Module 2: Cardiovascular and Hemodynamics Pathology Flashcards

Question

Describe the correlation of coronary artery disease and atherosclerosis

Answer 1

Coronary artery disease (CAD) is a dangerous manifestation of atherosclerosis, leading to ischemic heart disease and myocardial infarction ## Footnote Atherosclerosis contributes significantly to morbidity and mortality

Answer 2

Modifiable: * Hyperlipidemia * Hypertension * Smoking * Diabetes mellitus * Inflammation Non-Modifiable: * Genetics * Age * Gender

Answer 3

* Endothelial damage * Accumulation of lipoproteins and monocytes * Immune response and fatty streak formation * Smooth muscle proliferation and plaque formation * Plaque rupture or calcification

Answer 4

Fibrous cap damage can lead to plaque rupture, exposing the lipid core to the bloodstream and causing thrombosis ## Footnote This can result in heart attacks or strokes

Answer 5

* Angina pectoris * Myocardial infarction * Transient ischemic attack (TIA) * Stroke * Peripheral ischemia

Answer 6

* Lifestyle changes * Medications (e.g., statins, blood thinners) * Surgical options (e.g., angioplasty, bypass surgery)

Answer 7

morbidity, mortality

Answer 8

Foam cells form from macrophages that phagocytize LDL particles, leading to the formation of fatty streaks ## Footnote These streaks are the earliest visible lesions in atherosclerosis

Answer 9

The lipid core is exposed to the bloodstream, leading to thrombosis and potential blockage of the artery

Answer 10

* Coronary Artery Disease (CAD) * Peripheral Artery Disease (PAD) * Transient Ischemic Attack * Cerebral Vascular Accident

Answer 11

Process of stopping the flow of blood (bleeding) ## Footnote Involves the formation of blood clots at a site of injury

Answer 12

* Vascular spasm * Primary hemostasis (platelet plug formation) * Secondary hemostasis (coagulation) ## Footnote Each step is crucial for effective blood clotting and prevention of excessive bleeding.

Answer 13

Formation of a platelet plug at the site of injury ## Footnote Activated platelets aggregate and adhere to the damaged vessel wall.

Answer 14

* Collagen fibers * von Willebrand Factor (vWF) * Thrombin * ADP * Thromboxane A2 (TxA2) ## Footnote These factors initiate the recruitment and activation of additional platelets.

Answer 15

* Change shape to form extensions * Secrete more von Willebrand's factors, calcium, serotonin, ADP, and thromboxane A2 ## Footnote These changes enhance platelet aggregation and recruitment.

Answer 16

Potent vasoconstrictor released by damaged endothelial cells ## Footnote It helps reduce blood flow at the injury site.

Answer 17

Binds to collagen and helps platelets attach to vessel wall and activates them ## Footnote Essential for platelet adhesion and activation.

Answer 18

Activated platelets aggregate to form a plug at the site of injury ## Footnote This is crucial for limiting blood loss.

Answer 19

Reinforces the platelet plug with a fibrin mesh ## Footnote Clotting factors are activated to convert fibrinogen to fibrin.

Answer 20

Converts fibrinogen to fibrin ## Footnote Thrombin is a key enzyme in coagulation.

Answer 21

Enzymatic breakdown of the fibrin threads/mesh within a blood clot ## Footnote It allows the clot to dissolve after the vessel is healed.

Answer 22

* Plasminogen: Precursor to plasmin * t-PA: Activates plasmin, breaks down fibrin ## Footnote t-PA is released by endothelial cells and increases production when clotting factors are near.

Answer 23

* t-PA: Activates fibrinolysis * Decreased vitamin K: Reduces clotting factor production * Heparin: Inactivates thrombin * Warfarin: Blocks vitamin K effects * Aspirin: Prevents platelet aggregation ## Footnote These medications are used to prevent excessive clotting.

Answer 24

Conditions that lead to excessive bleeding ## Footnote They can occur due to defects in hemostasis.

Answer 25

Conditions that lead to excessive clotting ## Footnote These disorders can result in complications like DVT and stroke.

