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Questions and Answers
What is the primary consequence of congenital heart disease?
What is the primary consequence of congenital heart disease?
Obstruction of blood flow or shunts
What is the main difference between forward and backward heart failure?
What is the main difference between forward and backward heart failure?
Forward failure: decreased cardiac output; Backward failure: accumulation of blood in venous circulation
What is the most common cause of right-sided heart failure?
What is the most common cause of right-sided heart failure?
Left-sided heart failure
What is the primary cause of ischemic heart disease?
What is the primary cause of ischemic heart disease?
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What is the characteristic of unstable angina?
What is the characteristic of unstable angina?
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What is the pathologic feature of left-sided heart failure?
What is the pathologic feature of left-sided heart failure?
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What is the compensatory mechanism aimed at maintaining arterial pressure in heart failure?
What is the compensatory mechanism aimed at maintaining arterial pressure in heart failure?
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What is the primary cause of hypertensive heart disease?
What is the primary cause of hypertensive heart disease?
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What is the characteristic of valvular heart disease?
What is the characteristic of valvular heart disease?
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What is the primary cause of infective endocarditis?
What is the primary cause of infective endocarditis?
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Study Notes
Complications of Heart Disease
- Congestive heart failure
- Sudden cardiac death
- Unexpected cardiac death within 1 hour of symptom onset
- About ½ of all cardiac deaths
- Most are caused by lethal arrhythmias
- 80-90% of patients have atherosclerotic stenosis
- Arrhythmias are caused by scarring, damage, and electrical instability in the conduction system
Hypertensive Cardiovascular Disease
- Cardiac disease occurring because of longstanding hypertension
- Gross morphology:
- Cardiac hypertrophy: Increase in the weight of the heart and thickness of the left ventricle (concentric hypertrophy)
- Accompanied by significant coronary artery atherosclerosis
- Complications of hypertensive cardiovascular disease:
- CHF
- Lethal cardiac arrhythmias
- Atrial fibrillation secondary to left atrial dilation
Valvular Heart Disease
- Degeneration
- Inflammation
- Infection
- 2dary involvement after myocardial disease
Degenerative Valvular Diseases
- Calcific aortic stenosis
- Age-related calcification of valves in elderly or in people with congenital valvular malformations
- Mitral valve prolapse
- Enlarged, oedematous floppy valves due to valve matrix damage
- Associated with Marfan syndrome
- Complications: mitral regurgitation, infective endocarditis, thrombosis
Rheumatic Fever
- Acute inflammatory disease in children, due to infection by group A streptococcal infection (pharyngitis)
- Cross-reaction of antibodies against bacterial antigens cross-react with cardiac tissue components causing inflammation
- 70% of patients have mitral valve disease
- Any cardiac component may be affected
Rheumatic Heart Disease
- Acute:
- Acute valvulitis or pancarditis
- Other clinical features of rheumatic fever: Sydenham chorea, skin rash, and arthritis
- Chronic:
- Distortion, thickening, and fibrosis of valves
- Mitral valve: fish mouth, button-hole deformities
Infective Endocarditis (IE)
- Microbial colonization of valves
- Blood-borne organisms
- IV drug users, dental procedures, sepsis
- Acute IE:
- Highly virulent organisms attack normal valve causing necrosis, ulcers, vegetations, and thrombi which may embolize
- Rapid fever, chills, and flow complications
- Subacute IE:
- Low virulent organisms colonize damaged valves
- Smaller vegetations
- Nonspecific clinical symptoms
Cardiomyopathy (CM)
- Primary heart disease, not caused by a known systemic disease
- 3 main types:
- Dilated CM
- