Histopathology Cardiovascular Disease Flashcards Preview

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Flashcards in Histopathology Cardiovascular Disease Deck (41)
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1
Q

Ischaemic Heart Disease Definition

A

Definition

2
Q

Ischaemic Heart Disease Factors that contribute to the reduction of coronary artery perfusion which results in myocardial ischemia

A
  1. Atherosclerotic stenosis
  2. Platelet aggregation
  3. Coronary artery vasospasm
  4. Non-atherosclerotic coronary artery disease
  5. Systemic Haemodynamic derangement
3
Q

Atherosclerotic Stenosis: Epi

A
  • Over 90% of patients with ischaemic heart disease have significant (>75% of cross section of the vessel) stenosis of one or more of the three major coronary arteries.
  • 30% have single vessel disease (left anterior descending- -LAD)/ Left circumflex/Right coronary.
  • 30% → 2 vessels
  • 40% triple vessel disease
4
Q

Atherosclerotic Stenosis: Site of Stenosis

A

• Usually Proximal (within the first 4 cm) in the LCA (LAD or LC) and somewhat more distal in the RCA.

5
Q

Platelet aggregation: Definition

A

Rupture and fissuring of atherosclerotic plaque seems to be the initiating factor in most acute cardiac events in IHD.

6
Q

Platelet aggregation: The Exposure of the plaque content leads to

A

Platelet adherence and aggregation with the development of thrombus which may remain localised to occlude the vessel or may embolise downstream,

7
Q

Vasospasm: Definition

A

Mechanisms unclear
Non-atheroscleroitc lesions of coronary arteries
• Coronary artery emboli
• Arteritis (Kawasaki’s syndrome, Polyarteritis nodosa)
Coronary artery dissection
Systemic haemodynamic derangements
Left ventricular failure

8
Q

Vasospasm: Systemic haemodynamic derangements

A

A drop in blood pressure (shock, haemorrhage, operations etc) may severely reduce coronary artery perfusion in vessels which are already affected by fixed stenosis.

9
Q

Myocardial infarction: Two classical patterns of infarction

A
  • Localised transmural infarct in which the entire thickness of the wall is involved – definable occlusive disease.
  • Subendocardial type where there is extensive infarction involving the inner third of the myocardium. Usually severe triple vessel disease but often-specific occlusive lesions are absent.
10
Q

Myocardial infarction: LCA disease causes infarct in

A

Anterior wall, apex and anterior part of the interventricular septum

11
Q

Myocardial infarction: LC disease causes infarct in

A

Lateral wall

12
Q

Myocardial infarction: RCA disease causes infarct in

A

Posterior wall and posterior part of the septum?

13
Q

Myocardial infarction: Complications in myocardial infarction

A
Sudden cardiac death – 25%
Arrhythmias – more than 75%
Mural (endocardial) thrombosis – 30% +. Clinically significant muscle – 1-5%
Cardiogenic shock – 10%
Pericarditis – 30%
Left ventricular failure- 60%
14
Q

Cor pulmonale Definition

A

A right ventricular enlargement secondary to pulmonary hypertension caused by disorders that affect either the structure or function of the lungs.

15
Q

Cor pulmonale Excluded in the definition

A

Right ventricular enlargement caused by diseases of the left side of the heart or by congenital heart disease are excluded by this definition.

16
Q

Cor pulmonale Morphological terms

A

There is right ventricular dilation (as for instance in PE) and, in those disorders causing chronic cor pulmonale, right ventricular hypertrophy. (RV thickness > 0.5 cm).

17
Q

Cor pulmonale Disorders which predispose to Cor Pulmonale

A

Diseases of the lungs
Diseases of pulmonary vessels
Diseases affecting chest moement

18
Q

Cor pulmonale Diseases of the lungs

A

Chronic onstructive airways disease (COAD)
Pulmonary fibrosis
Cystic fibrosis

19
Q

Cor pulmonale Disease of pulmonary vessels

A

Pulmonary embolism

Primary pulmonary hypertension

20
Q

Cor pulmonale Diseases affecting chest movement

A

Kyphoscoliosis
Marked obesity (Pickwickian syndrome)
Neuromuscular disorders

21
Q

Cardiac Valvular Disease → Definition

A

A relatively restricted number of conditions are responsible for disorders of the cardiac valves.