Answer 26

Activates the coagulation cascade via the common pathway ## Footnote It plays a crucial role in the conversion of fibrinogen to fibrin.

Answer 27

Pathway that allows for the conversion of fibrinogen to fibrin ## Footnote It is activated by both intrinsic and extrinsic pathways.

Answer 28

Promotes platelet activation and aggregation ## Footnote It is released by activated platelets.

Answer 29

Causes vasodilation and inhibits platelet aggregation ## Footnote Released by healthy endothelial cells.

Answer 30

Blocks the production of Thromboxane A2 ## Footnote This prevents platelet aggregation.

Answer 31

False ## Footnote The main goal is to reinforce the platelet plug with fibrin.

Answer 32

Promotes coagulation ## Footnote Involves factors that lead to clot formation.

Answer 33

Prevents excessive or inappropriate clotting ## Footnote Involves factors that inhibit coagulation.

Answer 34

Inhibit platelet aggregation ## Footnote Aspirin is a common example of an antiplatelet medication.

Answer 35

* PT: Screens extrinsic pathway activity * PTT: Screens intrinsic pathway activity ## Footnote These tests help assess coagulation status.

Answer 36

Extravasation of blood from vessels ## Footnote Hemorrhage can occur due to various causes such as trauma or disease.

Answer 37

Association of the formation of thrombus ## Footnote Thrombotic conditions can lead to vessel blockage.

Answer 38

1-2mm hemorrhages; red in color ## Footnote They indicate small blood vessel leakage.

Answer 39

3-5mm hemorrhages; purple in color ## Footnote Purpura can signify more serious underlying conditions.

Answer 40

1-2cm hematomas; bruise or contusion ## Footnote Result from blood leaking from broken vessels beneath the skin.

Answer 41

Pooling of blood in soft tissue ## Footnote Hematomas can occur due to trauma or other causes.

Answer 42

* Endothelial injury * Stasis or turbulent blood flow * Hypercoagulability of the blood ## Footnote These factors are collectively known as the Virchow triad.

Answer 43

* Dissolution * Propagation * Embolization * Organization and recanalization ## Footnote These outcomes can significantly impact blood flow and overall health.

Answer 44

* Pain in leg or arm * Swelling in one leg or arm * Ischemia * Numbness or weakness on one side ## Footnote These symptoms can vary depending on the location of the thrombus.

Answer 45

Medications called tissue Plasminogen Activator (tPA) ## Footnote tPA is a clot-dissolving medication used in acute cases.

Answer 46

* Occlusion of the vessel * Emboli formation ## Footnote These complications can lead to serious health issues such as strokes or myocardial infarction.

Answer 47

* Swelling * Pain * Warmth * Redness ## Footnote DVT can lead to severe complications such as pulmonary embolism.

Answer 48

An intravascular solid, liquid, or gaseous mass carried by blood ## Footnote Emboli can lead to blockage of vessels and subsequent ischemia.

Answer 49

* Pulmonary thromboembolism * Systemic thromboembolism * Fat embolism * Amniotic fluid embolism * Air embolism ## Footnote Each type has distinct causes and clinical implications.

Answer 50

Widespread thrombosis leads to circulatory insufficiency ## Footnote DIC is a complication of various conditions and can lead to bleeding catastrophes.

Answer 51

A. True ## Footnote Most emboli originate from dislodged thrombi.

Answer 52

A. True ## Footnote Endothelial injury is a key factor in thrombus formation.

Answer 53

B. False ## Footnote Not all thrombi become emboli; some may dissolve or remain stationary.

Answer 54

A. True ## Footnote DVT typically presents with localized symptoms in one leg.

Answer 55

A localized abnormal dilation of a blood vessel due to a weakening in the vessel wall that may be congenital or acquired. ## Footnote Aneurysms can be caused by inadequate or abnormal connective tissue synthesis, excessive connective tissue degradation, loss of smooth muscle cells, atherosclerosis, or hypertension.

Answer 56

Classifications include: * True Aneurysm * False Aneurysm (Pseudoaneurysm) * Dissecting Aneurysm ## Footnote True aneurysms involve all three layers of the vessel wall, while false aneurysms have a breached vessel wall contained by surrounding tissue.

