6-20-10 Patho II Heart Tumors +
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| S/S of Heart tumors are related to | Anatomical location (not their histological types)
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| Most myocardial tumors are clinically revealed by | Disturbances of conduction of rhythm
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| The most common type of primary cardiac tumor | Myxomas (a benign mucus type tumor)
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| Sporadic Myxomas usually happen at what age in what gender | Mean age of 56 yrs and 70% female
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| The majority of Myxomas occur where | Left Atrium (if found elsewhere should suspect malignancy - like left ventricle)
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| T/F: The majority of Myxomas are found as single, alone tumors | True
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| Clinical S/S of Myxomas are | Nonspecific including embolization and mechanical interference with cardiac function
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| What is the most common cardiac tumor in Infants and Children | Rhabdomyomas
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| T/F: Rhabdomyomas are benign striatified muscle tumors | True
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| T/F: Rhabdomyomas are solitary tumors like myxomas | False -Rhabdomyomas are multiple
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| Rhabdomyomas are found with equal frequency in the | Left and Right Ventricles and septal myocardium
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| Clinical manifestations of Rhabdomyomas include | Cardiomegaly, RHF, LHF, Murmurs, and may mimic other Dx (mitral stenosis, aortic stenosis, subaortic stenosis, infundibular pulmonic stenosis, and mitral atresia
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| What is the second most common benign cardiac tumor in children | Fibromas
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| T/F: Fibromas are more prominant in Females | False - Equal between genders
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| T/F: Fibromas are derived from Fiboblasts and are considered connective tissue tumors | True - they resemble soft tissue fibromatoses found in other areas of the body
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| Angiomas are composed of what kind of benign proliferating cells | Endothelial cells
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| T/F: Angiomas are rare and are found most often in the intraventricular septum or AV node | True
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| T/F: Angiomas, being benign, are not very harmful | False - depending on their location (AV node or Septum) may cause complete heart block and sudden death
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| A type of tumor that contains three germ layers and occur mostly in the anterior mediastinum | Teratomas
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| When a Teratoma occurs (usually occurs in a child)in the heart, what part of the heart does it not usually form at/in | The Left side (atria or ventricle). It usually forms in the RA, RV, or Intraventricular Septum
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| T/F: Sarcomas are in the same class as Myxomas, Angiomas, Fibromas, and Teratomas | False - Sarcomas are Malignant (all the other were benign)
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| What percentage of cardiac tumors exhibit malignant chacteristics and metastic behaviors | 25%
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| They are the second most frequent cardiac tumors overall and are also malignant | Sarcomas
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| Sarcomas are derived from what kind of cells | Mesenchyme - which are the precursers of connective tissue (muscle and bone); therefore Sarcomas display a wide variety of morphological types (angio, rhabodo, fibro..)
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| Death from Sarcomas most often occurs from a few ? to a couple of ? | Weeks, years
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| Cardiac finding (r/t Sarcomas) include unexplained (8 things) | CHF, Precordial pain, Pericardial effusion, Tamponade, Arrhythmias, Conductive disturbances, Obstructive Vena Cava, and Death
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| Name 5 benign tumors (talked about in the slides) | Myxomas, Rhabdomyomas, Fibromas, Angiomas, and Teratomas
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| These malignant tumors are most often found in the Right atrium and may be infiltrative or polypoid in nature | Angiosarcomas
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| Angiosarcomas show a 2:1 ratio of which genders | Male:Female (2:1)
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| Which tumor is characterized by ill-defined,varible anastomotic vascular channels lined with atypical endothelial cells | Angiosarcomas
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| Which tumors are of striated muscle infiltrate the myocardium and sometimes form a polypoid into the cardiac chambers (sometimes mistaken for myxoma) | Rhabdosarcomas
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| Rhabdomyoblasts are the histological hallmark of what tumor | Rhabdosarcomas
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| What is the management of Benign cardiac tumors | Surgical excision - usually results in complete cure
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| Why the prompt surgical date for a benign tumor | Even though not malignant they may be lethal due growing and obstructing valves, cavities, causing emboli, or causing arrhythmias
