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83 Cards in this Set
- Front
- Back
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What is the most common cause of sudden cardiac death in a young person?
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V-Fib
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What is the msot common cause of V-Fib in a young, healthy person?
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HCM
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In HCM, where do you see characteristic thickening of the heart?
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IV Septum
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What is the most common (overall) cause of sudden cardiac death?
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Acute plaque changes superimposed on atherosclerotic artery
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What is a likely cause of multiple foci of myocardial fibrosis?
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Multiple MIs
Chronic Ischemic Heart Disease |
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Most common kind of cardiomyopathy?
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DCM - 90%
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CO in DCM
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Significantly lower
Fatigue woud be a common sign limiting the amount of activity you would have |
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Most common cause of death in RCM
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CHF
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In which phases of the cardiac action potential is K+ moving out of the cell? On EKG what would this result in?
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Phase 2 and Phase 3
Phases 2 and 3 are depolarization so it would probably extend Q-T interval |
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Common sign of torsades de pointes?
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Syncope
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Congential QT prolongation is due to ?
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Mutation in K-channel protein
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Most striking physical finding in acute pericarditis
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Pericaridal Friction Rub
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What relieves the pain associated with pericarditis?
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Sitting up, leaning forward
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Most common variants of acute pericarditis?
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Fibrinous and serofibrinous
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Common cause of pericarditis?
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Viral, Rheumatic fever, MI, uremia
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Kassmauls Sign
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Increased JVP upon inspiration seen in chronic constrictive pericarditis, which takes months or years
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Pulsus Paradoxus
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Drop in systolic BP of 20 mm Hg or more upon inspriation. Seen in chronic constrictive pericarditis, which takes months or years
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Pericardial Knock
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Precoridal sound heard in early diastle in aptients with constrictive pericarditis, which takes months or years
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What happens to LV with long-standing hypertension
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Concentric Hypertrophy
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What is the type of hypertrophy we see post-MI?
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Dilated Hypertrophy because we lose cells that get replaced with fibrous tissue and there is increased volume
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What happens to ventricle size due to mitral insufficeicny?
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Increases LVEDV causing dilated ventricular hypertrophy
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What ventricle changes do we see in an ASD?
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Right Dilated Ventricular Hypertrophy
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What is Wolf-Parkinson-White syndrome?
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Alternative conducation pathway that bypasses the AV node
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What can lessen the murmur produced by mitral regurgitation?
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Squating - increases preload and afterload so more blood in heart
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What happens to the mitral valve in myomatous degeneration?
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Redundancy and elongation of valve cusps and chordae tendinae
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What causes MVP?
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Think, this is a subset of MR. It's due to connective tissue defects that cause elastin and microFIBRIL to be deposit on valve
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Mneumonic FIbriln = Marfan
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Paul is a Fucking Idiot - FI---Fibrilin - Marfan
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What can a Dilated CM and inferior MI both lead to?
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Cause regurgitation. Either by stretching the valve ring or by a papillary muscle necrosis. But you won't heart the snap b/c there's no extra tissue
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Progressive fatigue is usually a sign of what?
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Low cardiac output
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Which ventricles are dilated in DCM?
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Both
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What happens to the EDV in DCM?
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It's increased
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What happens to the end-systolic volume in DCM?
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It's also increased, didn't get rid of all of it's blood
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How is dilated cardiomyopathy diagnosed?
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Diagnosis of exclusion
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Which valve is usually affected in IE of IVDA?
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Tricuspid - theyre putting drugs in their veins so its going to right heart
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Which organism typically causes IE in IVDA?
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S. Aureus
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Complications of IE?
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Vegetations can embolize and go to lungs, brains, or other systemic sights
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What is a procedure that can be followed by subacute IE?
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Dental work
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What type of IE proceeds dental work?
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Strep Viridans
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Which type of valves does S. Aureus affect? Strep Viridans
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S. Aureus will affect any valve
Strep Viridans only affects previously damaged valves |
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IE associated with S. Bovis is typically seen in what illness?
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Colon cancer
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New murmur
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S. Aurues IE
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Organisms that could cause IE but don't grow on standard culture
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HACEK
Haempholus Actinobacillus Cardibacterium Eiknella Kingella |
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Dystrophic calcification is a hallmark of what?
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Cell injury and death
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Dark purples sharped edged aggregates on a valve in H&E stain?
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Calification
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Where do the msot prominent extra-cardiac signs of LHF occur?
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Lungs
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What happens in the lungs as a result of LHF?
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Increased pulmonary venous pressure, build of fluid in interstitial space and eventual intra-alveolar edema
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Is wheezing specific to LHF?
