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Clinical Pathology > cardiovascular diseases 2 > Flashcards

cardiovascular diseases 2 Flashcards

1
Q

what 3 factors contribute to increasing cardiac work load

A

pressure overload-hypertension
pressure and volume overload- valvular disease.
Regional dysfunction with volume overload- MI

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2
Q

what coping mechanism does the hurt used when the cardiac output or work exceeds the limit.

A

ventricular hypertrophy

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3
Q

what coping mechanism does the heart use when hypertrophy fails to lower cardiac work/ouput

A

dilates- predisposes you to heart failure

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4
Q

Cardiac dysfunction is characterised by

A

heart failure
arrhythmia’s
neurohumoral stimulation

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5
Q

what is hypertrophy and dilation characterised by

A

decreased heart size and mass, increased protein synthesis, induction of immediate-early genes, induction of feral gene program, abnormal proteins, fibrosis, inadequate vasculature.

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6
Q

what happens to the kidneys in LHS heart failure (systemic heart failure)

A

not enough blood to the kidneys
pre-renal azotaemia- increase urea in blood.
salt and fluid retention- due to RAS.
renin aldosterone activation
natriuretric peptides-produced by atria to stop salt and water retention (oppose RAS)

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7
Q

Symptoms in the brain due to LHS heart failure

A

irratability, decreased attention, stuporacoma.

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8
Q

what effects does LHS heart failure have upon the lungs

A

pulmonary congestion and oedema.

blood is dumped back into the pulmonary circulation as LHS is blocked.

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9
Q

symptoms of LHS heart failure upon the lungs

A 
pulmonary hypertension
dyspnea (shortness of breath), orthopnea (shortness of breath when lying down but relieve by sitting up), paroxysymal nocturnal dyspnea (shortness of breath when lying down which in no relieved by sitting up)
blood in sputum
cyanosis
elevated pulmonary pressure
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10
Q

what causes right sided heart failure

A

dumping blood into the peripheries

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11
Q

symptoms and sizes of right sided heart failure

A

– Liver and spleen- symptoms due to blood being duped back into the venous system via the superior and inferior vena cava as no space in right atrium to take blood in so affects hepatic portal circulation.
• Congestive splenomegaly
• Ascites

–	Kidneys
–	Pleura/Pericardium
•	Pleural and pericardial effusions
•	Transudates
–	Peripheral tissues.
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12
Q

what is nutmeg liver and which heart failure is it a sign of

A

right hand side heart failure.
• Passive congestion.
dark at the peripheries as they are not perfused by the hepatic artery, and pale at the peripheries, as blood supply reaches here because of hepatic portal vein

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13
Q

what does regurgitation mean,

what type of valve problem is it

A

blood flows back

Closing problems

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14
Q

what does stenosis mean, what type of valve problems is it.

A

narrowing

opening problem of the valve

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15
Q

on which side do most valavular diseases occur, left or right

A

left

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16
Q

main causes of aortic stenosis

A

calcification of a deformed valve, rheumatic heart disease

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17
Q

main causes of mitral stenosis

A

rheumatic heart disease

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18
Q

what infection is followed by rheumatic heart failure

A

group A strep infection

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19
Q

pathogenesis of rheumatic heart disease

A
  1. Strep A induces a immune reaction and antibodies are produced
  2. Antibodies cross attack tissue glycoproteins in the heart as the antigens are similar.
  3. Results in vegetation’s, myocardial Ashchoff body and fibrous pericarditis were 2 layers of pericardium stick together due to fibrous exudate which forms between them.
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20
Q

symptoms of acute rheumatic heart disease

A

Inflammation

  • Aschoff bodies
  • Anitschkow cells- macrophages increased size of nuclei
  • Pancarditis- inflammation of the whole heart.
  • Vegetations on chordae tendinae at leaflet junction
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21
Q

symptoms of chronic rheumatic heart disease

A

Thickened valves
commisural fusion
thick, short, chord tendinae

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22
Q

consequences of aortic stenosis

A

increased ventricular pressure, hypertrophy, dilatation and then angina, syncope, arrthymia and heart failure

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23
Q

main cause of aortic stenosis

A

calcium deposits

24
Q

Mitral annular calcifications lead to stenosis or regugitations

A

regurgitations, however stenosis is still possible

25
Q

what 3 conditions cause aortic regurgitation

A
  • Syphilis
  • Rheumatoid Arthritis
  • Marfan
26
Q

Can infections cause aortic valve regurgitation

A

YES -endocarditis

27
Q

Can infections cause mitral valve regurgitation

A

YES

28
Q

what drug causes mitral valve regurgitation

A

Fen Phen

29
Q

what type of tissue disorders is mitral valve prolapse associated with

A

connective

30
Q

what machine easily detects mitral valve prolapse

A

echocariogram.