Answer 57

Saccular (berry) aneurysm. ## Footnote These are commonly found in cerebral arteries, especially at the Circle of Willis.

Answer 58

SUDDEN HEADACHE, WORSE HEADACHE OF LIFE, NOTHING IMPROVES PAIN. ## Footnote These symptoms indicate a potential rupture of the aneurysm.

Answer 59

Occurs in the abdominal aorta, often due to atherosclerosis; more frequent in men and smokers; concerns include obstruction and rupture. ## Footnote Rupture can lead to severe complications, including hemorrhage.

Answer 60

Commonly associated with hypertension; can be ascending or descending. ## Footnote May lead to serious complications if not managed promptly.

Answer 61

General term for inflammation of the blood vessels. ## Footnote Vasculitis can lead to vessel damage, thickening, narrowing, ischemia, and potentially aneurysm formation.

Answer 62

Mechanisms include: * Autoimmune * Infectious * Drug-induced * Paraneoplastic * Idiopathic ## Footnote Each mechanism may affect different sizes of blood vessels and have specific disease names.

Answer 63

Complications include vessel damage and ischemia; treatment options include immunosuppressants and steroids. ## Footnote Specific treatment may vary depending on the underlying cause of vasculitis.

Answer 64

Abnormally dilated, tortuous veins produced by prolonged, increased intraluminal pressure with vessel dilation and incompetence of the venous valves. ## Footnote Commonly involved veins are superficial veins of the upper and lower leg.

Answer 65

Leads to stasis, congestion, edema, pain, and thrombosis. ## Footnote Secondary tissue ischemia can result from chronic venous congestion and poor drainage.

Answer 66

Treatment options include: * Self-care (losing weight, exercising, elevating legs) * Compression stockings * Medical procedures, including surgery ## Footnote Treatment aims to relieve symptoms and prevent complications.

Answer 67

Result from blockage of blood flow to the liver, leading to blood flowing into smaller veins that cannot handle the increased volume. ## Footnote Can lead to significant complications, including hemorrhage.

Answer 68

Result from primary varicose dilation of the venous plexus at the anorectal junction. ## Footnote Often caused by prolonged pelvic vascular congestion due to pregnancy or straining to defecate.

Answer 69

Smaller version of varicose veins; superficial, small veins. ## Footnote Often a cosmetic concern and less likely to cause complications compared to larger varicose veins.

Answer 70

False ## Footnote Symptoms of brain aneurysms typically present suddenly, especially upon rupture.

Answer 71

True ## Footnote X-rays can reveal aortic aneurysms, especially in cases of significant enlargement.

Answer 72

True ## Footnote This is one of the mechanisms that can lead to vasculitis.

Answer 73

A small, rounded, pouch-like bulge on one side of the vessel. ## Footnote Commonly seen in cerebral arteries, particularly in the Circle of Willis.

Answer 74

Uniform, circumferential dilation along a segment of a vessel. ## Footnote Typically seen in abdominal and thoracic aortic aneurysms.

Answer 75

Common causes include: * Atherosclerosis * Hypertension * Congenital weaknesses ## Footnote True aneurysms involve all three layers of the vessel wall.

Answer 76

Occurs when blood enters a tear in the intima and tracks between the layers of the vessel wall. ## Footnote Aortic dissection is a prime example and can be catastrophic if not managed emergently.

Answer 77

Accumulation of fluid in tissues ## Footnote Edema can occur in various conditions, affecting tissue function.

Answer 78

Accumulation of fluid in body cavities ## Footnote An example is ascites, which is fluid collection in the abdominal cavity.

Answer 79

* Increased hydrostatic pressure * Reduced osmotic pressure * Lymphatic obstruction * Increased vascular permeability (inflammation)

Answer 80

Hydrostatic pressure and osmotic pressure

Answer 81

* Exudate: Protein-rich fluid; caused by increased vascular permeability due to inflammation. * Transudate: Low protein fluid; common in non-inflammatory disorders.

Answer 82

Localized due to impaired venous return (e.g., deep venous thrombosis) or generalized most commonly caused by congestive heart failure (CHF)

Answer 83

Conditions include nephrotic syndrome, severe liver disease, reduced albumin production, and protein malnutrition

Answer 84

Lymphedema primarily caused by lymphadenopathy or damage/removal of lymph nodes

Answer 85

* Hyperemia: Increased vasodilation and inflow of arterial blood; active process, redder in color. * Congestion: Decreased outflow of venous blood; passive process, cyanotic in color.

Answer 86

Condition where cells, tissues, and organs are not getting enough blood flow

Answer 87

Characterized by systemic hypoperfusion of tissues, leading to impaired tissue perfusion and cellular hypoxia

Answer 88

* Cardiogenic Shock: Low cardiac output due to myocardial damage. * Hypovolemic Shock: Low cardiac output due to blood or plasma volume loss. * Septic Shock: Arterial vasodilation and venous pooling due to infection.

Answer 89

Advanced and life-threatening stage of sepsis leading to severe impairment of the body's response to infection and profound drop in blood pressure

Answer 90

Gram-positive bacteria

Answer 91

Hypotension, weak rapid pulse, tachypnea, cool clammy cyanotic skin

Answer 92

Infarct: Area of ischemic necrosis caused by occlusion of vascular supply; infarction: process by which an infarct lesion forms

Answer 93

* Red (hemorrhagic): Loss of blood leads to red color. * White (anemic/ischemic): Lack of blood supply leads to white color. * Ischemic Coagulative Necrosis: Main histologic finding. * Liquefactive Necrosis: Commonly seen in central nervous system.

Answer 94

Hypovolemic

Answer 95

Ischemic coagulative

Answer 96

Refers to red blood cells that are smaller than normal ## Footnote Microcytic anemia is often associated with iron deficiency.

Answer 97

Refers to red blood cells that are larger than normal ## Footnote Macrocytic anemia can be caused by vitamin B12 or folate deficiency.

Answer 98

Refers to red blood cells that have less color than normal ## Footnote Hypochromic anemia is typically seen in iron deficiency anemia.

Answer 99

Immature red blood cells released into the bloodstream ## Footnote Reticulocytes mature within 1-2 days.

Answer 100

The process by which red blood cells are produced in the bone marrow ## Footnote Erythropoiesis is stimulated by erythropoietin.

Answer 101

Includes hemoglobin levels, hematocrit, red blood cell count, reticulocyte count ## Footnote These measurements help in diagnosing different types of anemia.

Answer 102

A reduction in the oxygen-transporting capacity of blood ## Footnote Commonly classified by mechanism of action and red cell morphology.

Answer 103

Through its mechanism of action and/or basis of red cell morphology ## Footnote Mechanisms include blood loss, destruction, decreased production, and hemoglobin dysfunction.

Answer 104

* Fatigue * Weakness * Pallor * Jaundice * Heart palpitations * Hypotension * Mental fog * Pica * Lassitude * Cold hands and feet ## Footnote These symptoms reflect the body's response to reduced oxygen delivery.

Answer 105

Accelerated red blood cell destruction and decreased red blood cell lifespan ## Footnote Common traits include increased erythropoiesis and elevated levels of RBC byproducts.

Answer 106

* Increased reticulocytes * Splenomegaly * Hemosiderosis * Jaundice ## Footnote These manifestations arise from excessive RBC breakdown and bilirubin accumulation.

Answer 107

Abnormally shaped red blood cells (spherocytes) that lack central pallor ## Footnote Spherocytes are hyperchromic and are prone to destruction in the spleen.

Answer 108

Involves an inherited mutation causing abnormal beta-globin subunit of hemoglobin ## Footnote Results in microvascular obstructions and a significantly reduced RBC lifespan.

Answer 109

Results from deletions in the HBA1 and HBA2 genes leading to microcytic and hypochromic RBCs ## Footnote Thalassemias affect hemoglobin production leading to anemia.

Answer 110

Caused by physical injury to red blood cells, leading to their destruction ## Footnote Often seen in conditions like microangiopathic hemolytic anemia.