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Hell no - think lung diseases
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What drug class has been associated w/ secondary pulmonary hypertension?
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Appetite-Suppressants
Fen-Fen, Phentermine |
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What genetic disordres are associated with cerebral Berry aneurysms?
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Adult Polycystic Kidney Disease
Ehlers-Danlos |
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What can lead to aortic dilation?
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Aging, Hypertension, Aortic Stenosis, Arteritis, Atherolsclerosis
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Causes of renal vascular sclerosis?
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Atherosclerosis, Fibromuscular Dysplasia, and Systemic Vasculitis
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What is medial calcinosis?
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Calcific deposits in muscular arteries - femoral, tibials, radial, ulnar, and gentals
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Light microscopy changes at:
0-4 hours: 4-12 hours: 12-24 hours: 1-5 days: 5-10 days: 10-14 days: 2 weeks - 2 months: |
0-4: No changes
4-12: Coagulation Necrosis, wavy fibers 12-24: coagulation and marginal band necrosis 1-5 d: PMNS! 5-10 d: Macrophages 10-14 d: granulation tissue 2w-2months: fibrosis, collagen, scar |
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Histology of viral myocarditis?
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Lymphocytic infiltrate, focal necrosis, inflammatory cells
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What type of cardiomyopathy is associated with thiamine defeciency?
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Dilated Cardiomyopathy
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Physical exam finding of a newborn with PDA?
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Continuous machinery murmur
Best heard at LUSB |
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Causes of PDA (teratogens)?
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Fetal Alcohol
Rubella |
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Relieving response of children to tetrology of fallot
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Squatting - this increases peripheral resistance, this back up to aorta where that increases pressure could shove blood in to a patent ductus
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What demographic does SLE primarily affect?
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Women, 20-40`
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What aspect of SLE results in its involvement of the pericardium?
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Serositis - inflamation of the serosa - pleuritis, percarditis
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What type of exudate would we find on acute serositis caused by SLE?
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Fibrinous Exudate - this isn't tamponade though
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In what position is the pericardial friction rub best heard?
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Patient sitting up, leaning forward
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Causes of aortic dissection?
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Long-standing hypertension
Marfan's Ehlor-Danlos |
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Signs of a cardiac tamponade
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Kussmaul's
Pulsus Paradoxus Hepatomegaly |
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What cause Janeway lesions?
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Septic Microemboli containing bacteria, neutrophils, and necrotic material
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What type of skin lesion would we be more likely to see in a hypersensitivity vasculitis like HSP?
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Nodule, non-flat
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Where do Janeway lesions most commonly appear?
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Soles of hand and feet
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What can cause ruptured chordae tendinae?
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MI or endocarditis, but ruptured chordae tendinae won't cause endocarditis
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Diseases that cause myocardial fibrosis?
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Sarcoidosis
Dermatomyositis Muscular Dystrophy Scleroderma |
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Things that can lead to endocarditis
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Scarring
Inflammation Damage |
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What do the vegetations of bacterial IE contain other than immune cells and bacteria?
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Fibrin
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When do you see Kusmauls sign?
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Not in tamponade like i said earlier!!!
It's in chronic constrictive pericarditis |
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When do you hear a loud P2?
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Pulmonary Hypertension
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When do you a hear a pericardial knock?
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Chronic constrictive pericarditis
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What is a common cause of chronic constrictive pericarditis?
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Tuberculosis Caseous Pericarditis
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How does chronic constrictive pericarditis lead to heart failure?
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Restricts diastolic ventricular filling - lowers CO - backflow of blood - RHF - the works
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Most common cause of death post-MI?
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V-fib, arrthymia
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Most common cause of death in SCD due to a CAD issue?
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V-fib
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What is the most likely cause of a congenital defect in the lower part of the interatrial septum?
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Failure of endocardial cushion to fuse
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Name one of the endocardial cushion defects that we know
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Ostium Primum ASD
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What congenital syndrome is an endocardial cushion defect usually associated with?
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Down Syndrome
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What is the most common valvular findings with endocardial cushion defects?
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Cleft in anterior leaflet of mtiral vavle and septal leaflet of the tricuspid valve
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Identify the appropriate cardiac abnormality associated with each:
Down Syndrome DiGeorge's Turner's Marfan's Tuberous Sclerosis Fredreich's Ataxia |
Down's - endocardial cushion defect - ostium primum ASD
Marfan's - cystic medial necrosis, myxomatous deg Turner's - Coarctation DiGeorge's - Tetrology of Fallot Fredrich's - Hypertrophic Cardiomyopathy Tuberous Sclerosis - rhabdomyoma |
