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TERM 3 BIOL2292 PATHO 2 > CARDIAC LECTURE 2: Endocardial, valvular, myocardial, pericardial & congenital heart disease > Flashcards

CARDIAC LECTURE 2: Endocardial, valvular, myocardial, pericardial & congenital heart disease Flashcards

1
Q

What are 4 reasons the endocardial or valvular structures may be damaged?

A
  1. Inflammation
  2. Scarring
  3. Calcification
  4. Congenital
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2
Q

What is the term for the failure of the valve to open completely?

A

Stenosis

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3
Q

What is the term for the inability of the valve to close completely?

A

Regurgitation/insufficiency

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4
Q

What is the term for the sounds of improper flow or leaking of blood?

A

Murmurs

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5
Q

What is the term for impaired blood flow from the left atrium to the left ventricle during ventricular diastole?

A

Mitral stenosis

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6
Q

Why does mitral stenosis lead to atrial enlargement/hypertrophy?

A

The blood cannot leave the left atrium, increasing the pressure in the chamber

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7
Q

Why does mitral stenosis lead to pulmonary hypertension, right ventricular hypertrophy, and right sided heart failure?

A

The pressure in the pulmonary circuit and right side of the heart is elevated since the blood cannot flow into the left ventricle properly

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8
Q

What is the term for backflow of blood from the left ventricle to the left atrium during ventricular systole?

A

Mitral regurgitation

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9
Q

Why does mitral regurgitation lead to left sided dilation and hypertrophy?

A

Due to extra blood volume in the heart

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10
Q

Why does mitral regurgitation lead to left sided heart failure?

A

Left side of the heart must work harder to pump enough blood out to the body, as blood pumped out of the LV goes back into the LA

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11
Q

What is the term for displacement of the mitral valve leaflets into the left atrium during ventricular systole?

A

Mitral valve prolapse

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12
Q

What are the signs and symptoms of mitral valve prolapse?

A

Typically asymptomatic, but patients may eventually develop mitral regurgitation or heart failure

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13
Q

Which valve disorder results in obstruction of aortic outflow from the left ventrciel into the aorta during systole?

A

Aortic stenosis

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14
Q

What is the predominant cause of aortic stenosis?

A

Age-related calcium deposits

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15
Q

Why does aortic stenosis result in left ventricular hypertrophy and left sided heart failure?

A

Pressure builds up in LV, muscle must work harder to pump

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16
Q

What valvular disorder involves blood leaking back from the aorta into the left ventricle during diastole?

A

Aortic regurgitation

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17
Q

What causes aortic regurgitation?

A

Aortic valve or root dilation

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18
Q

Why does aortic regurgitation lead to left ventricular dilation and hypertrophy and eventually left sided heart failure?

A

Left ventricle must accomodate a higher volume of blood

LV works harder to pump blood to the rest of the body

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19
Q

Why would mitral stenosis lead to atrial clots?

A

Because the blood cannot flow out of the left atrium, causing stasis

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20
Q

What is a unique clinical sign of aortic regurgitation?

A

Wide pulse pressure

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21
Q

Which cardiac disorder is an acute inflammatory disease that follows infection with group A streptococci, and involves immune attack on individual’s own tissues?

A

Rheumatic heart disease

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22
Q

What tissues do antibodies target in rheumatic heart disease?

A

Connective tissue in joints, skin, and heart (especially valves)

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23
Q

Which cardiac disorder involves invasion and colonization of the endocardium/heart valves by microorganisms, and leads to vegetations and tissue destruction?

A

Infective endocarditis

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24
Q

What are vegetations in infective endocarditis composed of, and why are they significant?

A
  1. Platelets, fibrin, cellular debris, pathogens
  2. Pathogens hide from immune system within vegetations
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25
Q

What is required in contracting infective endocarditis?

A

Microbes gain access to bloodstream through incision or via GI tract

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26
Q

Which form of infective endocarditis can develop in anyone if the number or virulence of the pathogen is high enough?

A

Acute infective endocarditis

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27
Q

Which form of infective endocarditis only develops in susceptible hosts with pre-existing conditions?

A

Subacute infective endocarditis

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28
Q

What are 3 consequences of infective endocarditis?

A
  1. Valve stenosis
  2. Heart failure
  3. Septic emboli
29
Q

What are 4 complications that can develop with artificial valves?

A
  1. Coagulation
  2. Intravascular hemolysis due to shear force
  3. Structrual deterioration
  4. Infective endocarditis
30
Q

What is the term for an inflammatory disorder of the myocardium characterized by
damage and necrosis of cardiomyocytes?

A

Myocarditis

31
Q

What are 4 causes of myocarditis?

A
  1. Infection
  2. Toxins
  3. Allergies
  4. Autoimmune
32
Q

What are 2 histological characteristics of myocarditis?

A
  1. Cytotoxic T cell and macrophage infiltration
  2. Collagen deposition
33
Q

What are 2 treatments for myocarditis?

