Lecture 9 Heart and Blood Vessels Flashcards
(132 cards)
1
Q
Define congenital cardiovascular disease
A
Heart disease present from birth
2
Q
Define congenital cardiovascular disease
A
Heart disease present from birth
3
Q
Define cardiac failure
A
4
Q
How does heart compensate and what results?
A
Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.
5
Q
Signs/symptoms of CV disease?
A
All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).
6
Q
Define stenosis (valvular heart disease).
A
Failure to completely open.
7
Q
What are the three ways for valvular heart disease?
A
Stenosis, incompetence/regurgitation and vegetations
8
Q
What does incompetence/regurgitation mean for valvular heart disease?
A
Failure to close, allowing reversible flow
9
Q
What does vegitation mean for valvular heart disease?
A
Abnormal tissue growth on valve (fibrin, platelets and bacteria)
10
Q
What is the most common valvular disease?
A
Stenosis of aortic and mitral valves. (2/3rd of
11
Q
What is valvular stenosis mainly due to?
A
Primary valve cusp abnormality
12
Q
Why do vegetations form?
A
From infective endocarditis & rheumatic fever
13
Q
What is the clinical presentation of vegetations?
A
Sepsis, heart failure, new murmur.
14
Q
As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?
A
Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use
15
Q
What is the pathological cause for mitral stenosis?
A
Rheumatic fever
16
Q
What is the pathological cause for mitral incompetence?
A
Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps
17
Q
What is the pathological cause for aortic stenosis?
A
Rheumatic fever, calcific degerneration
18
Q
What is the pathological cause for aortic incompetence?
A
Rheumatic fever, dilation of aortic root, rheumatological disorders.
19
Q
Ehst is the pathological cause for endocarditis?
A
Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves
20
Q
What are the clinical features of mitral stenosis?
A
Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.
21
Q
What are the clinical features of mitral incompetence?
A
Murmur. Variable haemodynamic effect
22
Q
What are the clinical features of aortic stenosis?
A
Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.
23
Q
What are the clinical features of aortic incompetence?
A
Murmur. Collapsing pulse. Angina. L vent failure/ sudden death
24
Q
What are the clinical features of endocarditis?
A
Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,
25
Define endocardium?
inner lining of the heart and its valves
26
Where does infection occur in the endocardium?
Edge of heart valves
27
What does endocarditis on the R side mean?
IV drug use
28
What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?
Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys
29
What affects previously normal valves?
IV drug abusers
30
When considering prophylaxis and endocarditis?
MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.
31
Define preicardium
Heart sac
32
What causes pericarditis and mycarditis?
TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,
33
Name some unusual cardiac diseases?
Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.
34
Name dilated cardiac diseases
Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid
35
Name hypertrophic cardiac diseases
Idiopathic, genetic, storage disease
36
Name restrictive cardiac diseases?
Idiopathic, amyloidosis, radiation induced, chemo related
37
What can hypertrophic cardiomyopathy led to?
end stage dilation
38
a 1/3rd of hypertrophic cardiomyopathy have?
intermittent left ventricular outflow obstruction
39
Clinical features of HCM?
Black outs, SOB, chest pain, palpitations, atrial fib,
40
What causes HCM?
50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements
41
What I didn't know that could cause aneurysms?
Autoimmune diseases, bacteria, fungus, syphilis
42
Aneurysm treatments?
Stents, surgery, reducing arterial pressure
43
Where are atherosclerotic aneuryms found?
Lower abdominal aorta and iliac arteries
44
Where are aortic dissections found?
Aorta and major branches
45
Where are berry aneurysms found?
circle of willis
46
Where are micro aneurysms found?
intracerebral vapillaries
47
Where are syphilitic aneurysms found?
ascending & arch of aorta
48
Where are mycotic (infective) aneurysms found?
Root or aorta and and vessel
49
What are the clinical effects of atherosclerotic aneurysms
Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage
50
What are the clinical effects of aortic dissection?
Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta
51
What are the clinical effects of micro-aneurysms?
Intracerebral haemorrhage (hypertension)
52
What are the clinical effects of syphilitie aneurysms?
Aortic incompetence
53
What is the circle of willis?
