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DMD 5247 > Heart Pathology > Flashcards

Heart Pathology Flashcards

(61 cards)

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1
Q

heart failure

A

heart cannot pump blood sufficient to meet the body’s needs

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2
Q

early compensations of heart failure

A

catecholamines
frank-starling mechanism
hypertrophy

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3
Q

eventual outcome of heart failure

A

ischemia

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4
Q

where does blood pool with left heart failure

A

lungs
-pulmonary edema

cyanosis is another consequence of left heart failure

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5
Q

where does blood pool with right heart failure

A

periphery of the systemic circuit
-peripheral edema

hepatomegaly
splenomegaly
ascites

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6
Q

left heart failure common causes

A

systemic hypertension
mitral or aortic valve disease
primary heart disease(amyloidosis)

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7
Q

heart changes during left heart failure

A

left ventricular hypertrophy
left ventricular dilation
left atrium may be enlarged

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8
Q

consequences of left heart failure

A 
dyspnea
orthopnea
enlarged heart
increased heart rate
rales
mitral regurgitation
systolic murmur
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9
Q

common causes of right heart failure

A

left heart failure
Cor Pulmonale
some congenital heart diseases

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10
Q

heart changes during right heart failure

A

right ventricular hypertrophy
right ventricular dilation
right atrium may be enlarged

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11
Q

consequences of right heart failure

A

peripheral edema
enlarged liver: hepatomegaly
enlarged spleen: splenomegaly

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12
Q

congenital heart disease

A

abnormalities at birth

cause is usually 90% unknown

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13
Q

3 classifications of congenital heart disease

A

left to right
right to left
coarctation

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14
Q

Left to right classification of congenital heart disease

A

ASD: atrial septal defect
VSD: ventricular septal defect
PDA: Patent ductus arteriosis

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15
Q

Atrial Septal Defect

A

may cause pulmonary hypertension

can be surgically repaired

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16
Q

Ventricular Septal Defect

A

most common
most close spontaneously
size and location matters

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17
Q

Patent Ductus Arteriosus

A
  • in the fetus, allows flow from PA to aorta
  • Generally closes by day 2 of life
  • size matters
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18
Q

Right to left classification of congenital heart disease

A

tetralogy of fallot

transposition of great arteries

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19
Q

tetralogy of fallot

A

ventricular septal defect
pulmonary stenosis
overriding aorta
right ventricular hypertrophy

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20
Q

transposition of great arteries

A

embryonic lethal in the absence of shunt

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21
Q

coarctation

A

aortic coarctation

  • narrowing of aorta
  • causes cyanosis and low blood pressure systemically
  • size matters
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22
Q

ischemic heart disease

A

myocardial perfusion can’t meet demand

usually a result of reduced coronary artery blood flow

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23
Q

4 syndromes of ischemic heart disease

A
  • angina pectoris
  • acute MI
  • chronic IHD
  • sudden cardiac death
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24
Q

stable angina pectoris

A 
intermittent chest pain
stable/chronic
-most common
-pain on exertion
-fixed narrowing of coronary arteries
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25
variant angina pectoris
pain at rest | coronary artery spasm
26
unstable/pre-infarction angina pectoris
- unpredictable pain | - plaque disruption and thrombosis
27
acute myocardial infarction
necrosis of myocardium from ischemia - due to coronary artery thrombosis - prompt reperfusion can salvage myocardium
28
clinical features of acute myocardial infarction
severe, crushing chest pain not relieved by nitroglycerin sweating, nausea
29
subendocardial infarction
affects only the inner 1/3-1/2 of the heart wall | -inner wall more affected because blood supply goes first to the outer wall
30
transmural infarction
- affects more than 1/2 of the heart wall | - more serious
31
chronic IHD
-accumulation of small ischemic insults leads to mechanical failure
32
sudden cardiac death
often a result of a lethal arrythmia without myocyte necrosis
33
hypertensive heart disease
- can affect the left or right ventricle - cor pulmonale is right ventricle enlargement due to pulmonary hypertension - PH from primary lung disorder
34
valvular heart disease can be caused by:
- murmurs - angina - CHF - Fainting
35
forms of valvular heart disease
stenosis | insufficiency
36
stenosis
failure to open
37
insufficiency
failure to close | regurgitation
38
aortic valve stenosis
stiffening and narrowing of the aortic valve - blood has difficulty exiting the heart - prolonged ejection sound
39
clinical manifestations of aortic valve stenosis
``` crescendo-decrescendo systolic heart sound decrease in stroke volume increased left ventricular pressure decreased systolic blood pressure hypertrophy of the left ventricle ```
40
aortic regurgitation
- failure of the aortic valve to properly close | - blood leaks back into the ventricle after ventricular contraction
41
clinical manifestations of aortic regurgitation
- diastolic murmur(blowing sound) of high pitch over the left ventricle - hypertrophy of the left ventricle - left ventricular failure - doppler echocardiography reveals blood flow back through the aortic valve
42
Mitral stenosis
narrowing or stiffening of the mitral valve (left AV valve) | blood flowing into the ventricle during diastole
43
clinical manifestations of mitral stenosis
- subtle crescendo diastolic murmur(rumbling) - decreased blood flow from the left atrium to the left ventricle - increased left atrial pressure - hypertrophy and dilation of the left atrium - atrial dysrhytmias(fibrillation) - increases pulmonary blood pressure - pulmonary edema - right heart failure
44
mitral regurgitation
failure of the mitral valve(left AV valve) to properly close | blood passing into atrium from ventricle during contraction
45
clinical manifestations of mitral regurgitation
``` systolic murmur hypertrophied left ventricle left heart failure pulmonary hypertension and edema right heart failure doppler echocardiography reveals blood flow back though mitral valve ```
46
Rheumatic valvular disease
rheumatic fever - diffuse inflammatory disease caused by immune response to infection by the group A Beta hemolytic streptococci - Febrile illness: inflammation of the joints, skin, nervous system, and heart - if left untreated, rheumatic fever causes rheumatic heart disease
47
mitral valve prolapse
ballooning of mitral leaflets | most patients are asymptomatic
48
infective endocarditis
microbial invasion of the heart valves, endocardium | usually mitral and aortic valves
49
Acute infective endocarditis
highly virulent infection attacks normal valve(e.g. S. aureus) 50% of patients die withing weeks Often requires surgery
50
Subacute infective endocarditis
low virulent infection colonizes abnormal valve | long course, most recover
51
cardiomyopathies
diverse group of disorders in which myocardium dysfunctions
52
dilated cardiomyopathy
congestive cardiomyopathy
53
hypertrophic cardiomyopathy
hypertension is a leading cause
54
restrictive cardiomyopathy
deposition of material in myocardium
55
causes of dilated cardiomyopathy
viral alcohol/toxin genetic abnormality
56
causes of hypertrophic cardiomyopathy
hypertension sarcomere mutation ventricle can't fill
57
causes of restrictive cardiomyopathy
deposition of material in myocardium heart wall is stiff, can't fill idiopathic amyloidosis or sarcoidosis
58
pericardial disease
disorders of the pericardium - acute pericarditis - pericardial effusion
59
acute pericarditis
causes severe chest pain that worsens with respiratory movements an with lying down dangers: tamponade, chronic fibrosis
60
pericardial effusion
accumulation of fluid within the pericardium | -tamponade: physical pressure compresses heart
61
tumors
primary tumors are very uncommon -most are benign malignant heart cancers are often metastasized from lung or lymphoma

DMD 5247 (13 decks)

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