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53 Cards in this Set

  • Front
  • Back
name the epidemic cardiovascular diseases
atherosclerosis
hyperlipoproteinemia
systemic hypertension
8 characteristics of atherosclerosis
1. inflammatory disease involving formation of lipid plaques in arterial walls and subsequent scarring
2. begins with fatty streak lesions and progresses to raised lesions, and finally results in complicated plaques
3. plaques have a fibrous cap and contain foam cells, lymphocytes, and cholesterol in the middle
4. advanced lesions can involve thrombosis, calcification, ulceration, and structural weakening of the vessel
5. may be caused by endothelial injury, lipid infiltration, infectious agents, or an inflammatory process
6. increased plasma LDL levels increase risk for atherosclerosis
7. disease progression may lead to gradual or sudden occlusion of blood vessels or hemorrhage
8. high-risk groups include older individuals, males, Caucasians, people with diabetes or hypertension, smokers, or people with elevated homocysteine levels
4 characteristics of hyperlipoproteinemia
1. serum triglycerides and cholesterol are carried by chylomicrons, VLDL, LDL, and HDL
2. apolipoproteins are required for synthesis, secretion, and stabilization of lipoproteins
3. primary hyperlipidemia is a genetic disease, and secondary hyperlipidemia is non-familial
4. defects in the LDL receptor lead to increased production of LDL in familial hypercholesterolemia
5 characteristics of systemic hypertension
1. most frequently affects blacks and males
2. primary, or essential, hypertension, is idiopathic
3. secondary hypertension may be caused by renal disease, endocrine disease, coarctation of the aorta, or other factors
4. vascular changes include hypertrophy of vascular muscle and intimal proliferation, with an increase in elastic tissue
5. severe hypertension accelerates atherosclerosis and may cause organ damage
7 congenital heart diseases
atrial septal defect
ventricular septal defect
atrioventricular septal defect
truncus arteriosus
hypoplastic left heart syndrome
transposition of great vessels
tetralogy of fallot
atrial septal defect
1. defects of the ostium secundum, or fossa ovalis, are most common
2. may also involve defects in the ostium primum, sinus venosus, or coronary sinus
3. left-to-right shunt may cause pulmonary hypertension and eventual reversal of the shunt
4. may also cause paradoxical embolization
ventricular septal defect
1. defects commonly involve the membranous septum or possibly the muscular septum
2. left-to-right shunt increased pulmonary pressure
3. Eisenmenger’s complex involves arterial oxygen unsaturation due to blood flow in both directions through the defect
4. results in a loud holosystolic murmur at the fourth interspace
Atrioventricular Septal Defect
1. defect involves a common opening between mitral and tricuspid orifices with one complex valve
2. causes a left-to-right shunt with regurgitation and volume overload
3. often leads to early death by heart failure or pneumonia
4 characteristics of truncus arteriosus
1. one great vessel leaves the heart through a semilunar valve
2. classified into one of several types, depending where the pulmonary arteries arise
3. involves an obligatory ventricular septal defect
4. entails a poor prognosis due to cyanosis or volume overload
4 characteristics of hypoplastic left heart syndrome
1. most severe form involves aortic valve atresia with mitral valve defects, combined with endocardial fibroelastosis in the left ventricle
2. other forms involve mitral valve atresia, mitral valve stenosis, hypoplasia of the aortic arch, or atresia of the aortic arch
3. manifested by cyanosis and inadequate systemic output
4. cardiac transplantation is the only reliable treatment
3 characteristics of transposition of the great vessels
1. must include a pulmonary-systemic communication via a patent ductus arteriosus or septal defect
2. clinical features include cyanosis, cardiac failure, and respiratory failure
3. may be corrected by an atrial switch or arterial switch operation
3 characteristics of tetralogy of fallot
1. components are a ventricular septal defect, right ventricular outflow obstruction, right ventricular hypertrophy, and a dextro-positioned aorta
2. leads to cyanosis and a poor prognosis if uncorrected
3. may be corrected by a Blalock-Taussig shunt or other procedures
4 ischemic heart diseases
angina pectoris
myocardial infarction
sudden cardiac death
chronic ischemic heart disease
3 angina pectoris characteristics
1. involves chest pain due to ischemia without infarction
2. often occurs in association with increased oxygen demand
3. classified as stable angina, Prinzmetal’s (variant) angina, or unstable or crescendo angina
8 characteristics of myocardial infarction
1. transmural infarctions are commonly caused by occlusion of a narrowed artery, leading to necrosis extending across the wall of the ventricle