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| The major role of surgery regarding malignant tumors is to | Diagnose. A diagnosis of malignancy excludes the possibility of a curable benign tumor
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| T/F: There is a high success rate with Chemo and Radiation of Cardiac Sarcomas | False
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| Buerger Disease is also called | Thromboangiitis Obliterans (that is the correct spelling ..giitis)(it is a PAD)
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| Name two Peripheral Arterial Diseases | Thromboangiitis Obliterans (Buerger Disease) and Raynaud Disease
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| This PAD tends to occur in young males who are heavy cigarette smokers, consists of inflammation of periphery arteries and accompanied by thrombi and arterial vasospasm | Thromboangiitis Obliterans
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| What eventually occurs with small and medium size arteries in the hands and feet with Thromboangiitis Obliterans | Portions are Obliterate ("Obliterans")- rendering them physiologically useless
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| S/S of Thromboangiitis Obliterans (5 things) | Pain, Tenderness (of affected parts), Rubor (redness of skin), Cyanosis, Ischemia and gangrene (advanced cases)
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| Treatment of Thromboangiitis Obliterans includes | Cessation of smoking, increase ciculation (vasodilators and exercise), Sympathectomy (reduce vasospasm), Amputation (gangrene)
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| Name the Diagnosis of the following: Charcaterized by attacks of vasospasm in the small arteries and arterioles of the fingers and toes | Both Raynaud Phenomenon and Raynaud Disease
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| What is the difference between Raynaud disease and Raynaud Phenomenon | The causes are different
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| What is the diagnosis called in which attacks of vasospasm in the arteries is caused by secondary means like cold conditions, vibrating machinery, Pulmonary HTN, or Collagen vascular disease | Raynaud phenomenon
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| What is the cause of Raynaud Disease | The origin is unknown
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| Which PAD is more common in females and which one is more common in males | Raynaud Disease = women, Thromboangiitis Obliterans = males (heavy smokers)
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| Clinical manifestations of both Raynaud Phenomenon and Disease include | Bilateral changes in skin color (pallor or cyanosis), and sensation (numbness and cold) which progresses from distal to proximal
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| When the vasospasm resolves in Raynaud Phenomenon and Disease what presents | Rubor accompanied by throbbing and parestesias
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| What is the treatment for Raynaud Phenomenon | Removing the stimulus or treating the symptoms
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| What is the treatment of Raynaud Disease | Prevent or alleviate the vasospasm (removing the stimulus is not an option since it is not known)
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| What is a distended, tortuous, and palpable vein called | A Varicose Vein
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| What causes a Varicose Vein | Trauma (causing more valves) or gradual venous distention due to a combination of standing for a long time (gravity pooling blood in legs)
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| Which vein is usually associated with varicose veins | Saphenous
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| Varicose veins (valvular incompetence) can progress to CVI which stands for | Chronic Venous Insufficiency
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| What other clinical manifestations do varicose vein present | Edema, hyperpigmentation, ischemia of ther feet and ankles
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| Necrosis of cells and tissue related to trauma or pressure on an area of reduced circulation developes into | Venous Stasis Ulcers - which are susceptibleto infection
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| Treatment of varicose veins | Will start uninvasive - stockings, no long periods of standing, and no restrictive clothing. If ineffective then surgical vein stripping performed
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| Up to 65% of patients with lower extremity trauma develope this | DVT (Deep Venous Thrombosis)
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| Why are DVT more common than DAT | Decreased blood pressure and flow in veins (more stasis)
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| Causative agents for venous thrombus include (3 things) | Hypercoagulability (pregnancy, oral contraceptives use, coag dz, some cancers), Vessel trauma (physical or IV med), and Venous Stasis
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| With a DVT, the Coagulation Cascade causes | Inflammation, extreme tenderness, swelling, and redness in the area of the thrombi
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| What is the major risk of a DVT | It (or part of it) will be transported to the pulmonary circulation causing pulmonary emboli
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| If a DVT swelling compresses local nerve what happens | Neuralgia (severe sharp pain)
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| DVT management includes | Anticoagulation with Heprin, Rest and possibly Thrombectomy
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