Circle of vessels around the base of the brain
54
What is the circle of willis?
Circle of vessels around the base of the brain
55
Define cardiac failure
heart unable to pump blood at rate required for normal functioning
56
How does heart compensate and what results?
Cardiac hypertrophy and/or dilation. Eventually inability to maintain normal.
57
Signs/symptoms of CV disease?
All-over excessive fluid filled veins -> systemic venous congestion and oedema. SOB, Fatigue, pulmonary oedema (fluid in lungs).
58
Define stenosis (valvular heart disease).
Failure to completely open.
59
What are the three ways for valvular heart disease?
Stenosis, incompetence/regurgitation and vegetations
60
What does incompetence/regurgitation mean for valvular heart disease?
Failure to close, allowing reversible flow
61
What does vegitation mean for valvular heart disease?
Abnormal tissue growth on valve (fibrin, platelets and bacteria)
62
What is the most common valvular disease?
Stenosis of aortic and mitral valves. (2/3rd of
63
What is valvular stenosis mainly due to?
Primary valve cusp abnormality
64
Why do vegetations form?
From infective endocarditis & rheumatic fever
65
What is the clinical presentation of vegetations?
Sepsis, heart failure, new murmur.
66
As well as general reasons like hypertension and age degeneration, what are underlying causes of valvular disease?
Calcific aortic valve disease? Carcinoid syndrome, prosthetic heart valves and IV drug use
67
What is the pathological cause for mitral stenosis?
Rheumatic fever
68
What is the pathological cause for mitral incompetence?
Rheumatic fever, Dilation of mitral valve, papillary muscle fibrosis/dysfunction, degeneration of valve cusps
69
What is the pathological cause for aortic stenosis?
Rheumatic fever, calcific degerneration
70
What is the pathological cause for aortic incompetence?
Rheumatic fever, dilation of aortic root, rheumatological disorders.
71
Ehst is the pathological cause for endocarditis?
Rheumatic disease, bacteria, IV drug use, calcific valve disease, prosthetic heart valves
72
What are the clinical features of mitral stenosis?
Murmur. L atrial and R ventricle hypertrophy. Pulmonary hypertension.
73
What are the clinical features of mitral incompetence?
Murmur. Variable haemodynamic effect
74
What are the clinical features of aortic stenosis?
Murmur. L ventricle hypertrophy. Angina, syncope, L vent failure/ sudden death.
75
What are the clinical features of aortic incompetence?
Murmur. Collapsing pulse. Angina. L vent failure/ sudden death
76
What are the clinical features of endocarditis?
Murmurs. malaise, clubbing, arthralgia, pyrexia, skin lesions, spenomegaly, glomerulonephritis, haematuria,
77
Define endocardium?
inner lining of the heart and its valves
78
Where does infection occur in the endocardium?
Edge of heart valves
79
What does endocarditis on the R side mean?
IV drug use
80
What affects abnormal valves usually after dental extraction/ cleaning/ bronchoscopy or tonsillectomys?
Streptococci (a haemolytic). Cocci (cucu) because I never saw this after tonsillectomys
81
What affects previously normal valves?
IV drug abusers
82
When considering prophylaxis and endocarditis?
MUST give antibiotics to those at risk of developing endocarditis prior to any procedure that may produce a bacteraemia.
83
Define preicardium
Heart sac
84
What causes pericarditis and mycarditis?
TB, uraemia, carcinoma, MI, post surgery, Drugs, connective tissue disease, radiation, viral, bacterial, parasitic,
85
Name some unusual cardiac diseases?
Cardiomyopathy, Sarcoidosis, amyloidosis, thyrotoxicosis, myxoedema, alcoholism, pregnancy, drug induced.
86
Name dilated cardiac diseases
Idiopathic, alcohol, peripartum, genetic, myocarditis and sarcoid
87
Name hypertrophic cardiac diseases
Idiopathic, genetic, storage disease
88
Name restrictive cardiac diseases?
Idiopathic, amyloidosis, radiation induced, chemo related
89
What can hypertrophic cardiomyopathy led to?
end stage dilation
90
a 1/3rd of hypertrophic cardiomyopathy have?
intermittent left ventricular outflow obstruction
91
Clinical features of HCM?
