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32 Cards in this Set
- Front
- Back
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What are some of the adverse effects of diffuse myocarditis/cardiomyopathy?
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Poor contractility-->poor CO-->hypotension
Stretching out so valve leaflets won't come together-->regurgitation-->Pulmonary edema Syncopy secondary to hypotension |
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What is the pathophysiology of thrombi secondary to valvular dysfunction?
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Valvular dysfunction-->regurgitation-->distended atria-->poor contractility-->static blood
This can also happen from ventricular enlargement |
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What is the treatment for diffuse dilation of the heart? What is the rationale?
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Diuretics
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In dilated cardiomyopathy, what chambers of the heart are enlarged?
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All of them
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What are the causes of dilated cardiomyopatWhat are hy?
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Genetic problems (having to do with the sarcomeres)
Alcoholism Transplant rejection Viral causes (Coxie) |
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What differentiates alcoholic dilated cardiomyopathy from the other types of cardiomyopathy?
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It can be reversed: STOP DRINKING!
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What is the mechanism by which px. with dilated cardiomyopathy retain volume?
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Renin/ATII axis
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In a patient with dilated cardiomyopathy, what is the consequence of too much volume retained? Too little?
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Pulmonary edema
Syncopy |
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What are some of the histological changes associated with dilated cardiomyopathy?
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Large irregular nuclei
Different sized muscle cells Nonspecific hypertrophy |
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What is the way to definitively diagnose dilated cardiomyopathy?
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Getting an endomyocardial biopsy
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What type of patients is it particularly important to get an endocardial biopsy from? Why?
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Transplant patients
They can't feel pain because the heart they have doesn't have any nerves-->can't feel pain associated with heart problems |
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Histologically, what is the difference between viral myocarditis and an acute MI?
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Acute MI: neutrophils
Viral (and transplant rejection) myocarditis: lymphocytes and monocytes |
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What are common causes of myocardial abscess formation?
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Septic infection of the heart
Direct extension of infection from valves Symptomatic infections (rare) |
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If someone has traveled to South America and is having heart problems, what should you think of?
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Chagas
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Histologically, what are the signs of chagas?
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Lymphocytes
Chagas parasites inside the myocardium |
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What are infectious causes of myocarditis?
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Toxoplasmosis
Lyme disease Chagas Giant cell myocarditis |
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What are the symptoms of amyloidosis of the heart?
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Restrictive physiology
SOB Decreased CO |
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What kind of stain is used to identify amyloid deposits in tissue?
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CONGO RED!!!
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If a seemingly healthy athlete drops dead while competing, what is something that should come up in your mind as a cause?
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Idiopathic hypertrophic subaortic stenosis
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What is a disease that causes amyloidosis?
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Plasma cell neoplasm/multiple cell myeloma
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What is the treatment for idiopathic hypertrophic subaortic stenosis?
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SURGERY!
EXCISE PARTS OF THE HEART! |
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What is a cause of carcinoid heart? Where are symptoms seen? Why is this?
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Endocrine tumors-->high concentrations of vasoactive amines on the venous side of the circulation
Right heart problems The amines are inactivated inside the lungs |
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What part of the world has a high incidence of endocardial fibroelastosis?
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East africa
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What is the pathologic finding in endocardial fibroelastosis?
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Diffuse endocardial fibroelastic thickening-->decreased compliance of heart
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What is the cause of the rheumatic disease sequelae?
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Infection by beta hemolytic strep
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What kind of exudate is seen with acute rheumatic fever pericarditis?
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Fibrionous
Lymphocytes and monocytes |
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What are causes of acute suppurative pericarditis?
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Bacteremia
Pneumonia Valve infection eroding through the myocardium Foreign body in the heart |
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What are infectious causes of acute pericarditis?
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Viral
TB Bacterial |
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What are noninfectious causes of acute pericarditis?
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Post MI
Uremia Cancerous involvement Radiation induced Connective tissue diseases (lupus) Drug induced |
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What space does blood in an aortic dissection typicaly go into?
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Outer elastic lamina: space between the media and adventitia
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What predisposes someone to an aortic dissection?
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Mechanical trauma (caths)
Hypertension Age Intrinsic weakness of artery walls (Marfan's) Syphilis |
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What autoimmune disorders cause aortitis?
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Ankylosing spondylitis
Reiters syndrome |