2. subendocardial infarctions are due to severe coronary artery disease, preventing perfusion of the less vascular areas, causing a circumferential infarct
3. presents with severe, radiating chest pain, sweating, nausea, and shortness of breath
4. diagnosed by electrographic changes and enzymatic abnormalities
5. no changes visible at first, pallor and cyanosis become visible at 18-24 hours, infarct becomes yellow with a hyperemic border in the first week, and granulation tissue with collagen leads to scar formation in the following weeks and months
6. microscopic examination shows coagulative necrosis and neutrophil infiltration between days 1 and 3, dissolution of necrotic fibers is seen between days 3 and 7, granulation tissue is seen developing in the periphery between days 7 and 10, collagenization is seen by 2 weeks and finishes in 7 weeks
7. early complications include arrhythmias, pump failure, or infarct extension
8. later complications include rupture, mural thrombus, fibrinous pericarditis, or ventricular aneurysm
3 characteristics of Sudden Cardiac Death
1. unexpected death by cardiac causes within one hour of symptom onset
2. typically involves a lethal arrhythmia
3. may result from a conducting system anomaly, myocarditis, valvular disease, or most commonly ischemia
3 characteristics of chronic ischemic heart disease
1. condition of progressive congestive failure due to ischemic damage
2. involves severe coronary artery disease with patchy areas of fibrosis, healed infarction, and dilation of the ventricles
3. microscopic examination shows diffuse interstitial fibrosis and some areas of dense scarring, other areas of atrophy
6 valvular heart diseases
mitral stenosis
mitral regurgitation
aortic stenosis
aortic regurgitation
tricuspid stenosis
tricuspid regurgitation
4 mitral stenosis characteristics
1. generally results from rheumatic heart disease
2. presents with symptoms of left heart failure
3. antibodies to group A Streptococcus antigens cross-react with antigens present in the heart
4. may lead to inflammation, vegetation, and scarring on the valve
3 mitral regurgitation characteristics
1. may be caused by mitral valve prolapse as leaflets become floppy
2. frequently remains asymptomatic, may cause chest pain or heart failure
3. ischemia may cause necrosis and rupture of papillary muscles
5 aortic stenosis characteristics
1. may result from congenital or acquired bicuspid aortic value
2. also caused by idiopathic senile calcification of the value
3. leads to hypertrophy of the left ventricle
4. treated by valve replacement or commisurotomy
5. common symptoms are angina, syncope, and congestive heart failure
2 aortic regurgitation characteristics
1. caused by diseases of the aortic leaflets or aortic root
2. may result from endocarditis, vascular disease, or syphilis
3 characteristics of tricuspid stenosis
1. complication of carcinoid metastasis to the liver
2. may be caused by endothelial damage induced by serotonin
3. leads to endocardial fibrosis of valve cusps
characteristic of tricuspid regurgitation
1. rare disorder caused by endomyocardial fibrosis with eosinophilia
4 endocarditis diseases
acute bacterial endocarditis
subacute bacterial endocarditis
fungal endocarditis
non bacterial thrombic endocarditis
4 characteristics of acute bacterial endocarditis
1. often occurs in normal hearts or after cardiac surgery
2. drug addiction and chronic alcoholism are predisposing factors
3. commonly results from S. aureus or beta hemolytic Streptococci
4. sometimes involves right-sided valves, most frequently in IV drug abusers
4 subacute bacterial endocarditis
1. usually occurs in the context of underlying heart disease
2. frequently involves Streptococcus viridans
3. characterized by insidious onset
4. almost always involves the left-sided valves
3 characteristics of fungal endocarditis
1. organisms involved include Candida or Aspergillus
2. blood cultures are positive less frequently than in bacterial endocarditis
3. typically seen with prosthetic valves, IV drug abusers, or immunocompromised hosts
3 characteristics of non-Bacterial Thrombotic Endocarditis
1. can result from endothelial damage, resulting in masses of fibrin and platelets on valves
2. predisposing factors are hypercoagulability and trauma
3. may allow for attachment of organisms and infection
4 myocarditis diseases
lymphocytic myocarditis
giant cell myocarditis
hypersensitivity myocarditis
hypereosinophilic myocarditis
5 lymphocytic myocarditis diseases
1. inflammatory process resulting in chronic inflammation and necrosis of myocytes
2. possibly caused by enteroviral infection, or likely Chagas’ disease
3. pathogenesis involves viral cytotoxicity with immune-mediated damage
4. heart can become enlarged, soft, discolored, and dilated
5. generally asymptomatic, but may present with acute heart failure and arrhythmias
4 characteristics of giant cell myocarditis
1. rare disorder of young to middle-aged adults
2. generally becomes rapidly fatal