Black outs, SOB, chest pain, palpitations, atrial fib,
92
What causes HCM?
50% familial, autosomal dominant. Genetic defect 1 of 4 genes that encode cardiac contractile elements
93
What I didn't know that could cause aneurysms?
Autoimmune diseases, bacteria, fungus, syphilis
94
Aneurysm treatments?
Stents, surgery, reducing arterial pressure
95
Where are atherosclerotic aneuryms found?
Lower abdominal aorta and iliac arteries
96
Where are aortic dissections found?
Aorta and major branches
97
Where are berry aneurysms found?
circle of willis
98
Where are micro aneurysms found?
intracerebral vapillaries
99
Where are syphilitic aneurysms found?
ascending & arch of aorta
100
Where are mycotic (infective) aneurysms found?
Root or aorta and and vessel
101
What are the clinical effects of atherosclerotic aneurysms
Lower limb ischaemia, pulsatile abdominal mass, rupture, massive haemorrhage
102
What are the clinical effects of aortic dissection?
Loss of peripheral pulses, haemopericardium, rupture, double barrelled aorta
103
What are the clinical effects of micro-aneurysms?
Intracerebral haemorrhage (hypertension)
104
What are the clinical effects of syphilitie aneurysms?
Aortic incompetence
105
What are the clinical effects of mycotic (infective) aneurysms?
Thrombosis or rupture. Cerebral infarction of haemorrage.
106
What is the circle of willis?
Circle of vessels around the base of the brain
107
When is someone offered 24hr ambulatory monitoring?
When they have BP 140/90
108
What is mild diastolic bp between?
95-104mmHg
109
What is moderate diastolic bp between?
105-114mmHg
110
What is severe diastolic bp?
>115mmHg
111
Primary hypertension is also known as?
Essential hypertension (95%)
112
Risk factors for essential hypertension?
(non-modifiable) Genes, family history. (Modifiable) diet, lifestyle weight, alcohol, smoking.
113
Causes of secondary hypertension?
Renal (polycystic kidney disease), Endocrine (thyrotoxicosis), vascular (raise IV volume), neurogenic (acute stress)
114
What is benign hypertension?
Remains stable, normal life until complications arise
115
What is malignant hypertension?
Accelerated hypertensive disease, 5% of cases. Rapid ^ BP 90% die in first year.
116
Hypertension can lead to what for blood vessels?
atherosclerosis, arteriosclerosis and ^risk of MI, rupture and dissection
117
Define sclerosis
Thickening/hardening of body tissue
118
Hypertension can lead to what for the heart?
Heart disease, left ventricular hypertrophy, cardiac failure and MI
119
Hypertension can lead to what for the kidney?
Benign nephrosclerosis and renal failure
120
Hypertension can lead to what for the eyes?
Hypertensive retinopathy,
121
What are retinopathy grades?
Grade I: thicking of arterioles. II: arteriolar spasms. III haemorrages. IV Papilloedema (seen in malignant hypertension)
122
Define adverse prognosis?
preventing success in outcomes
123
Factors indicating adverse prognosis in hypertension?
Male, young, black ethnicity, smoker, persistent diastolic BP > 115, diabetes, hypercholesterolemia, obesity, organ damage.
124
What can diabetic vascular disease cause?
Damage to vessels/ kidneys/ nerves/ retinas
125
Complications of diabetic vascular disease?
Gangrene, renal failure and blindness
126
Define gangrene
Localised death of tissue
127
How can diabetic vascular disease be improved?
effective diabetes control
128
What is deep vein thrombosis?
When normal venous return is impeded -> thrombosis.
129
What causes DVT?
immobility, malignancy, pregnancy, child birth, oestrogens, haematological disorders, IV cannulas.
130
What is varicosities?
Common problem. Torte and distended veins. Ulceration on ankles and lower legs.
131
What causes varicosities?
incompetent valves in legs, imparied venous return, stasis, oedema, fibrin deposits around veins.
132
Common congenital CV diseases?
Septal defects, patent ductus arteriosus, corarctation of aorta (narrowed), transposition of vessels, fallot's tetralogy