22
Q

Cardiac Valvular Disease →Types

A

Mitral Valve disease
Aortic Valve disease
Aortic Valve disease
Cardiomyopathy

23
Q

Cardiac Valvular Disease → Mitral Valve disease

A

Stenosis

Regurgitation

24
Q

Cardiac Valvular Disease → Regurgitation intrinsic valve lesions

A
  • Rheumatic heart disease
  • Bacterial endocarditis
  • Floppy mitral valve
  • Calcification of valve ring (senile)
25
Q

Cardiac Valvular Disease → Regurgitation extrinsic valve lesions

A
  • Papillary muscle dysfunction
  • Rupture
  • Fibrosis
  • Rupture of chordae
26
Q

Cardiac Valvular Disease → Aortic Stenosis

A
  • Calcific disease
  • Bicuspid valve with calcification
  • Tricuspid valve
  • Rheumatic pattern of disease
  • Rheumatic damage with mitral disease
  • Rheumatic damage with normal mitral valve
  • Congenital valve stenosis
27
Q

Cardiac Valvular Disease → Aortic valve regurgitation

A
  • Tricuspid (normal valve)
  • Rheumatic
  • Aortic root disease
  • Aortitis
  • Non-inflammatory medial degeneration
  • Post bacterial endocarditis
  • Bicuspid valve
  • Post bacterial endocarditis
  • Without bacterial endocaritis
28
Q

Cardiomyopathy: Definition

A

Intrinsic myocardial disease which does not arise from inflammatory disorders or from IHD

29
Q

Cardiomyopathy: Three morphological patterns

A

Dilated
Hypertrophic
Restricted

30
Q

Cardiomyopathy: Dilated cardiomyopathy

A

A number of diverse conditions are described as resulting in dilated cardiomyopathy
• Alcohol
• Pregnancy associated nutritional deficiency
• Genetic defect
• Post-viral myocarditis

31
Q

Cardiomyopathy: Hypertrophic pattern

A

Autosomally dominant pattern of inheritance giving rise to asymmetric left ventricular hypertrophy in young people.

32
Q

Cardiomyopathy: Restricted pattern

A

Usually the result o amyloid infiltration of the myocardium in the elderly

33
Q

Sites of atheroma formation

A
  • Coronary arteries
  • Carotid arteries
  • Distal aorta
  • Femoral arteries
34
Q

Aneurysm: Definition

A

Localised abnormal dilation of any vessel. Aneurysms developed as a result of a localised weakness, usually acquired, in the vessel wall.

35
Q

Aneurysm: Large aneurysmal structures

A

Atherosclerotic (fusiform) aneurysm
Dissecting aneurysm (Acute aortic dissection))
Syphilitic (saccular) aneurysm

36
Q

Aneurysm: Medium sized aneurysmal structures

A

Saccular (Berry) aneurysm o Circle of Willis
Mycotic aneurysm
Traumatic aneurysm
Congenital Fibromuscular dysplasia

37
Q

Aneurysm: Microaneurysms

A

Charcot-Bouchrd aneurysms
Diabetic microaneurysms
Cerebral amyloid angioopathy

38
Q

Vasculitis: Definition

A

Inflammation and necrosis of blood vessel walls.

39
Q

Vasculitis: Large vessels effects

A

Predominant effect larger vessels the predominant effect will be ischaemia as a result of thrombotic occlusion of the vessel at the site of the inflammatory focus. The ischaemia will usually manifest itself as tissue necrosis.

40
Q

Vasculitis: Smaller vessels

A

While tissue necrosis may occur, haemorrhage is commonly the redominant manifestation (eg vasculitic purpura; gastrointestinal haemorrhage).

41
Q

Vasculitis: Causes

A

Bacterial infection
Irradiation
Necrotising vasculitides.

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