Path 17- Infective Endocarditis, Non-Ischemic Diseases, Tumors

Front 1

Duke's criteria for diagnosis of Infective Endocarditis (3)

Back 1

1- Positive culture
2- Echo findings
3- New murmurs

Front 2

What is Carcinoid Syndrome?

Back 2

SCALP

Skin, Cardiac, Abdomen, Liver, Pulmonary

Front 3

What is carcinoid heart disease?

Back 3

Carcinoid tumors originate from neural crest cells that are capable of APUD (Amine Precursor Uptake and Decarboxylation)

Front 4

What substances do carcinoid tumors produce?

Back 4

1- Serotonin
2- Histamine
3- 5HIAA- serotonin metaboite

Front 5

Most common infectious cause of myocarditis

Back 5

Viral

Front 6

Non-infectious causes of myocarditis

Back 6

1- Hypersensitivity
2- Reaction to drugs

Front 7

When you see lymphocytes and monocytes in interstitial, perivascular areas, think

Back 7

VIRAL

Front 8

When you see neutrophils, think

Back 8

Bacterial

Front 9

When you see eosinophils, think

Back 9

Drug Hypersensitivity

Front 10

When you see giant cells, think

Back 10

Giant Cell myocarditis

Front 11

Dilated cardiomyopathy leads to

Back 11

Systolic failure- flabby HYPOcontracting heart

Front 12

Hypertrophic Cardiomyopathy leads to

Back 12

Diastolic failure

Front 13

Microscope- disarray and disorganization

Back 13

HCM

Front 14

What is the most common cause of sudden death in athletes?

Back 14

Hypertrophic Cardiomyopathy

Front 15

Restrictive Cardiomyopathy is what type of dysfunction? Systolic or diastolic

Back 15

Diastolic because muscle can't relax

Front 16

What is endomyocardial fibrosis?

Back 16

Fibrosis of the endocardium and myocardium, may be from thrombus origin, cause unknown

Front 17

What is Loeffler's Endomyocarditis?

Back 17

High Eosinophils cause damage

Front 18

Endocardial Fibroelastosis

Back 18

fibrosis and elastosis

Front 19

3 examples of restrictive cardiomyopathy

Back 19

1- Endomyocardial fibrosis
2- Loeffler's endomyocarditis
3- Endocardial fibroelastosis

Front 20

What is cardiac myxoma?

Back 20

Most common benign primary tumor of the heart, from primitive mesenchymal cells

Front 21

Where is cardiac myxoma most commonly found?

Back 21

Left atrium

Front 22

Lepidic cells found in

Back 22

Cardiac myxoma

Front 23

Peculiar structures resembling glands or blood vessels are characteristic of

Back 23

Cardiac Myxoma

Front 24

Myxomas can cause

Back 24

Valve obstruction and embolism

Front 25

How do you diagnose myxomas?

Back 25

Echocardiogram

Front 26

Causes of concentric LVH (3)

Back 26

1- Essential Hypertension (most common)
2- Aortic stenosis
3- HCM

Front 27

Causes of concentric RVH (2)

Back 27

1- Pulmonary HTN
2- Pumonary artery stenosis

Front 28

In ventricular hypertrophy, increased AFTERLOAD causes what

increases PRELOAD causes what

Back 28

Afterload- Concentric hypertrophy

Preload- Eccentric hypertrophy

Front 29

Causes of eccentric hypertrophy of left ventricle (2)

Back 29

1- Mitral or aortic valve regurgitation
2- Left to right shunting

Front 30

Causes of eccentric hypertrophy of right ventricle (1)

Back 30

Tricuspid valve or pulmonary valve regurgitation

Front 31

Most common cause of IE

Back 31

Strep viridans

Front 32

Most common valve with IE

Back 32

Mitral

Front 33

Aortic and tricuspid involved with IE with IVDA (Intravenous drug abuse)

Back 33

Notes

Front 34

Endocarditis with regurgitation, RF and fibrotic heart disease with stenosis

Back 34

Notes

Front 35

IE pathology

Back 35

Vegetations destroy valve leaflet and chordae tendinae

Front 36

IE signs

Back 36

1- Immunocomplex vasculitis- glomerulonephritis, Roth's spot
2- Microembolization- splinter hemorrhages, janeway lesions, osler's nodes, petechiae, infarctions

Front 37

SLE causes LSE

Back 37

Notes

Front 38

Libman-Sacks endocarditis

Back 38

Sterile vegetation, caused by SLE, Mitral valve involvement- regurg more common
-On both sides of valve

Front 39

Acute IE caused by what bacteria

Back 39

Staph aureus

Front 40

Subacute IE caused by

Back 40

Strep virdians

Front 41

Strep bovis and IE

Back 41

Colon cancer

Front 42

Staph epidermidis and IE

Back 42

Prosthetic valves

Front 43

FROM JANE

Back 43

Fever
Roth's spots
Osler's nodes
Murmur
Janeway lesions
Anemia
Nail-bed hehorrhage (splinter)
Emboli

Front 44

Most common cause of myocarditis and pericarditis

Back 44

Coxsackie virus

Front 45

Doxorubicin and daunorubicin can cause

Back 45

Myocarditis

Front 46

Increased CK-MB and Troponins I and T indicate

Back 46

Myocarditis

Front 47

Pericardial friction rub most likely indicates

Back 47

Pericarditis

Front 48

Most common cause of Dilated cardiomyopathy

Back 48

Myocarditis

Front 49

3 Types of Cardiomyopathy

Back 49

1- Dilated
2- Hypertrophic
3- Restrictive

Front 50

Murmur intensity increases with DECREASED preload (Standing up, Valsalva)

Back 50

HCM

Front 51

Tx for HCM

Back 51

Beta Blockers

Front 52

How does HCM cause Sudden Death?

