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47 Cards in this Set
- Front
- Back
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What are the four mechanisms of cardiac dysfunction?
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Pump failure (systolic or diastolic)
Alterations to flow Shunts Arrythmias |
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What situations would cause acute heart failure?
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Large MI
Rupture papillary muscle/ chordae tendinae Fluid overload |
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What causes left heart failure? What are symptoms?
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Ischemia, hypertension, myocardial disease, aortic/ mitral disease.
Dyspnea, orthopnea, PND, crackles |
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What causes right heart failure? What are symptoms?
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Left sided heart failure, cor pulmonale, tricuspid/ pulmonic disease.
Congestive hepatomegaly, splenomegaly, pericardial effusion, edema. |
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What are heart failure cells?
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Hemosiderin-laden macrophages in the lungs that are present due to extravasation of erythrocytes into the lung tissue, causing them to rupture.
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What cardiac changes occur due to systemic hypertension?
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Concentric hypertrophy.
Eventually- Loss of myocytes, interstitial fibrosis, dilation. Heart failure. |
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What causes cor pulmonale?
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Thromboemboli, COPD, pulmonary fibrosis.
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What are cardiac changes due to pulmonary hypertension?
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Right ventricle hypertrophy and dilation.
Right sided heart failure. |
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What type of dysfunction occurs with dilated cardiomyopathy?
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Systolic dysfunction with reduced EF
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What causes dilated cardiomyopathy?
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Viral infection
Genetics Toxins Peripartum Idiopathic |
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What are clinical features of dilated cardiomyopathy?
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Usually younger patients
Biventricular failure CHF, thromboembolism, arrythmia, valvular regurgitation |
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What are gross features of hypertrophic cardiomyopathy?
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LVH with septal wall thicker than free wall.
Subaortic stenosis. |
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What type of dysfunction occurs due to hypertrophic cardiomyopathy?
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Diastolic and systolic.
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What are microscopic features of hypertrophic cardiomyopathy?
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Enlarged nuclei.
Myofiber disarray. |
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What are the causes of hypertrophic cardiomyopathy?
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Mutations of genes coding for sarcomeric proteins.
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What are clinical features of hypertrophic cardiomyopathy?
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Left sided heart failure
Systolic murmur Arrythmia Angina/ infarction Sudden death |
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What type of dysfunction occurs due to restrictive cardiomyopathy?
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Diastolic dysfunction
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What are causes of restrictive cardiomyopathy?
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Amyloidosis
Radiation fibrosis Sarcoidosis Metastases Inborn errors of metabolism Hydroxychloroquine |
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What is the microscopic appearance of restrictive cardiomyopathy? What special stain is used?
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Amorphous, eosinophilic substance.
Congo red- green birefringence under polarized light. |
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What are the most common causes of infective myocarditis?
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Coxsackie virus
Borrelia Candida T. cruzi Trichinosis |
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What causes immune myocarditis?
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SLE
Rheumatic fever Drug reactions |
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What is the morphology of infective myocarditis?
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Neutrophil infiltration
Myocyte necrosis |
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What is the morphology of hypersensitivity myocarditis?
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Eosinophilia
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What is the morphology of giant cell myocarditis?
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Large, multinucleated macrophages
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What is the morphology of Chaga's myocarditis?
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Dot like spherules within the myocytes.
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How is myocarditis diagnosed?
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Muffled heart sound, third heart sound, mitral regurg.
Inflammatory infiltration with myocyte necrosis on biopsy. History of illness. |
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What is giant cell myocarditis? What is the histology? What is the cause?
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Usually fatal condition of young adults with rapidly progressive CHF and arrythmia.
Immune mediated. Multinucleated giant cells present. |
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What cardiac changes occur with Chagas disease?
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Dilation, thinning of ventricles, aneurysm.
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What is the pathology of endomyocardial fibrosis? Where is it found?
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Fibrosis of endocardium of ventricles and AV valves. Restrictive cardiomyopathy.
Common in tropical countries. |
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What is acute pericarditis usually secondary to?
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MI
Heart surgery Infection from lungs Immune disorders Radiation Uremia |
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What causes primary pericarditis?
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Viruses
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What characterizes serous pericarditis? What are causes?
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Low amount of protein and acellular fluid.
Caused by rheumatic fever, SLE, uremia. |
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What characterizes fibrinous pericarditis? What are causes?
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Serous fluid mixed with fibrin.
Caused by uremia, MI, radiation, rheumatic fever, SLE. |
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What characterizes purulent pericarditis? What are causes?
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Pus-like exudate.
Caused by pyogenic bacteria. |
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What characterizes hemorrhagic pericarditis? What are causes?
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Blood mixed with fibrin or pus.
Caused by neoplastic infiltrate or cardiac surgery. |
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What characterizes caseous pericarditis? What are causes?
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Granulomatous inflammation.
Mycobacterial. |
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What are clinical signs of fibrinous pericarditis? What can it progress to?
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Friction rub, chest pain, diffuse ST elevation.
May progress to constrictive pericarditis. |
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What are clinical signs of purulent pericarditis? What can it progress to?
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Friction rub, chest pain, prominent signs of infection.
Scarring leads to adhesive mediastinopericarditis/ constrictive pericarditis. |
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What occurs in constrictive pericarditis?
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Pericardium encasing the heart scars and restricts diastole.
Looks like restrictive cardiomyopathy. |
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What are the most common causes of cardiac tamponade?
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Neoplasia
Idiopathic pericarditis Acute renal failure. |
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What is Beck's traid of cardiac tamponade?
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Hypotension
Absent heart sounds JVD |
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What is the most common primary myocardial tumor? Where is it located?
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Atrial myxoma, located in the left atrium.
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What are features of atrial myxoma? What are complications?
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Gelatinous, friable mass in the left atrium.
Can cause obstruction of the AV valve and embolization of the tumor. |
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What is rhabdomyoma associated with?
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Tuberous sclerosis.
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What aspects of the heart transplant have improved survival?
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Immunosuppressive therapy
Endomyocardial biopsy Candidate selection |
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What distinguishes acute heart transplant?
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Weeks-months
Morphology similar to myocarditis |
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When does graft arteriopathy occur after a heart transplant? What is the hallmark pathology?
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Years after transplant.
Intimal thickening causing a narrow lumen- silent MI |
