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Heart And Blood Vessels Flashcards

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0
Q

What 4 things cause heart failure?

A

Ischaemic heart disease, hypertension, diseased heart valves, congenital heart disease.

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1
Q

What is heart failure?

A

Heart unable to pump, blood at rate required for normal functioning.

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2
Q

What happens during heart failure?

A

The heart compensates leading to cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.

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3
Q

Give 4 symptoms of heart failure

A

Shortness of breath
Fatigue
Fluid in lungs
Fluid all over

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4
Q

What are the different types of heart failure?

A

Acute vs chronic

One sided vs both sides

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5
Q

What is valvular stenosis?

A

Failure to open completely, impeding flow

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6
Q

What is valvular incompetence/regurgitation?

A

Failure to close allowing reverse flow

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7
Q

What are valvular vegetations?

A

Abnormal tissue growth on valve (fibrin, platelets, bacteria)

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8
Q

Which is the most common valve disease?

A

Aortic and mitral stenosis.

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9
Q

What is valvular stenosis usually due to?

A

Primary valve cusp abnormality, chronic process.

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10
Q

What is valvular regurgitation usually due to?

A

Disease of cusps and damage to supporting structure eg tendinous cords, papillary muscles.

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11
Q

What can vegetations result from?

A

Infective endocarditis and rheumatic fever.

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12
Q

List 11 underlying causes of valvular heart disease

A 
Infection - endocarditis/rheumatic disease
Calcific aortic valve disease
Age related degeneration
Carcinoid syndrome
Fibrosis and muscle rupture after MI
Heart failure
Hypertension
Congenital
Prosthetic heart valves
Connective tissue disorders
IV Drug use
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13
Q

What is the pathological cause of mitral stenosis?

A

Rheumatic fever

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14
Q

What are the clinical features of mitral stenosis?

A

Pulmonary hypertension, L atrial and R ventricular hypertrophy, murmur.

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15
Q

What are the 4 causes of mitral incompetence?

A

Rheumatic fever, dilation of mitral valve, papillary muscle fibrosis and dysfunction, degeneration of valve cusps.

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16
Q

What are the clinical features of mitral incompetence?

A

Variable haemodynamic effect

Murmur

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17
Q

What are the 2 pathological causes of aortic stenosis.

A

Rheumatic fever and calcific degeneration.

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18
Q

What are the clinical features of aortic stenosis?

A

Murmur, left ventricular hypertrophy, angina, syncope, left ventricular failure or sudden death

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19
Q

What are the pathological causes of aortic incompetence?

A

Rheumatic fever, dilation of aortic root, rheumatological disorders.

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20
Q

What are the clinical features of aortic incompetence?

A

Murmur, collapsing pulse, angina, left ventricular failure.

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21
Q

What are the pathological causes of endocarditis?

A

Rheumatic disease, bacteria, prosthetic heart valves, cardiac valve disease, IV drug use.

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22
Q

What are the clinical features of endocarditis?

A

Malaise, clubbing, cardiac murmurs and failure, arthralgia, pyrexia, skin lesions, splenomegaly, haematuria, glomerulonephritis.

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23
Q

What are 7 symptoms/consequences of valvular disease?

A

Stroke, arrhythmias, syncope (fainting), ventricular hypertrophy, angina, heart failure, infarcts to kidney and spleen.