A
  1. Immunosuppressants
  2. Supportive therapy
34
Q

Which term describes a heterogeneous group of diseases involving structural or functional abnormalities of the myocardium?

A

Cardiomyopathies

35
Q

How are cardiomyopathies classified by cause?

A

Primary and secondary

36
Q

Which type of cardiomyopathy is the most common type, and is characterized by dilation/impaired contraction of one or both ventricles?

A

Dilated cardiomyopathy

37
Q

In what manner does the heart enlarge in dilated cardiomyopathy?

A

Heart can triple in size, but ventricular walls look normal or thinned

38
Q

Which cardiomyopathy is purely genetic, and is characterized by thickened, hypercontractile ventricular muscle mass?

A

Hypertrophic cardiomyopathy

39
Q

What are 2 ways hypertrophic cardiomyopathy impairs cardiac function?

A
  1. Impaired diastolic filling
  2. Aortic stenosis / obstruction
40
Q

What are 2 treatments for hypertrophic cardiomyopathy?

A
  1. CCBs and beta blockers (relaxes ventricles to improve filling)
  2. Surgical septal myectomy
41
Q

What is the main difference between dilated and hypertrophic cardiomyopathy?

A

Dilated=hypocontractility
Hypertrophic=hypercontractility

42
Q

Which type of cardiomyopathy is the rarest form, and is characterized by a rigid, fibrotic, noncompliant ventricle?

A

Restrictive cardiomyopathy

43
Q

How does restrictive cardiomyopathy impair cardiac function?

A

Ventricles cannot fill

44
Q

What are 2 reasons for restrictive cardiomyopathy?

A
  1. Genetic mutations in genes for sarcomeres and cytoskeleton
  2. Amyloidosis (protein fragment deposition in heart)
45
Q

How is restrictive cardiomyopathy treated?

A

There is no treatment

46
Q

What is the term for accumulation of fluid in the pericardial sac?

A

Pericardial effusion

47
Q

What are 4 types of pericardial effusion?

A
  1. Serous
  2. Serosanguineous
  3. Purulent
  4. Chylous
48
Q

What is the term for exaggerated systolic BP decrease with inspiration, a clinical manifestation of cardiac tamponade?

A

Pulsus paradoxus

49
Q

What is the term for 3 clinical manifestations of cardiac tamponade: hypotension, dilated neck veins, and muffled heart sounds?

A

Beck’s triad

50
Q

What procedure would be performed to treat cardiac tamponade?

A

Pericardiocentesis

51
Q

What is the cause of most cases of acute pericarditis?

A

Idiopathic, presumed viral

52
Q

What auscultation finding is characteristic of acute pericarditis?

A

Pericardial friction rub

53
Q

What are 2 treatments for acute pericarditis?

A
  1. NSAIDs
  2. Pericardial drainage
54
Q

Chronic pericarditis can lead to what condition, where the pericardial sac becomes dense, non-elastic, fibrous, and scarred?

A

Constrictive pericarditis

55
Q

What are 3 treatments for chronic pericarditis?

A
  1. NSAIDs
  2. Glucocorticoids
  3. Pericardiectomy
56
Q

What are the 2 major forms of congenital heart diseases?

A
  1. Shunts
  2. Obstructions
57
Q

What is the term for a shunt where deoxygenated blood enters the left side of the heart without passing through the lungs?

A

Cyanotic defect

58
Q

What is the term for a shunt where oxygenated blood enters the right side to be sent to the lungs again, causing right sided hypertrophy?

A

Acyanotic defect

59
Q

What is the term for the fetal heart valve that allows blood to flow from the right atrium straight to the left atrium?

A

Foramen ovale

60
Q

What is the term for the channel between the pulmonary artery and the aorta in the fetal heart?

A

Ductus arteriosus

61
Q

In cases of atrial and ventricular septal defects, which way will the blood flow?

A

Left to right (acyanotic), at least at first

62
Q

Why may a septal defect eventually reverse to become a right-left shunt?

A

Increase in pulmonary blood flow leads to pulmonary hypertension and right ventricular hypertrophy

63
Q

What is the most common congenital cardiac defect?

A

Ventricular septal defects

64
Q

What are the consequences in patent ductus arteriosus?

A

Pulmonary hypertension
Right sided heart failure

65
Q

Which congenital heart defect is characterized by obstruction of blood flow from the right ventricle to the pulmonary circulation, usually due to abnormal fusion of valvular cusps?

A

Pulmonary stenosis

66
Q

How can pulmonary stenosis be treated?

A

Balloon valvuloplasty

67
Q

What are the 4 features of tetralogy of Fallot?

A
  1. Pulmonary stenosis
  2. Ventricular septal defect
  3. Overriding aorta
  4. Right ventricular hypertrophy
68
Q

What kind of shunting is involved in tetralogy of Fallot?

A

Right to left (cyanotic)

TERM 3 BIOL2292 PATHO 2 (19 decks)

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