Answer 111

A parasite infection that infects and destroys RBCs, leading to a significant decrease in their numbers ## Footnote Mosquitos transmit the parasite, which multiplies in the liver before infecting RBCs.

Answer 112

Characterized by microcytic and hypochromic RBCs ## Footnote Caused by insufficient iron for hemoglobin synthesis.

Answer 113

Characterized by the presence of large, immature red blood cells called megaloblasts ## Footnote Results from deficiencies in vitamin B12 or folate.

Answer 114

* Folate deficiency anemia * Vitamin B12 deficiency anemia ## Footnote Both vitamins are crucial for DNA synthesis and hematopoiesis.

Answer 115

Characterized by the body's inability to absorb vitamin B12 due to lack of intrinsic factor ## Footnote Often caused by autoimmune destruction of stomach cells producing intrinsic factor.

Answer 116

Characterized by the bone marrow's inability to produce blood cells ## Footnote Can be caused by exposure to certain drugs, chemicals, and radiation.

Answer 117

Characterized by an increase of red blood cells per unit volume in circulation ## Footnote Also known as erythrocytosis.

Answer 118

* Primary polycythemia: Clonal, neoplastic disorder with normal or low EPO levels * Secondary polycythemia: Increased RBC production driven by excessive EPO ## Footnote Secondary causes include high altitude, lung disease, and certain cancers.

Answer 119

C. Hemorrhagic anemia ## Footnote Hemorrhagic anemia typically results from acute or chronic blood loss.

Answer 120

D. Iron deficiency anemia ## Footnote Iron deficiency anemia is due to insufficient iron, not RBC destruction.

Answer 121

A. True ## Footnote Increased reticulocyte count indicates the bone marrow's response to anemia.

Answer 122

Myeloid stem cell line and lymphoid stem cell line ## Footnote Myeloid stem cells produce RBCs, platelets, granulocytes, and monocytes, while lymphoid stem cells produce B lymphocytes and T lymphocytes.

Answer 123

Acute, chronic, lymphocytic, myelogenous ## Footnote The major categories include Acute lymphocytic leukemia (ALL), Acute myelogenous leukemia (AML), Chronic lymphocytic leukemia (CLL), and Chronic myelogenous leukemia (CML).

Answer 124

* Tiredness * Weakness * Shortness of breath * Pale skin * Increased infections * Bruises * Bleeding * Weight loss * Fever * Night sweats * Loss of appetite * Bone/joint pain * Swelling of abdomen

Answer 125

* Complete blood count (CBC) * Peripheral blood smear * Bone marrow biopsy * Chromosome tests ## Footnote Diagnosis involves observing changes in WBCs and decreased RBCs and platelets.

Answer 126

Acute lymphocytic leukemia (ALL) ## Footnote It accounts for almost 1 out of 3 cancers in children and teens.

Answer 127

* Progresses quickly * Affects lymphocytes ## Footnote If untreated, it can be fatal within a few months.

Answer 128

* Induction (remission) * Consolidation (intensification) * Maintenance

Answer 129

* Slow development * Mainly affects older adults * Average diagnosis age is around 70 years ## Footnote Many individuals may not show symptoms for several years.

Answer 130

Acute myeloblastic leukemia or acute myelocytic leukemia

Answer 131

Approximately 68 years ## Footnote AML is generally rare in individuals under 45.

Answer 132

Mutation in the BCR-ABL gene (proto-oncogene)

Answer 133

Hodgkin lymphoma and non-Hodgkin lymphoma

Answer 134

Reed-Sternberg cell

Answer 135

Individuals in early adulthood (20s) and late adulthood (after age 55) ## Footnote It is the most common cancer diagnosed in teenagers aged 15 to 19 years.

Answer 136

* More than 60 subtypes * Involves a greater variety of lymphocytes * Does not involve Reed-Sternberg cells

Answer 137

Hodgkin lymphoma progresses in a determined direction (from neck to lower extremities), while non-Hodgkin lymphoma can develop anywhere in the body.

