8. Heart & Blood Vessels – The Rest Flashcards Preview

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Flashcards in 8. Heart & Blood Vessels – The Rest Deck (58)
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1

Introduction

Heart Disease (Cardiac Disease)
Blood Vessel Disease (Vascular Disease)
Disease present from birth (Congenital Cardiovascular
Disease)

2

Cardiac Disease



Vascular Disease

Ischaemia and MI (previously covered)
Cardiac Failure
Valvular Heart Disease
Pericarditis and Myocarditis
Unusual Cardiac Diseases

Congenital Cardiovascular disease

3

Vascular Disease

Atherosclerosis (previously covered)
Aneurysms
Hypertension
Diabetic Vascular Disease
Vein Diseases

4

Cardiac Failure

What is the normal function of the heart?
What is a syndrome?
Heart unable to pump blood at rate required for normal functioning

5

What happens when the heart does not pump as effectively as it should?

Oedema – pulmonary and peripheral
Tiredness

6

Many Causes

Ischaemic Heart Disease
Hypertension
Valvular Heart Disease
Arrhythmias
Congenital Heart Disease

7

Cardiac Failure

Initially the heart ‘Compensates’
Leads to cardiac hypertrophy and/or dilatation, and eventual inability to maintain normal

8

Cardiac Failure

Symptoms/Signs:
Shortness of breath (SOB)
Fatigue
Fluid in lungs (Pulmonary Oedema)
All-over, excessive, fluid-filled veins (Systemic Venous Congestion & Oedema)

9

Classification

Acute vs Chronic
Left vs Right Vs both sided (congestive)

10

Treatment

Treat the underlying cause
There are a range of medicines used to help control heart failure

11

What does a valve do?

A valve regulates flow in one direction only

Think how this works in the heart

12

Valvular Heart Disease - Mechanisms (1)

Stenosis - Failure to open completely, impeding forward flow

Incompetence/Regurgitation - Failure to close, allowing reverse flow

Vegetations – abnormal tissue growth on valve (fibrin, platelets & bacteria)

13

Valvular Heart Disease - Mechanisms (2)

Most common disease - stenoses of the aortic and mitral valves
Account for 2/3rds of all valve disease
Valvular stenosis mainly due to primary valve cusp abnormality, a chronic process
Valvular regurgitation may result from disease of cusps but also damage to supporting structures (tendinous cords, papillary muscles)
Vegetations can result from Infective Endocarditis & Rheumatic Fever

14

Valvular Heart Disease – Underlying Causes

Infection – Endocarditis/Rheumatic disease
Calcific aortic valve disease
Age-related degeneration
Carcinoid Syndrome
Fibrosis & muscle rupture after MI
Heart failure
Hypertension
Congenital
Prosthetic Heart Valves
Connective Tissue Disorders
IV Drug use

15

Mitral Stenosis

Rheumatic Fever

Pulmonary hypertension
L atrial & R ventricular hypertrophy
Murmur

16

Mitral Incompetence

Rheumatic Fever
Dilatation of Mitral valve
Papillary muscle fibrosis & dysfunction
Degeneration of valve cusps

Variable Haemodynamic effect
Murmur

17

Aortic Stenosis

Calcific degeneration
Rheumatic fever

Murmur
L Ventricular hypertrophy
Angina, syncope, L ventricle failure or sudden death

18

Aortic Incompetence

Rheumatic Fever
Dilatation of aortic root
Rheumatological disorders

Murmur
Collapsing pulse
Angina
L Ventricular failure

19

Endocarditits (vegetations)

Rheumatic Disease
Bacteria
Prosthetic Heart Valves
Calcific Valve Disease
IV Drug use

Malaise
Clubbing
Cardiac murmurs & failure
Arthralgia
Pyrexia
Skin lesions
Splenomegaly
Haematuria
Glomerulonephritis

20

Valvular Heart Disease

Symptoms/Consequences of Valvular disease:
Differ with the site/type lesion
Stroke
Arrythmias
Ventricular hypertrophy
Angina (Chest pain)
Syncope (Fainting)
Heart failure
Infarcts to kidneys and spleen
Poor prognosis once symptoms

21

Infective Endocarditis (1)

Endocardium is the inner lining of the heart and its valves.

Endocarditis is when this lining becomes infected/inflammed

22

Infective Endocarditis (2)

Infection occurs on the edge of heart valves
Vegetation is a mass of bacteria, fibrin, platelets
Right-sided in IV drug use
Left-sided in others

23

Infective Endocarditis (3)

Colonization of the heart valves or mural endocardium usually by bacteria
Streptococci (α haemolytic) affects abnormal valves usually after dental extraction / cleaning / bronchoscopy / tonsillectomy

Staph aureus affects previously normal valves, usually IV drug abusers

PROPHYLAXIS - Imperative to give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia

24

Clinical Presentation

Sepsis
Heart Failure
New murmur

25

Pericarditis & Myocarditis (1)

Inflammatory Reaction involving the Heart Sac or Heart Muscle Many Causes:
Viral, Bacterial, Parasitic, TB, Uraemia (urine products in blood)
Carcinoma, MI, Post surgery, Drugs, Connective tissue disease, Unknown, Radiation

26

Pericarditis & Myocarditis (2)

Types: Acute
Chronic
Symptoms and Signs: Chest Pain
Cardiac Failure
Treatment: Anti-inflammatory Drugs
Surgical Excision of the Pericardium

27

Unusual Cardiac Diseases

Cardiomyopathy
Multisystem Diseases – like Sarcoidosis & Amyloidosis
Thyrotoxicosis
Myxoedema
Alcoholism
Pregnancy
Iatrogenic (drug-induced) disease

28

Cardiomyopathy

Disease of heart muscle

29

Dilated

Idiopathic, alcohol, peripartum, genetic, myocarditis, sarcoid

30

Hypertrophic

Genetic, idiopathic, storage disease