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1

The left ventricle is hypertrophied and dilated, with secondary left atrial dilation. The lungs are heavy and boggy, with perivascular and interstitial transudate, alveolar septal edema, and intra-alveolar edema. Hemosiderin-laden macrophages are present. SEE SLIDE 11.1.

Left-sided heart failure(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381

2

Hemosiderin laden macrophages are also called _______

Heart failure cells. SEE SLIDE 11.1. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381

3

Earliest and most significant complaint of patients with left-sided heart failure

Dyspnea(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381

4

Most common cause of right sided HF.

Left-sided HF(TOPNOTCH)

5

This is a particularly dramatic form of breathlessness, awakening patients from sleep with attacks of extreme dyspnea bordering on suffocation.

Paroxysmal nocturnal dyspnea (PND) (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381

6

Isolated right sided HF occuring in patients with intrinsic lung disease that result in chronic pulmonary hypertension.

Cor Pulmonale(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381

7

Long standing severe right-sided HF leads to fibrosis of centrilobular areas, creating this condition.

Cardiac cirrhosis(TOPNOTCH)

8

Term used when the liver has congested centrilobular areas (due to back up of blood) surrounded by paler peripheral regions. SEE SLIDE 11.2.

Nutmeg liver (CPC of the liver)(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 381

9

Hallmark of right sided HF.

Pedal and pretibial edema(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 382

10

Most congenital heart disease arises from faulty embryogenesis during what AOG?

3 - 8 weeks AOG(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 382

11

An abnormal communication between chambers of the heart or blood vessels.

Shunt(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 383

12

Smooth-walled defect near the foramen ovale, usually without associated cardiac abnormalities. It comprises 90% of ASDs.

Ostium secundum ASD(TOPNOTCH) Robbins Basic Pathology, 9th Ed., p 371

13

Chamber abnormalities seen in ASD.

Accompanied by right atrial and ventricular dilation, right ventricular hypertrophy, and dilation of the pulmonary artery-- reflecting chronic right-sided volume overload. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p 371

14

Reversal of blood flow through a prolonged left-to-right shunt due to pulmonary hypertension, yielding a right-to-left shunt. This causes unoxygenated blood to go into circulation, causing cyanosis.

Eisenmenger syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 383

15

These occur at the lowest part of the atrial septum and can extend to the mitral (anterior leaflet) and tricuspid valves (septal leaflet).

Ostium primum ASD. SEE SLIDE 11.3. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 384

16

Incomplete closure of the ventricular septum leading to left-to-right shunting. The right ventricle is hypertrophied and often dilated. Diameter of pulmonary artery is increased because of the increased volume by the right ventricle.

Ventricular Septal Defect(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385

17

This arises from the left pulmonary artery and joins the aorta just distal to the origin of the left subclavian artery.

Ductus arteriosus(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385

18

The most common cause of cyanotic congenital heart disease. Heart is large and "boot-shaped" as a result of right ventricular hypertrophy.

Tetralogy of Fallot. SEE SLIDE 11.4. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 385

19

Components of Tetralogy of Fallot.

Pulmonary valve stenosis, Overriding of aorta, Right ventricular hypertrophy, Ventricular septal defect. SEE SLIDE 11.4. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 386

20

It is a discordant connection of the ventricles to their vascular outflow. The defect is an abnormal formation of the truncal and aortopulmonary septa.

Transposition of the Great Arteries. SEE 11.5 (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 386

21

Predominant manifestation of TGA?

Early cyanosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 387

22

Characterized by circumferential narrowing of the aortic segment between the LEFT SUBCLAVIAN ARTERY and the ductus arteriosus. DA is usually patent and is the main source of blood to the distal aorta. RV is hypertrophied and dilated, pulmonary trunk is also dilated.

Preductal "infantile" coarctation of the aorta. SEE SLIDE 11.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 387

23

Aorta is sharply constricted by a ridge of tissue at or just distal to the NONPATENT ligamentum arteriosum. Constricted segment is made of smooth muscle and elastic fibers that are continuous with the aortic media, and lined by thickened intima. Ductus arteriosus is closed. Proximally, the aortic arch and its vessels are dilated, LV is hypertrophic.

Postductal "adult" coarctation of the aorta. SEE SLIDE 11.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 387

24

There is upper extremity hypertension, due to poor perfusion of the kidneys, but weak pulses and low blood pressure in the lower extremities. Claudication and coldness of the lower extremities also present. Enlarged intercostal and internal mammary arteries due to collateral circulation, seen as rib "notching" on xray.

Postductal coarctation of the aorta (without a PDA). SEE SLIDE 11.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388

25

Left-to-right or Right-to-Left shunt?Atrial septal defect

Left-to-right(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388

26

Left-to-right or Right-to-Left shunt?TOF

Right-to-Left(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388

27

Left-to-right or Right-to-Left shunt?VSD

Left-to-right(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388

28

Left-to-right or Right-to-Left shunt?Eisenmenger syndrome

Right-to-Left (TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388

29

Left-to-right or Right-to-Left shunt?Transposition of great arteries

Right-to-Left(TOPNOTCH)Robbins Basic Pathology, 8th Ed. p. 388

30

A condition wherein ischemia causes pain but is insufficient to lead to death of myocardium.

Angina pectoris(TOPNOTCH)

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