Answer 138

lump in the neck, under the arm, or in the groin

Answer 139

Regulates rate and rhythm of heart ## Footnote Influenced by variables such as exercise, drugs, hormonal levels, ANS, and oxygen levels

Answer 140

Disturbance in or loss of regular rhythm; variation from normal heartbeat rhythm ## Footnote Can relate to atria, ventricles, or entire heart

Answer 141

Through electrocardiogram (EKG) ## Footnote Abnormal EKG indicates arrhythmia

Answer 142

* Fast/slow heart rate * Heart palpitations * Lightheadedness, dizziness * Chest pain, shortness of breath * Anxiety ## Footnote Sensations may include heart racing, skipping a beat, or fluttering

Answer 143

* Atrial fibrillation (A fib) * Atrial flutter * Premature atrial contractions (PAC) * Ventricular fibrillation (V fib) * Premature ventricular complex (PVC) * Sinus arrhythmia * Sick sinus arrhythmia

Answer 144

Most common type of serious arrhythmia; irregular rhythm with fast, chaotic contractions of the atria ## Footnote Electrical impulse originates outside of the SA node

Answer 145

* Reduced cardiac output * Stroke due to thrombus formation * Long term can lead to heart failure

Answer 146

* Medications to manage arrhythmia and prevent blood clots * Catheter ablation to destroy abnormal impulse areas

Answer 147

Similar to atrial fibrillation; fast and regular rhythm in the atria ## Footnote Atria contract rapidly but in a regular rhythm

Answer 148

Most common type of arrhythmia; impulse generated outside of SA node; commonly asymptomatic ## Footnote May create a fluttering sensation in the chest

Answer 149

Chaotic, disorganized impulses to the ventricles; fatal within minutes if untreated ## Footnote Requires immediate treatment with defibrillation

Answer 150

Irregular impulse causing early contraction of ventricles; commonly asymptomatic ## Footnote Heart typically returns to normal conduction afterward

Answer 151

Irregular heartbeat that can be too fast (tachycardia) or too slow (bradycardia)

Answer 152

Dysfunction of the SA node leading to chaotic heart rates; treatment commonly involves a pacemaker

Answer 153

Occurs due to sustained ventricular arrhythmias in individuals with underlying structural heart disease

Answer 154

Automated External Defibrillator (AED)

Answer 155

D. Atrial fibrillation is commonly treated with a pacemaker

Answer 156

A broad term encompassing several closely related syndromes caused by myocardial ischemia ## Footnote It results from an imbalance between cardiac blood supply and myocardial oxygen requirements.

Answer 157

Manifestations include: * Angina Pectoris * Acute Myocardial Infarction (MI) * Chronic IHD with Heart Failure (HF) * Sudden Cardiac Death (SCD) ## Footnote These presentations are direct consequences of insufficient blood supply to the heart.

Answer 158

IHD is the largest cause of mortality worldwide, accounting for over 12% of global deaths ## Footnote The overall death rate from IHD in the U.S. has fallen by over 50% since the mid-1960s.

Answer 159

Dominant cause is insufficient coronary perfusion relative to myocardial demand, primarily due to: * Coronary Artery Disease (CAD) * Acute plaque change, thrombosis, and vasospasm ## Footnote More than 90% of cases arise from reduced coronary blood flow due to obstructive atherosclerotic disease.

Answer 160

An intermittent chest pain caused by transient, reversible myocardial ischemia ## Footnote Characterized by paroxysmal and usually recurrent attacks of chest discomfort.

Answer 161

Caused by transient myocardial ischemia insufficient to induce myocyte necrosis. Symptoms include: * Chest pain * Discomfort in other areas ## Footnote Pain usually lasts from 15 seconds to 15 minutes.

Answer 162

Diagnosis includes: * Angiography * Stress test Treatment options include: * Lifestyle changes * Nitrates * Vasodilators * Blood thinners * Statins * Blood pressure medications ## Footnote These treatments aim to improve blood flow and reduce symptoms.

Answer 163

Necrosis of heart muscle resulting from ischemia, commonly referred to as a heart attack ## Footnote Roughly 1.5 million people per year in the U.S. suffer an MI.

