Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
42 Cards in this Set
- Front
- Back
|
What is the minimal criteria for hypertensive heart disease?
|
Left Ventricular hypertrophy with a history of hypertension
|
|
|
What are some problems the systemic hypertensive heart disease can cause?
|
myocardial dysfunction
cardiac dilation CHF Sudden Death |
|
|
What is the morphology of hypertensive heart disease?
|
thinkening of the LV
can cause reduction in volume of lumen of LV the stiff LV causes the LA to enlarge |
|
|
How does hypertensive heart disease present?
|
Can show up on EKG
may present as atrial fibrilation or CHF |
|
|
What are some causes of Pulmonary hypertensive Heart Disease?
|
acute - massive pulmonary embolism
chronic - prolonged pressure overload, emphysema, cystic fibrosis, obesity |
|
|
What is the morphology of pulmonary hypertensive heart disease?
|
Acute - RV dialates. There is no increase in wall thickness
Chronic - thickening of ventricular wall, encroaching on LV chamber. Tricuspid regurgitation. |
|
|
What are the most common forms of aquired valvular heart disease?
|
aortic stenosis - calcification
mitral insufficiency - myxomatous degeneration (mitral prolapse) mitrail stenosis - rheumatic heart disease aortic insufficiency - dilation of ascending aorta from hypertension and aging |
|
|
Calcific Aortic Stenosis
|
most frequent
can be congenital - bicuspid malformation (affects people in 40s and 50s) can be aquired - age related or related to rheumatic fever (affects people in their 70s and 80s) |
|
|
What is the morphology associated with calcificated aortic stenosis?
|
calcific masses in the cusps
rheumatic aortic stenosis can have fusion of cusps - can also involve mitral valve |
|
|
What is the clinical picture of someone with a calcified sortic valve?
|
causes left ventricular hypertrohphy
angina syncope CHF high mortality rate |
|
|
What is the clinical picture of someone with hypertensive heart diesase?
|
may be assymptomatic
may show up on EKG may present as atrial fibrilation or CHF control hypertension, disease may regress |
|
|
What is Cor Pulmonale?
|
pulmonary hypertensive heart disease
acute - massive pulmonary embolism chronic - pulmonary hypertension, emphysema, cystic fibrosis |
|
|
What are some differneces in the morphology of acute and chronic pulmonary hypertensive heart disease?
|
acute - NO increase in wall thickness... just chamber dilation
chronic - thickened ventricular wall, may compress LV chamber. Tricuspid regurgitation |
|
|
What are the most common causes of acquired valvular heart disease?
|
Aortic stenosis
Myxomatous mitral degeneration mitral stenosis from rheumatic heart disease aortic insufficiency |
|
|
Calcific Aortic Stenosis
|
most frequent valvular abnormality
can be congenital or acquired most are age related can be caused by rheumatic fever congenital bicuspid - disease by 50 acquired - disease in 70's and 80's |
|
|
What is the morphology of calcific aortic stenosis?
|
calcified masses within cusps
rheumatic aortic stenosis has commissural fusion and usually involves the mitral valve |
|
|
What is the clinical picture of someone with calcified aortic stenosis?
|
stenosis causes LVH
can cause angina and syncope CHF high mortality rate can have valvular degeneration, valvular fusion, or degenerative calcifications |
|
|
What is the clinical picture of a person with a diseased congenital bicuspid aortic valve?
|
aortic dilation
cusp prolapse prediposition to infective endocarditis aortic coarcation aneurysm disections |
|
|
Myxomatous Mitral degeneration
|
most often young women
most common in industrialized nations enlarged or floppy - can prolapse into LA during systole |
|
|
What is the morphology of myxomatous mitral degeneration?
|
intercordal ballooning of leaflets - thinning or ruptured cords
annular dilation - characteristic tricuspid often involved aortic and pulmonary valves may also be affected |
|
|
What is the morphology of myxomatous mitral valve disease?
|
commissural fusion is ABSENT
Mucoid deposits in leaflets |
|
|
What is the clinical presentation of someone with myxomatous mitral valve disease?
|
most are asymptomatic
middiastolic click ECHO- various degrees of mitral prolapse minority have chest pain dyspnea and fatigue infective endocarditis mitral insufficiency stroke - embolus from leaflet arrhythmias |
|
|
Rheumatic Heart Disease
|
acute, immunologically mediated inflamatory disease
occurs a few weeks after an episode of group A strep pharyngitis (not other organisms, not other sites) can progress to a chronic valvular disease |
|
|
What is the morphology of Acute Rheumatic Fever?
|
carditis - aschoff bodies (t cells some plasma and macros)
pancarditis - aschoff bodies in all three layers "bread and butter" endocarditis myocarditis necrosis of cusps tendinous cords verrucaee |
|
|
What are Anitschkow cells?
|
"caterpillar cells" - plump macrophages
|
|
|
What are the major manifestations of Acute Rheumatic Fever?
|
migratory polyarthritis
carditis subcutaneous nodules skin erythema chorea |
|
|
How do you diagnose ARF?
|
evidence of group A strep pharyngitis
Jones criteria (2 major or 1 major and 2 minor) between 10 days and 6 weeks after group A strep pharyngitis children streptolysin O and DNAse B antibodies |
|
|
What are the clinical manifestations of ARF?
|
migratory arthritis and fever
pericardial friction rubs weak heart sounds tachycardia arrhythmias |
|
|
What is the most important consequence of ARF?
|
chronic heart disease
mitral stenosis can be fatal |
|
|
What is the pathogenesis of Chronic rheumatic heart disease?
|
fibrosis from healing of inflamation
turbulence induced valvular deformities |
|
|
What is the morphology of chronic rheumatic heart disease?
|
deforming fibrosis of mitral valve
commissural fusion shortening thickening and fusion of tendinous cords can cause LA enlargement and RV hypertrophy |
|
|
What is the clinical picture of someone with chronic rheumatic heart disease?
|
causes murmurs
hypertrophy CHF Arrhythmias embolisms infective endocarditis valve replacement necessary |
|
|
Myxoma
|
Benign
most common primary tumor of the heart most common in left atria |
|
|
What is the morphology of a mxyoma?
|
usually a single mass
common in the fossa ovale in the atrial septum can cause obstruction of AV valve or wrecking ball effect on leaflets composed of stellate or globular myxoma, covered b[y endothelium, can contain psudeo glands/vessels |
|
|
What is the clinical picture of a patient with a myxoma?
|
Ball-valve obstruction, embolization
fever malaise EKG - diagnosis surgery for treatment Carney Syndrome - familial |
|
|
Rhabdomyoma
|
Most common primary tumor in childrem
small spider cells - glycogen laden vacuolse, myofibrils |
|
|
Noncardiac tumor metastasis
|
can cause pericardial effusion - may restrict filling or ejection
myocardial mets |
|
|
Which neoplasm has the greatest propensity to metastasize to the heart?
|
melanoma
|
|
|
What is superior vena caval syndrome?
|
tumor invasion to the superior venal cava
blocks blood flow from head and upper extremeties |
|
|
What are some indirect cardiac effects of radiation treatment?
|
pericarditis
pericardial effusion myocardial effusion CAD valvular fibrosis |
|
|
What are the most common indications for heart transplant?
|
dilated cardiomyopathy
ischemic heart disease |
|
|
What are some major complications of cardiac transplantation?
|
cardiac allograft rejection - lymphocytic inflamation
coronary arteriisclerosis - stenosising and proliferation, can cause MI and CHF |
