Flashcards in Heart Deck (43)
Where does the ostium primum anomaly occur?
Adjacent to the AV valves and is usally associated with a cleft anterior mitral leaflet
What rae the complicATIONS of ASD's?
Cyanoisis, Atrial Arrhythmias, RVH, Right HF, Bacterial endocarditis, and Paradoxical Emboli
What are VSDs characterized by?
left to right shunt
left ventricular dilation
What anatomical finding is often associated with coarctation of the aorta? clinical finding?
Reduced of Absent femoral pulses
HTN in UE
Which arteries are combined in Truncus ARteriosis?
Aorta, Pulmonary Artery, and Coronary ARteries
In Tetralogy of Fallot, where does the aorta receive blood from?
It overrides the VSD and receives blood from both ventricles
What characterizes Endocardial Fibroelastosis?
- Fibroelastotic thickening of the endocardium of LV (can affect valves)
- Gray-white patches of thickening accompanied by degeneration of subendocardial myocytes
What is the pathological cardiologic outcome of Hyperthyroidsim? What's the main pathophysiologic cause?
High output heart failure
This occurs because peripheral resistnace decreases which requires increased cardiac output.
Over what pathologic processes do mural thrombi often form?
On the endocardium, over the infarction
Over ventricular aneurysms- found at the healed, transmural myocardial infarct
When do subendocardial circumferential infarcts generally occur?
Post hypoperfusion of the heart secondary to poor coronary blood flow, often in the setting of hypotension.
Coronary artery narrowing is common (total occlusion rare and most associated with transmral myocardial infarction)
What is Dressler Syndrome?
Post (2-10 wks) MI syndrome delayed pericarditis. Pain develops and can be confused with postinfarction or recurrent angina.
What occurs for 1/2 deaths after acute MI?
actue infarction is often associated with Premature Vnetricular beats, VTach, complete Heart Block, and VFib- acute ischemia may promote conductiondisturbances and myocardial irritability.
What complications could be seen a between days 3 -7 post MI?
Postmyocardial infarction syndrome??
(1. anterior rupture leads to, Cardiac Tamponade
2. Septal Perforation+ Interventricular septum rupture, throombosis in LAD is MCC
3. Papillary muscle rupture associated with inferior AMIs due toRCA thromboisis and leads to MV REGURG)
What causes cardiac tamponade?
A ruptured myocardial wall
What clinical finding is associated with cardiac tamponade?
Pulsus paradoxus (>10mmHg fall in aerterial blood pressure with inspiration)
when can myocardial rupture and hemorrhage into the pericardial sac occur? Why this time?
Any time during the first 3 weeks but most commonly between the 1st and 4th days.
Because, during this interval the infarcted wall is weak, being composed of soft necrotic tissue.
What degrades the extracellular matrix with the infarct?
Proteases released by inflammatory cells
What complication typically occurs 1-3 days post MI (pathoma) or 2-10 weeks after a transmural MI (Rubin's)?
What defines Cor Pulmonale?
Right Ventricular Hypertrophy
Dilationsecondary to Pulmonary HTN
What's th emost common cause of Cor PUlmonale?
Chronic Obstructive Pulmonary Disease (usually as a result of smoking)
What are common causes of death in Hypertensive patients/?
CHF, Intracerebral hemoorrhage, Coronary atherosclerosis and MI, Dissecting aneurysm of the aorta, ruptured berrky aneurysm of the cerebral ciculation Renal failure (when nephrosclerosis becomes severe)
In Libman-Sacks endocarditis, where are the vegetations normally found?
On the undersurface of the mitral valve close to the origin of the leaflets form the valve ring
What is the likely causes and complication of marantic endocarditis?
Causes: Increased blood coagulability and Immune-complex deposition
Complication: embolization to distant organs
What are three main causes of calcific aortic stenosis?
1. Rheumatic Disease
2. Senile Calcific Stenosis
3. Congenital Bicuspid Aortic Stenosis
In general, it is related to the cumulative effect of years of trauma due to turbulent blood flow around the valve.
Inflammatory lesions distinctively within the heart that consist of foci of eosinophilic material surrounded by T lymphocytes, occasional plasma cells, and plump macrophages called "Anitschkow cells".
Describe Anitschkow cells
Reactive Histiocytes seen with abundant cytoplasm
central round to ovoid nuclei in which the chromatin is disposed in a central, slender, wavy ribbon )caterpillar cells).
What cardiac lesions develop from acute rheumatic fever?
Endocarditis, myocarditis and /or pericarditis
What diseases are the most common causes of Heart Failure in order of most common?
1. Chronic Rheumatic Disease 2. Valvular Stenosis or Insufficiency
What clinical manifestations are seen in bacterial endocarditis?
Infracts and abscesses (brain, kidneys, spleen, intestines, extremities) , neurological dysfunction, mycotic aneurysns of cerebral vessels, intracerebral bleeding