Answer 164

Most MIs are caused by acute coronary artery thrombosis ## Footnote The underlying cause is often atherosclerosis.

Answer 165

Approximately 1.5 million people per year in the U.S. suffer an MI; one-third die, often before reaching a hospital ## Footnote Women are generally protected from MI during reproductive years until menopause.

Answer 166

The three main arteries are: * Left Descending Artery * Right Coronary Artery * Left Circumflex Artery ## Footnote Each supplies oxygenated blood to specific regions of the myocardium.

Answer 167

Transmural infarct: * Extends through entire wall of myocardium * Occurs in about 3-6 hours Non-transmural infarct: * Does not extend through entire wall * Affects inner 1/3 area only ## Footnote This classification is crucial for understanding the severity and treatment of MIs.

Answer 168

Common symptoms include: * Chest discomfort * Discomfort in other upper body areas * Shortness of breath * Other signs (e.g., cold sweat, nausea) ## Footnote Women are more likely to experience nausea/vomiting and back or jaw pain compared to men.

Answer 169

Diagnosis includes: * Electrocardiogram (ECG) * Blood tests Treatment options: * Clot-busting medications * Angioplasty * Stint placement * By-pass surgery Prevention involves: * Lifestyle changes (diet and exercise) ## Footnote Early intervention can significantly improve outcomes.

Answer 170

A diagnosis referring to actual structural or functional problems with one or more of the heart valves ## Footnote Valvular heart disease can lead to various complications and symptoms depending on the type of valve affected.

Answer 171

A clinical finding that is a sound heard on auscultation, which may indicate valvular heart disease but doesn’t confirm it ## Footnote Some murmurs are 'innocent' and not related to a disease, commonly found in children and young adults.

Answer 172

Failure of a valve to open completely, obstructing forward flow, almost always due to a primary cusp abnormality ## Footnote Stenosis leads to calcification or valve scarring and is a chronic process.

Answer 173

Failure of a valve to close completely, allowing regurgitation (backflow) of blood ## Footnote Can result from intrinsic disease of the valve cusps or disruption of supporting structures.

Answer 174

* Asymptomatic * Heart murmur * Fatigue * Shortness of breath

Answer 175

* Auscultation * Imaging * Treatment options include medications and surgical replacement of the valve

Answer 176

Changes affecting the integrity of valvular extracellular matrix, including calcifications and decreased numbers of valve fibroblasts and myofibroblasts ## Footnote Degenerative changes in cardiac valves are an inevitable part of the aging process.

Answer 177

Calcific aortic degeneration, which can be viewed as a valvular-related atherosclerosis process ## Footnote Calcified masses grow on the outflow side of the cusps, mechanically impeding valve opening.

Answer 178

A condition that can cause long-term damage to the heart and its valves, typically resulting from rheumatic fever after group A β-hemolytic streptococcal infections ## Footnote The principal clinical manifestation is carditis.

Answer 179

Occurs when mitral valve cusps bulge or prolapse into the left atrium, commonly leading to regurgitation

Answer 180

Between S1 and S2 when the ventricles are contracting ## Footnote Common causes include aortic stenosis, pulmonic stenosis, mitral regurgitation, and tricuspid regurgitation.

Answer 181

Between S2 and the next S1 during ventricular filling/relaxation ## Footnote Common causes include aortic regurgitation, pulmonic regurgitation, mitral stenosis, and tricuspid stenosis.

Answer 182

Inflammation of the pericardium that presents with atypical chest pain, worsened in recumbency ## Footnote Can lead to immediate hemodynamic complications if it elicits a large pericardial effusion.

Answer 183

Fluid buildup within the pericardium that can exert pressure on the heart ## Footnote Can lead to cardiac tamponade, which restricts heart function.

Answer 184

Fluid buildup in the pericardial space putting pressure on the heart, leading to reduced cardiac output ## Footnote Results in reduced end-diastolic volume (EDV) and end-systolic volume (ESV).

Answer 185

Due to calcification of the aortic valves, left ventricular hypertrophy occurs, and cardiac output is decreased ## Footnote The correct answer is that all of the options are true.

