Cardiac Pathology Flashcards
(107 cards)
1
Q
Stable angina
A
.Chest pain with exertion or emotional stress
.due to atherosclerosis (>70% stenosis )
. Represent reversible injury
2
Q
Stable angina EKG shows
A
ST-segment depression (subendocardial ischemia)
3
Q
Unstable angina
A
.Chest pain occur at rest
.Due to rapture of atherosclerotic plaque with thrombosis and **incomplete occlusion of coronaries
.Represent reversible injury
4
Q
Unstable angina EKG shows
A
ST-segment depression
5
Q
Prinzmetal angina
A
Episodic Chest pain unrelated to exertion
Represent reversible injury
6
Q
Prinzmetal angina EKG shows
A
ST-segment elevation (due to transmural ischemia)
7
Q
Myocardial infarction
A
.Necrosis of cardiac myocytes
8
Q
MI occur due to
A
Rupture of atherosclerotic plaque with thrombosis and **complete occlusion of coronary artery
9
Q
Other causes of MI include
A
Vasospasm , emboli and vasculitis
10
Q
MI clinical features
A
Severe crushing chest pain (>20min)
Diaphoresis
Dyspnea
11
Q
MI usually involve
A
The left ventricle
12
Q
Cardiac enzymes include
A
Troponin I (the most sensitive and specific marker ) CK-MB (useful for detecting reinfarction)
13
Q
MI treatment
A
Aspirin/heparin Supplemental O2 Nitrate B blocker ACE inhibitor
14
Q
Fibrinlysis / angioplasty complication
A
Result in 1.contraction band necrosis
2.Reperfusion injury
15
Q
Microscopic changes during MI
………1Day……………..1week…………….1month
A
Coagulative necrosis /1day/inflammation /1week/granulation tissue/1month/Scar formation
16
Q
Complication of MI during coagulative necrosis phase
A
Arrhythmia
17
Q
Complication of MI during neutrophilic infiltration
A
Fibrinous pericarditis
18
Q
Complication of MI during macrophages infiltration
A
Rupture of ventricular free wall (lead to cardiac tamponade) Interventricular septum (shunt) papillary muscle (insufficiency)
19
Q
Complication of MI during Scar phase
A
Aneurysm , mural thrombus , **Dressler syndrome(autoimmune pericarditis)
20
Q
Fibrinous pericarditis only seen with
A
Transmural infarction
21
Q
Sudden cardiac death usually due to
A
Fatal ventricular arrhythmia
22
Q
Most common etiology of SCD is
A
Acute ischemia
23
Q
Causes of left sided heart failure
A
Ischemia MI Dilated cardiomyopathy Restrictive cardiomyopathy HTN
24
Q
Consequences of HF
A
Pulmonary congestion
Decreased forward perfusion
25
Right sided HF most commonly due to
Left failure
26
Other important causes of Right sided HF
Left to right shunt , chronic lung disease
27
Right sided HF clinical features
Jagular venous distension
Painful hepatosplenomegally may lead to cardiac cirrhosis
Dependent pitting edema
28
Most common congenital heart defect is
VSD , associated with ****fetal alcohol syndrome
29
VSD small defects are ..................
| VSD large defects can lead to ...................
Asymptomatic , Eisenmenger syndrome
30
Most common type of ASD is
Ostium secundum
31
Ostium primum type of ASD is associated with
****Down syndrome
32
ASD splits
S2 on auscultation
33
PDA associated with
Congenital rubella
34
Left to right shunts include
VSD , ASD and patent ductus arteriosus
35
PDA symptoms include
1. Holosystolic machine-like murmur
| 2. ********Eisenmenger syndrome(reversal of shunt ) result in lower extremity cyanosis
36
Treatment of PDA
Indomethacin (decrease PGE, result in PDA closure)
37
Tetralogy of Fallot is
Stenosis of RV outflow
Right ventricular hypertrophy
VSD
Aorta overrides the VSD
38
TOF patients learn to squat in response to cyanotic spell
| Result in
Increased arteriolar vascular resistance decrease shunting
| Allow more blood to reach the lung
39
Boot shaped heart on x-ray associated with
TOF
40
Transposition of great vessels definition
Pulmonary artery arises from LV and aorta arises from RV
41
Transposition of great vessels associated with
******Maternal diabetes
42
Creation of shunt after birth is required for survival of
Transposition of great vessels patients by PGE until surgery
43
Single large vessel arise from both ventricles is
Truncus arteriosus
44
Coarctation of aorta has two forms
Infantile and adult form
45
Infantile form fo coarctation of aorta
Associated with PDA
Distal to the aortic arch but proximal to the PDA
Present as lower extremity cyanosis
Associated with *******Turner syndrome
46
Adult form of coarctation of aorta
Not associated with PDA
Coarctation distal to the aortic arch
Present as HTN in UE and hypotension in LE
Associated with ******bicuspid aortic valve
47
Engorged arteries cause *****notching of ribs on X-ray occur with
Adult form of coarctation of aorta
48
Acute rheumatic fever definition
Systemic complication of pharyngitis due to group A beta haemolytic streptococci
49
RF caused by
*******Molecular mimicry ; bacterial M protein resemble human tissues
50
Acute RF affect
Children 2-3weeks after strep throat
51
RF JONES major criteria
Polyartheritis , pancarditis , subcutaneous nodules ,Erythema marginatum , Sydenham chorea
52
Fusion of the aortic valve commissures (fish mouth appearance) result in stenosis Occur with
Rheumatic Fever
53
Aortic stenosis usually from
Wear and tear (bicuspid aortic valve increase risk)
54
................................................................ distinguish rheumatic disease from wear and tear
Coexisting mitral stenosis and fusion of aortic valve commissure
55
................................................................ distinguish rheumatic disease from wear and tear