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24
What is infective endocarditis?
Infection on the edge of heart valve - vegetation is a mass of bacteria, fibrin and platelets. Puts stress on the valve and tissue can fly off and get stuck elsewhere.
25
IV drug users get infective endocarditis on which side of the heart?
The right side
26
Which bacteria causes infective endocarditis?
Streptococci - dental extraction, tonsillectomy | Staph aureus - IV drug users
27
Who is at high risk of developing endocarditis prior to any procedure that may produce bacteraemia and what should they be given?
Those at risk - heart surgery, previous infective endocarditis, immunosuppressed. Give antibiotics.
28
How do we treat vegetations?
High strength antibiotics and hospital admission
29
What is pericarditis?
Inflammation of the heart sac
30
What is myocarditis?
Inflammation of the heart muscle
31
Give 11 causes of pericarditis and myocarditis
``` Viral Bacterial Parasitic Uraemia Carcinoma MI post surgery Drugs Connective tissue disease Unknown Radiation ```
32
What are the two types of pericarditis and myocarditis?
Acute and chronic
33
What are the symptoms and signs of pericarditis and myocarditis?
Chest pain | Cardiac failure
34
How can you treat pericarditis and myocarditis?
Anti-inflammatory drugs | Surgical excision of the pericardium
35
Give 7 unusual cardiac diseases
``` Cardiomyopathy Multi-system diseases - sarcoidosis, amyloidosis Thyrotoxicosis Myxoedema Alcoholism Pregnancy Iatrogenic disease ```
36
What are the three types of cardiomyopathy
Dilated, hypertrophic, restrictive
37
What can cause dilated cardiomyopathy?
Idiopathic, alcohol, peripartum, genetic, myocarditis, sarcoid.
38
What causes hypertrophic cardiomyopathy
Genetic, idiopathic, storage disease.
39
What causes restrictive cardiomyopathy
Idiopathic, amyloidosis, radiation induced, chemotherapy related.
40
What is cardiac dilation?
Dilation of chambers, heart large and flabby
41
What is hypertrophic cardiomyopathy?
Heavy muscular hypercontracting Abnormal diastolic filling 1/3 have intermittent left ventricular outflow obstruction End stage dilation can occur Thickening of heart muscle causes young people to drop dead.
42
What are the clinical features of HCM?
Sob, chest pain, palpitations, blackout, sudden death, AF.
43
What is an aneurysm?
Localised, permanent, abnormal dilation of a blood vessel.
44
Give 12 causes of aneurysms?
Age, atherosclerosis ischaemia, hypertension, inflammation, diabetes, autoimmune diseases, bacteria, bacterial endocarditis, fungus, Marfan's syndrome, syphilis.
45
How can you treat aneurysms?
Stents, surgery, reducing arterial pressure.
46
What are the 6 types of aneurysms?
Atherosclerotic, aortic dissection, berry, micro aneurysm, syphilitic, mycotic (infective)
47
What is the site and clinical effects of an atherosclerotic aneurysm?
Lower abdominal aorta and iliac arteries, pulsating abdominal mass, lower limb ischaemia, rupture, massive haemorrhage.
48
Where would you find an aortic dissection and what are the clinical effects?
Aorta and major branches, loss of peripheral pulses, haemopericardium, external rupture, haemorrhage, double barrelled aorta.
49
Where do you find berry aneurysms and what do they cause?
Circle of Willis, subarachnoid haemorrhage
50
Where do you find micro aneurysms and what do they cause?
Intra cerebral capillaries, intra cerebral haemorrhage, associated hypertension.
51
Where do you find syphilitic aneurysm and what do they cause?
Ascending and arch of aorta, cause aortic incompetence.
52
Where would you find mycotic aneurysms and what do they cause?
Root and aorta of any vessel, thrombosis or rupture, causing cerebral infarction or haemorrhage.
53
What is the systolic blood pressure?
Pressure as the heart beats
54
What is the diastolic pressure?
Pressure as the heart relaxes
55
What is BP measured in.?
Millimeters of mercury.
56
When would you offer 24hr monitoring of BP
When it is continually over 140/90
57
What are the categories of diastolic BP?
Mild - 95/104 Moderate - 105-114 Severe - >115
58
Hypertension can be classified into...
Causes | Clinical
59
What are the two causes classification of hypertension?
Primary and secondary
60
How is hypertension classified clinically?
Benign and malignant
61
What is a nine modifiable risk factor for essential hypertension?
Genetics - family history
62
Give 4 modifiable risk factors of hypertension
Diet - high sodium Lifestyle - stress and physical inactivity Weight - obesity Alcohol and smoking
63
Give 4 secondary hypertension causes
Renal - polycystic kidney disease Endocrine - thyrotoxicosis Vascular - raised intra vascular volume Neurogenic - acute stress (surgery)
64
What is benign hypertension?
Normally remains stable, relatively normal life, until/unless complications arise
65
What is malignant hypertension?
Rapidly rising BP, 90% die within first year
66
What 5 organs does hypertension effect
``` Blood vessels Heart Kidney Eyes Brain ```
67
Give 4 complications of hypertension
Large blood vessel disease - atherosclerosis Small blood vessel disease - arteriolesclerosis Increased risk of rupture and dissection and MI
68
Give three heart disease complications of hypertension?
Left ventricular hypertrophy Cardiac failure MI
69
Give two complications of hypertension on the kidney
Benign nephrosclerosis | Renal failure
70
Give an example of hypertension complications in the eye
Hypertensive retinopathy - damage to the wall of the eye
71
What are the 4 grades of retinopathy
Grade 1 - thickening of arterioles Grade 2 - arteriolar spasms Grade 3 - haemorrhages Grade 4 - papilloedema
72
Give two complications of hypertension in the brain
Cerebral haemorrhage | Cerebral infarction
73
Give 10 factors indicating adverse prognosis in hypertension
``` Organ damage Male Young Black ethnicity Smoker Alcohol Obese Diabetes Persistent diastolic >115 High cholesterol ```
74
What four things does diabetic vascular disease damage.
Vessels, kidneys, nerves, retinas
75
What are 3 complications of diabetic vascular disease?
Gangrene, blindness, renal failure
76
Give six causes of DVT
Immobility, pregnancy and child birth, oestrogens, malignancy, clotting disorders, IV cannulas,
77
Give 6 causes of varicose veins
Valve incompetence in legs, stasis, oedema, impaired venous return, fibrin deposits around veins.
78
What can varicose veins cause
Ulceration
79
Give 7 common types of congenital cardiovascular disease
Septal defects, patent ductus arteriosus, narrowed aorta, valvular abnormalities, vessels the wrong way around, coronary artery defects, multiple defects - fallows tetralogy.

Pathology (7 decks)

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