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heart path

cardiac pathology

QuestionAnswer
Prinzmetal Angina intermittent chest pain at rest, generally considered to be caused by vasosasm
unstable angina prolonged or recurrent pain at rest, often indicative of imminent MI
Stable angina most common, pain is precipitated by excertion and is releived by rest or NTG
Stable angina results from severe narrowing of artherosclerotic coronary vessles, which are thus unable to supply sufficient oxygen to support increased mocardial demands of exertion
MI characterized by myocardial coagulative necrosis caused by soronary artery occlusion, releases myocardial enzymes and other proteins by altered membrane permeability of necreotic cells
MI cells in the evolution are neutrophils, macrophages, and fibroblasts
MI transmural- involve enteric thickness of wall, subendocardial- inner 1/3 to 1/2 of wall
Complications of MI ventricular aneurysm, mural thrombosis, ruptured papillary muscles, myocardial rupture, myocardial fialure, arrythmia
arrythmia most common cause of death in the first several hours after MI
Myocardial failure can lead to CHF and/or shock
myocardial rupture usually occurs 4-7 days after MI and may result in death from cardiac tamponade
Rheumatic fever multisystem inflammatory disorder with major cardiac manifestations, aslo characterized by transient mild migratory polyarthritis
Rheumatic fever occurs 1-4 weeks after pharyngitis caused by group A beta hemolytic strep
Aschoff Body classic lesions of rheumatic fever; is an area of focal interstitial myocarial inflammation that is characterized by large cells ( antischkow myocytes) and by occasional multinucleated giant cells
rheumatic fever carditis rheumatic endocarditis usually occurs in areas subject to greatest hemodynamic stress; in the early stages, the valve leaflets are red and swollen, and tiny warty, bead-like, rubbery vegetations form along lines of valve closure; valves become thickened,
manifestations of rheumatic fever (other than cardiac) fever, malaise, increased SED rate; joint involvement; skinlesions (subcutaneous nodules and erythema marginatum); CNS involvement( including sydenham chorea)
infective endocarditis bacterial or sometimes fungal infection of enocardium with prominent involvement of surfaces
infective endocarditis characterized by large, soft, friable, easily detached vegetation consisting of fibrin and intermeshed inflammatory cells and bacteria
infective endocarditis may be complincated by ulceration, often with perforation of valve cusps or rupture of one of the chordae tendineae
acute endocarditis is caused by staph aureus often secondary to infection elswhere in body
subacute endocarditis caused by less virulent oranisms such as strep viridans
subacute endocarditis tends to occur in patients with congenital heart disease or pre-existing valvular disease
endocarditis valvular involvment- mital (most frequent), mitral and aortic (40%), tricuspid (intravenous drug users)
enocarditis complication- distal embolization, septic infarcts, glomerulonephritis
nonbacterial thrombotic endocarditis associated with dibilitating disorders, such as metestatic cancer
nonbacterial thrombotic endocarditis characterized by small, sterile fibrin deposits randomly arranged along the line of closure of the valve leaflets; can result in peripheral embolization but, emboli are steril
libmen-sacks endocarditis ocurs in SLE, is characterized by small vegetations on either or both surfaces of the valve leaflets
endocarditis of carcinoid syndrome cuased by secretory products of carcinoid tumors (vasoactive peptides and amines, especially serotonin), results in thickened endocarcial plaques; rarely involves values on left side because lungs detoxify amines
mitral valve prolapse most frequent lesion, characterized by myxoid degenration of the ground substance of the valve
mitral valve prolapse results in stretching of posterior valve leaflet, producing a floppy cusp, produces systolic murmur with a midsystolic click
mitral valve prolapse usually benign, often associated with a variety of arrythmias, preidposes to infective endocarditis
mitral valve stenosis rheumatic heart disease
mitral valve insufficiency rheumatic hear diesase-, can result from mitral prolapse, inective endocarditis, or damage to a papillary muscle from MI, can be secondary to left ventricular dilation with stretching of the mitral valve ring