31
Q

clinical features of mitral valve prolapse

A 
•	Usually asymptomatic
•	Mid-systolic “click”
•	Holosystolic murmur if regurg. present
•	Occasional chest pain, dyspnea
% Infective endocarditis, mitral insufficiency, arrythmias, sudden death
32
Q

what stage of development do congenital heart defects occur in

A

faulty embryogenesis (week 3-8)‏

33
Q

what chromosome is important in cardiac development

A

chromosome 22.

34
Q

normal embryogenesis of the heart

A
  • 1 atria initially
  • Septum develops at the roof of atria and then descends- septum primum
  • Goes to endocardial cushion recedes back
  • the septum secundum (the second septum ) then begins to grow down on the right hand side of the septum primum
  • from the beginning, the septum has semilunar shape and its border delineates oval foramen - the foramen ovale
  • as the ostium secundum and oval foramen lie in different levels, the blood may pass from the right atrium into the left atrium in the fetal period
  • Through the oval foramen into the gap between both septae and through the ostium secundum
35
Q

what rote does foetal blood take upon entering the heart

A

• in foetal development as 02 blood comes form placenta the blood doesn’t need to go to the lungs so it goes RA-LA via foramen ovale and then to LV and the body.

36
Q

what 2 structures does the aorticopulmnary septum separate

A
  • This septum divides bulbus cordis and truncus into 2 main arterial trunks: aorta and pulmonary artery
  • It has spiral path that results in final topographical relations of both vessels that are known from the anatomy
37
Q

Do left to right shunts cause cyanosis

A

No

38
Q

Do right to left shunts cause cyanosis

A

Yes

39
Q

what is the major consequence of a left to right shunt

A

pulmonary hypertension

40
Q

what is a major consequence of a right to left shunt

A

pulmonary embolism, venous emboli.

41
Q

how many types of atrial septal defects are there

A

3 types
secumdum
primum
sinus venosus

42
Q

what is the most common CHD defect

A

ventricular septal defect.

43
Q

which septum is usually affected muscular of mucosal for Ventricular septal defect

A

mucosal

44
Q

patent ductus arterious is associated with which other defect problems

A

although rare

VSD, coarctation of aorta, pulmonary or aortic stenosis

45
Q

define atrioventricular septal defects

A

all 4 chambers are freely communicate with each other.

46
Q

tetralogy of falloffs consists of

A

– 1) VSD, large
– 2) OBSTRUCTION to RV outflow- smaller pulmonary artery.
– 3) Aorta OVERRIDES the VSD- enlarged aorta.
– 4) RVH

47
Q

define TGA ((TRANSPOSITION of GREAT ARTERIES)-

A

Aorta and pulmonary artery connect to the wrong chambers.

• Abnormal formation of truncal and aortopulmonary septa

48
Q

what defect is needed in order to survive a transposition of the great vessels

A

shunt – Patent ductus arterious or Patent foramen ovale

49
Q

define truncus arterious

A

Developmental failure of separation of truncus arteriosus- into aorta and pulmonary artery.

50
Q

what septal defect is truncus arteries associated with

A

VSD- ventricular septal defect.

51
Q

what types of shunts do tricuspid atresia need for survival

A

ASD, VSD, or PDA for survival

right to left shunt.

52
Q

define Total Anomalous Pulmonary Venous Connection (TAPVC)

A

• PULMONARY VEINS do NOT go into LA, but into L. innominate v. or coronary sinus

53
Q

3 types of obstructive CHD

A
  • COARCTATION of aorta
  • Pulmonary stenosis/atresia
  • Aortic stenosis/atresia
54
Q

in what gender is coarctation of the aorta more common

A

males

55
Q

3 forms of aortic stenosis

A
  • VALVULAR
  • If severe, hypoplastic LV→fatal
  • SUB-valvular (subaortic- below aortic valve leaflet)‏
  • Aortic wall THICK BELOW cusps
  • SUPRA-valvular- ( above aortic valve leaflet)
  • Aortic wall THICK ABOVE cusps in ascending aorta
56
Q

names of conditions starting with T have what kind of shunt present

A

right to left shunt

57
Q

names of conditions starting with d have what kind of shunt present

A

left to right shunt.

Clinical Pathology (45 decks)

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