3. presents with congestive heart failure, arrhythmia, and heart block
4. myocyte necrosis is seen with lymphocytes and histiocytic giant cells
2 characteristics of hypersensitivity myocarditis
1. associated with hypersensitivity to a number of drugs
2. involves interstitial inflammation without myocyte necrosis
3 characteristics hypereosinophilic myocarditis
1. involves persistent systemic eosinophilia
2. shows eosinophil infiltration of the endocardium and myocardium
3. extensive myocyte necrosis occurs, and mural thrombus may result
2 types congestive heart failure
left or right ventricular
3 characteristics left ventricular heart failure
1. caused by systemic hypertension, coronary artery disease, valvular heart disease, congenital defects, or cardiomyopathy
2. involves dilation of left atrium, pulmonary blood volume increase, pulmonary edema, and transfer of volume back to the right ventricle
3. commonly results in left ventricular hypertrophy, pulmonary edema, and decreased renal blood flow
2 characteristics right ventricular heart failure
1. most commonly caused by left heart failure or by cor pulmonale
2. manifested by edema, liver congestion, and right ventricular hypertrophy
3 types cardiomyopathy
dilated
hypertrophic
restrictive
5 characteristics dilated cardiomyopathy
1. characterized by dilation of the chambers, particularly the ventricles
2. can lead to reduced muscle contractility and some hypertrophy
3. progressively leads to congestive heart failure and possibly arrhythmias
4. associated with myocarditis, alcohol, diabetes, thiamine deficiency, and heavy metal toxicity
5. may be familial due to mutated dystrophin
hypertrophic cardiomyopathy
1. characterized by enlarged myofibers in disarray with boxcar nuclei
2. often occurs in young adults and causes sudden death in healthy victims
3. hypertrophied interventricular septum can occlude aortic outflow
4. leads to elevated diastolic pressure and diastolic dysfunction
5. may be treated with calcium channel blockers
4 characteristics restrictive cardiomyopathy
1. characterized by rigid ventricular walls and decreased diastolic filling
2. primary disease is caused by endomyocardial fibrosis or Loffler’s endocarditis parietalis fibroplastica
3. also caused by amyloidosis, idiopathic myocardial fibrosis, or ischemia
4. manifestations include dyspnea, increased pulmonary venous pressure, hepatomegaly, left heart failure, and pulmonary congestion
6 types cardiac tumors
myoma
fibroma
rhabdomyoma
papillary fibroelastoma
sarcoma
metastatic tumors
4 characteristics myoma
1. benign proliferation of primitive cells
2. variegated tumor attached by a stalk or pedicle
3. most commonly occurs in the left atrium
4. may cause constitutional symptoms and embolization
2 characteristics fibroma
1. most common pediatric cardiac tumor
2. can lead to heart failure, arrhythmias, chest pain, and sudden death
3 characteristics rhabdomyoma
1. hamartoma composed of altered cardiac myocytes
2. high association with tuberous sclerosis
3. may regress spontaneously
4 characteristics papillary fibroelastoma
1. benign tumor composed of avascular papillary excresences
2. characterized by fronds lined with endothelial cells
3. generally occurs in adults
4. frequently remains asymptomatic
3 characteristics sarcoma
1. all types of sarcomas may occur in the heart
2. often located in the left atrium
3. may present with dyspnea secondary to left ventricular inflow obstruction
3 characteristics metastatic tumors of the heart
1. lung carcinoma, lymphoma, breast carcinoma, leukemia, and melanoma may all involve the heart
2. symptoms are largely dependent upon the tumor location
3. may cause pericardial effusions with pericardial involvement, arrythmias, congestive heart failure, or syncope
4 types cardiavascular interventions
coronary artery bypass grafting
percutaneous coronary angioplasty
coronary artery stenting
4 characteristics coronary artery bypass grafting
1. segments from the saphenous vein or the internal mammary artery may be used
2. restenosis of the graft may occur due to damage during surgery, poor runoff, or twisting
3. fibrointimal proliferation or atherosclerosis may occur in the graft
4. grafts from the internal mammary artery usually remain patent for a long time
2 characteristics coronary angioplasty
1. catheters with balloons are passed into the coronary artery, and the balloon is inflated to dilate the arterial lumen
2. restenosis may occur acutely or over a longer period of time
3 characteristics coronary artery stenting
1. addresses the problem of restenosis following angioplasty
2. scaffolding holds the arterial wall open
3. inflammation and neointimal proliferation occur in reaction to the stent
4 characteristics cardiac transplantation
1. accepted treatment for treating end-stage heart disease
2. early pathology involves immediate failure, hyperacute rejection, or reperfusion injury
3. acute rejection typically occurs by cellular mechanisms
4. diffuse graft vasculopathy may be a long-term complicatio