aortic stenosis often present as calcific aortic stenosis, caused by; otherwise normal valve(age related), a congenital bicuspid aortic vlave, a valve affected by rheumatic heart disease
tricuspid rarely invovled alone in rheumatic heart disease but may be involved together with mitral and aortic, may be involved in the carcinoid syndrome
pulmonary valve most commonly affected by congenital malformations, rarely involved in rheumatic heart disease, may be involved in carcinoid syndrome
Hypertrophy of right ventricle caused by left ventricle failure, chronic lung disease, mitral valve disease, congenital heart disease with left to right shunt
Hypertrophy of left ventricle most commonly caused by hypertension and aortic or mitral valvular disease
right sided heart failure caused by left sided failure, left sided lesion, pulmonary hypertension, cardiomyopathy, diffuse myocarditis, tricuspid or pulmonary valvular disease
right sided heart failure manifested by renal hypoxia leading fluid retention and peripheral edema, enlarged and congested liver and spleen, distention of neck viens
left sided heart failure caused by ischemic heart disease, hypertension, aortic and mitral valvular disease and mycoardial disease
left sided heart failure manifestated as dyspnea and orthopnea, pleural effusion, reduced renal perfusion
chronic pericarditis usually tuberculous or pyogenic staph etiology
chronic pericarditis thickening and scarring of pericardium with loss of elasticity
chronic pericarditis often micking signs and symptoms of right sided heart failure, proliferation of fibrous tissue
Serous pericarditis SLE, rhuematic fever, and a variety of viral infections-->clear straw colored protein rich exudate with small numbers of inflammator cells
ffibrinous or serofribrinous pericarditis caused by uremia, myocardial infarction, acute rheumatic fever--> fibrin rich exudate
purulent or suppurative pericarditis caused by bacterial infection--> grossly cloudy or frankly purulent inflammatory exudate
hemorrhagic pericarditis caused by tumor invastion of pericardium, TB or other bacterial infection--> bloosy inflammatory exudate
chronic pericarditis usually tuberculous or pyogenic staph etiology,causes proliferation of fibrous tissue and thickening and scarring of pericardium with loss of elasticity, often mimics the signs of right heart failure
left sided heart failure caused by ischemic heart disease, hypertension, aortic and mitral valvular disease and mycoardial disease
left sided heart failure manifestated as dyspnea and orthopnea, pleural effusion, reduced renal perfusion
right sided heart failure caused by left sided heart failure, left sided lesion, pulmonary hypertension, cardiomyopathy and diffuse myocarditis,tricuspid or pulmonary valvular disease
right sided heart failure manifested by renal hypoxia leading to fluid retention and peripheral edema, enlarged and congested liver and spleen, distention on neck veins
hypertrophy of left ventricle most commonly caused by hyoertensin or mitral valvular disease
hypertrophy of right ventricle caused by left ventricular failure, chronic lung disease, mitral valve lesions, congenital heart disease with left to right shunt
cor pulmonale right ventricular hypertrophy and or dilation secondary to lung disease, characerized by pulmonary hypertension
hypertrophic cardiomyopathy hypertrophy of all 4 chamber walls, especially the ventricular septum; characterized by disoriented tangled and hypertophied myocardial fibers, inherited autosomal dominant, may result in left ventricular outflow obstruction
congested or dilated cardiomyopathy most common myopathy, 4 chamber hypertrophy and dilation and both right and left sided failure; in some cases it is related to alcoholism, thiamine deficiency, or prior myocarditis
cardiomyopathy refers to diseases of the heart that are non inflammatory and are not associated with hypertension, congential heart disease, valvular disease, or coronayr artery disease; usually characterized by otherwise unexplained ventricular dysfunction
restrictive cardiomyopathy caused by infiltrarive processes within myocardium that results in stiffining of heart muscle, wich inteferes with pumping action; exemplified by cardiac amyloidosis, which are reight and left sided failure
Created by: swohlers