Pathology Final - Heart
Card Set Information
Pathology Final - Heart
What is Cor pulmonale?
Right ventricular hypertrophy due to pulmonary hypertension secondary to disorders of the lungs or pulmonary vessels
ie - COPD, Chronic lung disease (cystic fibrosis, bronchiectasis, interstitial fibrosis, Recurrent thromboemboli
Acute cor pulmonale
abrupt onset of right ventricular dilatation due to a massive pulmonary embolism
Left sided heart failure
Results in pulmonary edema
Hemosiderin laden macrophages (heart-failure cells) in lungs
Right sided heart failure
Usually results from left-sided failure
Chronic passive congestion in liver (nutmeg liver)
Jugular vein distension
The most common congenital heart defect recognized in clinical practice; initially is non-cyanotic with left to right shunting of blood; in late stages flow is reversed
Tetralogy of Fallot
Important cause of cyanosis at birth!
Ventricular septal defect
Pulmonary artery stenosis
Right ventricular hypertrophy’
Dextroposition of the aorta
Left to right shunts
(not associated with cyanosis-most common type of shunt)
Ventricular septal defect (most common)
Patent ductus arteriosus
Atrioventricular septal defect
Right to left shunts
Tetralogy of Fallot
Transposition of the great arteries
Persistent truncus arteriosis
Obstructive congenital defects
Coarctation (narrowing) of the aorta
Pulmonary artery stenosis/atresia
Aortic valve stenosis/atresia
inflammation of heart muscle; most cases are of viral origin; can be of autoimmune origin such as seen in SLE
multifactorial disease of large and medium sized arteries that is characterized by the accumulation of lipids, fibrosis, and calcification of the arterial walls
: Advancing age, Sex (males) until menopause—then equal, Hereditary, Diet rich in lipids, Hypertension
: Fatty streaks and Intimal thickening, Atheromatous plaques, Progressive narrowing to complete occlusion of the arterial lumen
intermittent attacks of chest pain
Stable (exercise induced)
Prinzmetal (at rest, due to coronary vasospasms)
Unstable (at rest, lasts longer)
What are the two main etiological classifications of hypertension?
Essential (primary) –no apparent cause—90% of all cases
Secondary—due to identifiable cause such as renal, endocrine, of coarctation of aorta
What are the two pathological classifications of hypertension?
---stable elevation of Blood pressure over many years Characterized by hyaline arteriolosclerosis, thickening of elastic lamina; reduced size of vessel lumen; increased rigidity of vessel wall
—rare; rapid rise in blood pressure; young adults Characterized by fibrinoid necrosis of vessel wall; severe renal damage
What are the primary (multifactorial) causes of hypertension?
Dietary factors (alcohol, salt, caffeine, obesity)
Hormonal (abnormal renin-angiotensin-aldosterone pathway)
What are the causes of secondary hypertension?
Adrenal disorders ( pheochromocytoma, Cushings, Conn’s)
Other endocrine disorders
Drugs ( BCP, steroids)
Leading cause of death in US
are the most common type characterized by
Due to occlusion of one of the
by a thrombus at the site of a ruptured atherosclerotic plaque
What is the timetable/breakdown following a MI?
6-12 hours increased creatine kinase, troponin, and myoglobin
12-24 hours pale area
24-72 hours neutrophils
>72 hours neutrophils replaced by macrophages,
Resorption of necrotic muscle tissue and formation of granulation tissue. Scarring within six weeks
Myocardial infact complications include?
Left ventricular failure
Rupture of the heart wall or septum
Inflammation of heart muscle
Due to infection, immune mediated reaction, or unknown (Sarcoidosis)
Heart disease resulting from primary abnormality of myocardium
Excludes damage from extrinsic factors
What are the 3 types of cardiomyopathy?
: combination of dilatation and hypertrophy of all chambers, Ineffective contraction of heart muscles
: Affects mostly left ventricle and septum, Wall is substantially thicker, Ventricular outflow obstruction
: Impaired ventricular filling during diastole, Stiff inelastic ventricle; contractile function is normal, Can be caused by amyloid deposition
What are 3 types of endocarditis?
—massive destruction of valves and heart failure; Staph aureus, Subacute –Strep viridans, less severe
---Nonbacterial thrombotic endocarditis (marantic) characterized by deposition of small sterile fibrin thrombi on previously normal valves
Abnormal immune response to streptococci
Group A beta hemolytic strep
Abnormalities of heart valves—prone to calcification and infection
Pancarditis—may present with endocarditis, myocarditis, or pericarditis
What is the most common primary tumor of the heart?
Cardiac myxoma (typically in the left atrium)