Patho - cardiovascular dz Flashcards
(34 cards)
etiology of valvular heart dz
- acute vs chronic
- acquired vs congenital
- susceptibility to infective endocardiits
what valvular heart dz represents 2/3 of all valve dz
acquired stenosis of aortic or mitral valve
pathogenesis of rheumatic heart dz
M protein on GABS looks like proteins on heart valve
-triggers immune to attack the heart
= valvular heart dz
Acute Rheumatic fever jones criteria
PECCS
- Migratory Polyarthritis
- Erythema marginatum
- Acute carditis
- chorea
- subcutaneous nodules (used to be sedrate)
acute valvular dz vs chronic valvular dz
- acute - swollen, red, multisystem (rashes, joint pain, minimal lung involvement), M>F, aortic and mitral valve involvement, rarely just aortic involvement
- chronic - leaflets get fused together, also the chordae tendinae thicken, mitral valve especially, F>M
what is the most common cause of aortic stenosis
calcific aortic stenosis
acquired vs congenital calcific aortic stenosis
- acquired - develops in normal valve = later in life, leaflets stiff, but remains unfused, angina pectoris,syncope
- congenital - bicuspid instead of tricuspid, occrs earlier in life (40s-50s) more susceptible to calcification
tx - valve replacement - w/o tx mortality w/i 2 years
what is myxomatous degeneration of the mitral valve
aka mitral valve prolapse
- MC cause of mitral valve regurg
- usually involves posterior leaflet
- peak age 20-40
- W>M
- associated with Marfan’s syndrome
what is infective endocarditis
vegetation/infective lesion on valve
- usually bacterial
- acute rapid developing high virulence (staph) doesn’t matter if valves are normal or abnormal
- subacute/lower virulence = hemolytic strep = usually abnormal valves; occurs after dental/resp/acne disruption
what is the cause of R endocarditis
IV drug abuse until proven different
-goes into veins and first part of heart it reaches is the right side
2 broad classifications of valve replacement
- mechanical - no tissue componenet, clots occur more
2. bioprosthetic - human/pig tissue, clots can occur but not as much
what is the most common cause of myocarditis
viral
- sudden unexpected death
- coxsackie A&B
- will induce direct myocardial injury
- immune mediated damage adds to heart injury
how often is bacterial myocarditis seen
not much
3 types of myocarditis
- viral
- eosinophilic
- bacterial
3 types of cardiomyopathies
- dilated
- hypertrophic
- restrictive
cardiomyopathies can lead to
heart failure or arrthymias that lead to sudden death
what can cause cardiomyopathies
- alcohol abuse
- occupational exposure
- 3rd trimester/postpartum dilated cardiomyopathy
an EF of what will need a heart transplant
25% or less
dilated cardiomyopathies
- usually idiopathic
- could be genetic link
hypertrophic cardiomyopathy
- IHSS - septum is assymetrically involved in hypertrophy
- autosomal dominant - variable penetrance = everyone that has it wont be affected the same = 50% chance of having normal heart even with bad gene
- point mutation - should code for sarcomeres of heart muscles = uncontrolled hypertrophy = insufficiency
why can’t the ventricle pump efficiently in hypertrophy vs dilated ventricle
hypertrophy - can’t fill adequately
dilated - can’t contract (flabby)
restrictive cardiomyopathy
doesnt change morphology of heart but something resists contactility of heart
- genetic
- endomyocardial fibroelastosis = poor contractions
- electrical conduction interrrupted
three types of congenital heart dz
- left to right shunt = acyanotic at presentation
- right to left shunt = cyanotic at or near time of birth (pulm HTN); blood not getting oxygenated and then pumped to body
- coarctation of aorta = pre-ductal, post-ductal
what is the most common pediatric condition
congenital heart dz
-ranges in severity