Back 52

Ventricular tachycardia/fibrillation

Front 53

3 common causes of Restrictive cardiomyopathy

Back 53

1- Amyloidosis
2- Myocardial fibrosis after open-heart surgery
3- Radiation

Front 54

Cardiac myxomas are most common where?

Back 54

Left atrium

Front 55

Metastasis is more common than primary heart tumors

Back 55

Notes

Front 56

Myxomas more common in what age

Back 56

Adults

Front 57

Rhabdomyoma common in what age

Back 57

Children and infants

Front 58

Most common causing organism of IE

Back 58

Strep viridans
Staph- IV drug abusers

Front 59

Nonbacterial thrombotic endocarditis

Back 59

Sterile masses of fibrin, platelets, and blood elements
-No inflammation
-May embolize
-Associated with hypercoagulable states
-Seen in burns , cancer, sepsis, pulm. thrombosis, indwelling catheters of heart, leukemias, mucin-producing tumors of ovary, pancreas, GI tract

Front 60

Carcinoid affects what side and features

Back 60

Right side
-Valve and endocardial plaque like lesions- smooth muscle fibers, sparse collagen, and acid mucopolysaccharide rich matrix and subsequent fibrosis

Front 61

Chaga's disease

Back 61

T cruzi protozoa causes trypanosomiasis
Can cause dilated cardiomyopathy

Front 62

Viral myocarditis

Back 62

Coxsackie A and B and other enteroviruses most common
-Infants, pregnant women, and immune compromised people
-Suffer from flu-like disease without cardiac problems OR sudden death
-Most heal without sequelae

Front 63

Fielder's or Giant Cell Myocarditis

Back 63

UNKNOWN CAUSE!
Multinucleated giant cells, poor prognosis
Tx- cardiac transplantation

Front 64

Tissue changes in myocarditis

Back 64

Focal, patchy necrosis or damage

Front 65

X-linked DCM linked with what mutation

Back 65

Dystrophin

Front 66

Cause of death of DCM

Back 66

Cardiac failure
Arrhythmia/sudden death

Front 67

Cause of IE with prosthetic valves or indwelling central lines

Back 67

Staph epidermidis

Front 68

Pathogenesis of HCM

Back 68

Mutations in SARCOMERE!

Front 69

Disarray and disorganization
Myocypte Hypertrophy
Interstitial and replacement fibrosis

Back 69

HCM

Front 70

HCM complications (4)

Back 70

1) Cardiac failure
2) Thromboembolism
3) IE
4) Arrhythmia/Sudden death

Front 71

Enlarged dilated heart and DYSTOLIC DYSFUNCTION is

Back 71

Restrictive

Front 72

Some causes/assoctiations of dystolic dysfunction

Back 72

Amyloidosis, sarcoidosis, storage diseases, radiation fibrosis

Front 73

Seen in infants and young children
Focal or diffuse cartilage-like thickening of the mural endocardium of cardiac chambers owing to fibrosis and elastosis
-Associated with congenital cardiac anomaly, such as aortic valve obstruction
Can lead to cardiac failure and death

Back 73

Endocardial fibroelastosis

Front 74

Tropical African countries
Children and young adults
Fibrosis of the endocardium and subendocardium restricts ventricular volume and compliance, diastolic filling is reduced and cardiac failure

Back 74

Endomyocardial fibrosis

Front 75

Lepidic cells seen in

Back 75

Myxomas

Front 76

Complications of myxomas

Back 76

Valve obstruction/embolism

Front 77

PECULIAR structures resembling poorly formed glands or vessels are characteristic of

Back 77

Myxomas

Front 78

Myxomas are Benign

Back 78

Notes

Front 79

Most common primary tumor of the heart in children and associated with tuberous sclerosis

Back 79

Rhabdomyoma

Front 80

What is this?

Back 80

Infective endocarditis

Front 81

Back 81

Nonbacterial Thrombotic Endocarditis

Front 82

NBTE caused by sepsis is called

Back 82

Marantic Endocarditis

Front 83

Mucinous tumors of ovary, pancreas, and GI tract can cause

Back 83

NBTE

Front 84

Yellow white fibrotic patch, mucopolysaccarhide material, think

Back 84

Carcinoid Lesion

Front 85

Remember the left side of the heart is protected in carcinoid due to

Back 85

1) Metabolized by liver
2) Inactivated by the monoamine oxidase system in the pulmonary

Front 86

Remember HCM also known as
Assymetric septal hypertrophy
Idiopathic hypertrophic subaortic stenosis
Hyptertrophic obstructive cardiomyopathy

Back 86

Notes