Flashcards in Cardiovascular Diseases 2 Deck (68)
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1
Sterling's hypothesis
Volume of blood in the chamber is proportional to the contractile ability of the heart in that chamber
2
What are the 3 causes of increased cardiac workload?
Hypertension, vascular disease or MI
3
What is the result of increased cardiac work?
Increased stress- hypertrophy and/or dilation= cardiac dysfunction
4
What are the 2 main results of left sided heart failure that have effects throughout the body?
Low output
congestion
5
What are the effects of low output resulting from left ventricular heart failure
pre-renal azotremia (high N2content in blood)
Salt and fluid retention (renin-angiotensin activation/natriuretic peptides)
Brain-irritability, decreased attention, stupor>coma
6
What are the effects of congestion, resulting from left ventricular heart failure?
Lungs: pulmonary congestion and oedema. Dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, blood tinged sputum, cyanosis, increased pulmonary wedge pressure
7
Causes of right sided heart failure
Left heart failure
Cor pulmonale
8
What is cor pulmonale
Abnormal enlargement of the right side of the heart as a result of lung disease or pulmonary blood vessels
9
Organs/areas affected by right sided heart failure
Liver and spleen
Kidneys
Pleura/pericardium
Peripheral tissues
10
What are the effects of right sided heart failure on the liver and spleen
Passive congestion (nutmeg liver)
Congestive splenomegaly
Ascites
11
Autopsy findings of cardiac heart failure
Cardiomegaly, chamber dilation, hypertrophy of myocardial fibres, BOXCAR nuclei, pulmonary/peripheral oedema
12
What are BOXCAR nuclei?
Rectangular nuclei in hypertrophied myocytes
13
Valvular opening problems
Stenosis
14
Valvular closing problems
Regurgitation
15
70% valvular heard disease is made up of what 2?
Aortic and mitral stenosis
16
Causes of aortic stenosis
Senile-old age
Rheumatic heart disease
17
Causes of mitral stenosis
Rheumatic heart disease
18
Rheumatic heart disease follows what infection?
Group A strep
19
Effects of rheumatic heart disease
Pancarditis:
1)endocarditis
2)myocarditis
3)pericarditis
20
5 acute effects of rheumatic heart disease
Inflammation
Asschoff bodies (nodules)
Anitschlcow cells (enlarged macrophages with asschoff bodies)
Pancarditis
Vegetations on chordae tendinae
21
3 chronic effects of rheumatic heart disease
Thickened valves
Commisural fusion
Thick, short chordae tendinae
22
Left ventricular hypertrophy but no hypertension
Aortic stenosis
23
Calcification of the mitral skeleton, usually a result of regurgitation, but sometimes stenosis
Mitral annular calcification
24
What mitral valve dysfunction is more common in females than males?
Mitral annular calcification
mitral valve prolapse
25
Causes of aortic regurgitation
Syphilis
Rheumatoid arthritis
Marfan's syndrome
26
Causes of mitral regurgitation
Mitral valve prolapse
Infectious
Fen Phen (anti obesity drug)
Weakness in papillary muscles/chordae tendinae
Mitral annular calcification
27
Myxomatous (pathological weakening of tissue) degeneration of mitral valve. Associated with connective tissue disorders.
Mitral valve prolapse
28
Usually asymptomatic, mid-systolic 'click', holocystolic murmur if regurg present, occasional chest pain, dyspnoea
Mitral valve prolapse
29
Effects of mitral valve prolapse
97% no significant effects
3% infective endocarditis, mitral insufficiency, arrythmias, sudden death
30