mononuclear inflamm infiltrate, usually with T lymphocytes and macrophages
- Constrictive pericarditis (Haiti)
is a chronic fibrosing disease of pericardium that compresses heart and restricts inflow; get visceral and parietal layers fused in a dense mass of fibrous tissue;
could be caused by bacteria , viruses or fungi (LIKE ACTIVE TB!!!!); also previous radiation to mediastinum and cardiac surgery