Coexisting mitral stenosis and fusion of aortic valve commissure
56
Hallmark of aortic stenosis
Systolic ejection click followed by crescendo-decrescendo murmur
57
Hallmark of aortic stenosis
Systolic ejection click followed by crescendo-decrescendo murmur
58
Complications of aortic stenosis
Concentric left ventricular hypertrophy
Angina and syncope with exercise
Microangiopathic haemolytic anemia
59
Aortic regurgitation definition
Back flow of blood from aorta into LV during diastole
60
Aortic regurgitation arises due to
Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)
61
Aortic regurgitation clinical features
Early blowing diastolic murmur
Bounding pulses ; pulsating nail beds and head bobbing(********hyperdynamic circulation)
LV delation and eccentric hypertrophy
62
Complications of aortic stenosis
Concentric left ventricular hypertrophy
Angina and syncope with exercise
Microangiopathic haemolytic anemia
63
Aortic regurgitation definition
Back flow of blood from aorta into LV during diastole
64
Aortic regurgitation arises due to
Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)
65
Mitral valve prolapse definition
Ballooning of mitral valve into left atrium during systole
66
Complications of aortic stenosis
Concentric left ventricular hypertrophy
Angina and syncope with exercise
Microangiopathic haemolytic anemia
67
Aortic regurgitation definition
Back flow of blood from aorta into LV during diastole
68
Aortic regurgitation arises due to
Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)
69
Aortic regurgitation clinical features
Early blowing diastolic murmur
| Bounding pulses
70
Aortic regurgitation definition
Back flow of blood from aorta into LV during diastole
71
Aortic regurgitation arises due to
Aortic root dilation (syphilitic aneurysm ) or valve damage (IE)
72
Mitral valve prolapse definition
Ballooning of mitral valve into left atrium during systole
73
Mitral valve prolapse due to
Myxoid degeneration in valve making it floppy
74
Mitral valve prolapse clinical feature
Mid-systolic click followed by regurgitation murmur
75
Mitral valve prolapse clinical feature
Mid-systolic click followed by regurgitation murmur
76
Mitral regurgitation definition
Reflux of blood from LV into LA during systole
77
Mitral regurgitation Usually arises as a complication of
Mitral valve prolapse
78
Mitral regurgitation clinical feature
Holosystolic blowing murmur “louder with squatting or expiration”
79
Mitral regurgitation Usually arises as a complication of
Mitral valve prolapse
80
Mitral valve prolapse clinical feature
Mid-systolic click followed by regurgitation murmur
81
*****Chronic RHD create ................ while acute RHD create ....................
Mitral stenosis , mitral regurgitation
82
Mitral stenosis clinical feature
Opening snap followed by diastolic rumble (طنين)
83
Mitral stenosis clinical feature
Opening snap followed by diastolic rumble
84
*****Chronic RHD create ................ while acute RHD create ....................
Mitral stenosis , mitral regurgitation
85
Mitral stenosis leads to
Volume overload and dilatation of the LA
Pulmonary congestion
Pulmonary HTN
Atrial fibrillation
86
Mitral stenosis leads to
Volume overload and dilatation of the LA
Pulmonary congestion
Pulmonary HTN
Atrial fibrillation
87
Most common overall cause cause of infective endocarditis is
S.viridans (infect previously damaged valves)
88
Most common cause of IE in drug abuse
Staph aureus ( infect tricuspid)
89
Endocarditis of prosthetic valve is caused by
S.epidermidis
90
Endocarditis in patients with underlying colorectal carcinoma caused by
******S.bovis
91
Endocarditis with negative blood cultures include
HACEK organisms ( Hemophilus, Actinobacillus , cardiobacterium ,Eikenella , Kingella)
92
Infective Endocarditis clinical features
```
Fever
Murmur
Janeway lesions
Osler nodes (painful)
Anemia of chronic disease
```
93
Non bacterial Thrombotic endocarditis definition
Sterile vegetations that arise with hypercoagulable state or underlying adenocarcinoma
94
Sterile vegetation associated with SLE
| Vegetations present on both sides of mitral valve
******Libman-sacks endocarditis
95
Most common form of cardiomyopathy
Dilated cardiomyopathy
96
Dilated cardiomyopathy results in ...............dysfunction lead to biventricular CHF
Systolic
97
Dilated cardiomyopathy complications include
Mitral and tricuspid valve regurgitation , and arrhythmia
98
Causes of Dilated cardiomyopathy include
```
Idiopathic (most commonly )
Genetic mutation
Myocarditis (Coxsackie B virus )
*****Alcohol abuse
Drugs
*****pregnancy
```
99
Cause of Hypertrophic cardiomyopathy
******Genetic mutation in sarcomere protein (most commonly AD)
100
A common cause of sudden death in young athletes
Hypertrophic cardiomyopathy (by ventricular arrhythmia )
101
Hypertrophic cardiomyopathy biopsy
Myofiber hypertrophy with *****disarray
102
Causes of Resrtictive cardiomyopathy
```
Amyloidosis
Sarcoidosis
Hemochromatosis
Endocardial fibroelastosis (children)
Loeffler syndrome
```
103
Classic finding of Restrictive cardiomyopathy
Low voltage EKG , diminished QRS amplitudes
104
Most common primary cardiac tumour in adults
Myxoma (benign mesenchymal proliferation )
105
Myxoma present as
Pedunculated mass in the left atrium
| Causes syncope due to obstruction of mitral valve
106
Rhabdomyoma associated with
*******Tuberous sclerosis
107
Most common primary cardiac tumour in children is
Rhabdomyoma
