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DMD 5247 > Heart Pathology > Flashcards

Heart Pathology Flashcards

1
Q

heart failure

A

heart cannot pump blood sufficient to meet the body’s needs

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2
Q

early compensations of heart failure

A

catecholamines
frank-starling mechanism
hypertrophy

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3
Q

eventual outcome of heart failure

A

ischemia

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4
Q

where does blood pool with left heart failure

A

lungs
-pulmonary edema

cyanosis is another consequence of left heart failure

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5
Q

where does blood pool with right heart failure

A

periphery of the systemic circuit
-peripheral edema

hepatomegaly
splenomegaly
ascites

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6
Q

left heart failure common causes

A

systemic hypertension
mitral or aortic valve disease
primary heart disease(amyloidosis)

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7
Q

heart changes during left heart failure

A

left ventricular hypertrophy
left ventricular dilation
left atrium may be enlarged

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8
Q

consequences of left heart failure

A 
dyspnea
orthopnea
enlarged heart
increased heart rate
rales
mitral regurgitation
systolic murmur
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9
Q

common causes of right heart failure

A

left heart failure
Cor Pulmonale
some congenital heart diseases

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10
Q

heart changes during right heart failure

A

right ventricular hypertrophy
right ventricular dilation
right atrium may be enlarged

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11
Q

consequences of right heart failure

A

peripheral edema
enlarged liver: hepatomegaly
enlarged spleen: splenomegaly

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12
Q

congenital heart disease

A

abnormalities at birth

cause is usually 90% unknown

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13
Q

3 classifications of congenital heart disease

A

left to right
right to left
coarctation

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14
Q

Left to right classification of congenital heart disease

A

ASD: atrial septal defect
VSD: ventricular septal defect
PDA: Patent ductus arteriosis

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15
Q

Atrial Septal Defect

A

may cause pulmonary hypertension

can be surgically repaired

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16
Q

Ventricular Septal Defect

A

most common
most close spontaneously
size and location matters

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17
Q

Patent Ductus Arteriosus

A
  • in the fetus, allows flow from PA to aorta
  • Generally closes by day 2 of life
  • size matters
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18
Q

Right to left classification of congenital heart disease

A

tetralogy of fallot

transposition of great arteries

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19
Q

tetralogy of fallot

A

ventricular septal defect
pulmonary stenosis
overriding aorta
right ventricular hypertrophy

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20
Q

transposition of great arteries

A

embryonic lethal in the absence of shunt

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21
Q

coarctation

A

aortic coarctation

  • narrowing of aorta
  • causes cyanosis and low blood pressure systemically
  • size matters
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22
Q

ischemic heart disease

A

myocardial perfusion can’t meet demand

usually a result of reduced coronary artery blood flow

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23
Q

4 syndromes of ischemic heart disease

A
  • angina pectoris
  • acute MI
  • chronic IHD
  • sudden cardiac death
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24
Q

stable angina pectoris

A 
intermittent chest pain
stable/chronic
-most common
-pain on exertion
-fixed narrowing of coronary arteries
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25
Q

variant angina pectoris

A

pain at rest

coronary artery spasm

26
Q

unstable/pre-infarction angina pectoris

A
  • unpredictable pain

- plaque disruption and thrombosis

27
Q

acute myocardial infarction

A

necrosis of myocardium from ischemia

  • due to coronary artery thrombosis
  • prompt reperfusion can salvage myocardium
28
Q

clinical features of acute myocardial infarction

A

severe, crushing chest pain
not relieved by nitroglycerin
sweating, nausea

29
Q

subendocardial infarction

A

affects only the inner 1/3-1/2 of the heart wall

-inner wall more affected because blood supply goes first to the outer wall

30
Q

transmural infarction

A
  • affects more than 1/2 of the heart wall

- more serious

31
Q

chronic IHD

A

-accumulation of small ischemic insults leads to mechanical failure

32
Q

sudden cardiac death

A

often a result of a lethal arrythmia without myocyte necrosis

33
Q

hypertensive heart disease

A
  • can affect the left or right ventricle
  • cor pulmonale is right ventricle enlargement due to pulmonary hypertension
  • PH from primary lung disorder
34
Q

valvular heart disease can be caused by:

A
  • murmurs
  • angina
  • CHF
  • Fainting
35
Q

forms of valvular heart disease

A

stenosis

insufficiency

36
Q

stenosis

A

failure to open

37
Q

insufficiency

A

failure to close

regurgitation

38
Q

aortic valve stenosis

A

stiffening and narrowing of the aortic valve

  • blood has difficulty exiting the heart
  • prolonged ejection sound
39
Q

clinical manifestations of aortic valve stenosis

A 
crescendo-decrescendo systolic heart sound
decrease in stroke volume
increased left ventricular pressure
decreased systolic blood pressure
hypertrophy of the left ventricle
40
Q

aortic regurgitation

A
  • failure of the aortic valve to properly close

- blood leaks back into the ventricle after ventricular contraction

41
Q

clinical manifestations of aortic regurgitation

A
  • diastolic murmur(blowing sound) of high pitch over the left ventricle
  • hypertrophy of the left ventricle
  • left ventricular failure
  • doppler echocardiography reveals blood flow back through the aortic valve
42
Q

Mitral stenosis

A

narrowing or stiffening of the mitral valve (left AV valve)

blood flowing into the ventricle during diastole

43
Q

clinical manifestations of mitral stenosis

A
  • subtle crescendo diastolic murmur(rumbling)
  • decreased blood flow from the left atrium to the left ventricle
  • increased left atrial pressure
  • hypertrophy and dilation of the left atrium
  • atrial dysrhytmias(fibrillation)
  • increases pulmonary blood pressure
  • pulmonary edema
  • right heart failure
44
Q

mitral regurgitation

A

failure of the mitral valve(left AV valve) to properly close

blood passing into atrium from ventricle during contraction

45
Q

clinical manifestations of mitral regurgitation

A 
systolic murmur
hypertrophied left ventricle
left heart failure
pulmonary hypertension and edema
right heart failure
doppler echocardiography reveals blood flow back though mitral valve
46
Q

Rheumatic valvular disease

A

rheumatic fever

  • diffuse inflammatory disease caused by immune response to infection by the group A Beta hemolytic streptococci
  • Febrile illness: inflammation of the joints, skin, nervous system, and heart
  • if left untreated, rheumatic fever causes rheumatic heart disease
47
Q

mitral valve prolapse

A

ballooning of mitral leaflets

most patients are asymptomatic

48
Q

infective endocarditis

A

microbial invasion of the heart valves, endocardium

usually mitral and aortic valves

49
Q

Acute infective endocarditis

A

highly virulent infection attacks normal valve(e.g. S. aureus)
50% of patients die withing weeks
Often requires surgery

50
Q

Subacute infective endocarditis

A

low virulent infection colonizes abnormal valve

long course, most recover

51
Q

cardiomyopathies

A

diverse group of disorders in which myocardium dysfunctions

52
Q

dilated cardiomyopathy

A

congestive cardiomyopathy

53
Q

hypertrophic cardiomyopathy

A

hypertension is a leading cause

54
Q

restrictive cardiomyopathy

A

deposition of material in myocardium

55
Q

causes of dilated cardiomyopathy

A

viral
alcohol/toxin
genetic abnormality

56
Q

causes of hypertrophic cardiomyopathy

A

hypertension
sarcomere mutation
ventricle can’t fill

57
Q

causes of restrictive cardiomyopathy

A

deposition of material in myocardium
heart wall is stiff, can’t fill

idiopathic
amyloidosis or sarcoidosis

58
Q

pericardial disease

A

disorders of the pericardium

  • acute pericarditis
  • pericardial effusion
59
Q

acute pericarditis

A

causes severe chest pain that worsens with respiratory movements an with lying down
dangers: tamponade, chronic fibrosis

60
Q

pericardial effusion

A

accumulation of fluid within the pericardium

-tamponade: physical pressure compresses heart

61
Q

tumors

A

primary tumors are very uncommon
-most are benign

malignant heart cancers are often metastasized from lung or lymphoma

DMD 5247 (13 decks)

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