Answer 186

Wide variety of injuries/damage leading to heart disease includes: * Failure of the heart pumping * Obstruction * Valve lesions that prevent valve opening * Regurgitant flow * Shunted flow * Disorders of cardiac conduction * Rupture of the heart or major vessel ## Footnote Heart disease can arise from many underlying conditions and structural abnormalities.

Answer 187

Characterized by the heart unable to contract strong enough and/or fast enough to pump enough blood to meet the body’s metabolic demands due to a weakened myocardium.

Answer 188

Common causes of heart failure include: * Ischemic heart disease * Hypertension * Cardiomyopathy * Heart valve dysfunction * Myocardial infarction ## Footnote Each of these conditions can impair the heart's ability to pump effectively.

Answer 189

Left ventricle function is failing, leading to decreased cardiac output (CO) and blood backing up into the pulmonary system, causing congestion and edema.

Answer 190

Clinical manifestations include: * Dyspnea on exertion * Cough * Orthopnea * Paroxysmal nocturnal dyspnea (PND) * Crackles/Rales on auscultation ## Footnote These symptoms are indicative of fluid accumulation in the lungs.

Answer 191

Right ventricle does not pump blood out effectively, leading to reduced cardiac output and back up in the systemic circulation.

Answer 192

Clinical manifestations include: * Congestive hepatomegaly * Ascites * Systemic venous congestion * Pitting edema in legs * Extended jugular veins ## Footnote These symptoms are due to increased pressure in the venous system.

Answer 193

A condition where both the right and left sides of the heart are in failure.

Answer 194

Diagnosis can include: * Blood work * Electrocardiogram (ECG) * Echocardiogram * Stress test ## Footnote These tests help assess heart function and structure.

Answer 195

Cardiac muscle diseases that can be primary (confined to myocardium) or secondary (manifestation of systemic disorder).

Answer 196

Cardiomyopathy is classified into: * Hypertrophic cardiomyopathy (HCM) * Dilated cardiomyopathy (DCM) * Restrictive cardiomyopathy ## Footnote Each type has distinct characteristics and implications.

Answer 197

Characterized by myocardial hypertrophy, defective diastolic filling, and ventricular outflow obstruction, leading to reduced stroke volume.

Answer 198

Abnormalities of the heart or great vessels that are present at birth ## Footnote Accounts for 20% to 30% of all birth defects

Answer 199

* Malformations causing a left-to-right shunt * Malformations causing a right-to-left shunt * Malformations causing obstruction

Answer 200

A congenital heart defect where oxygenated blood flows abnormally from the systemic side of the heart back into the pulmonary circulation ## Footnote Leads to increased pulmonary volume and pressure

Answer 201

Congenital defects where oxygen-poor blood bypasses the lungs and flows directly into systemic circulation ## Footnote Distinguished by early cyanosis

Answer 202

Commonly not associated with acute cyanosis ## Footnote Includes conditions like atrial septal defects and ventricular septal defects

Answer 203

Early cyanosis due to poorly oxygenated blood from the right side of the heart flowing into arterial circulation ## Footnote Conditions include Tetralogy of Fallot and Transposition of the great vessels

Answer 204

An abnormal fixed opening in the atrial septum that allows unrestricted blood flow between the atrial chambers

Answer 205

A defect that allows left-to-right shunting from the left ventricle to the right ventricle ## Footnote Most common congenital cardiac anomaly at birth

Answer 206

Occurs when the ductus arteriosus doesn’t close, potentially leading to heart failure and cyanosis

Answer 207

Because deoxygenated blood from the right side of the heart flows directly into the systemic circulation

Answer 208

* Pulmonary valve stenosis * Right ventricular hypertrophy * Overriding aorta * Ventricular septum defect (VSD)

Answer 209

A condition where the aorta and pulmonary artery are switched, leading to cyanosis ## Footnote Detected prenatally or shortly after birth

Answer 210

Tetralogy of Fallot

Answer 211

It allows blood to bypass the fetus's lungs before birth

Answer 212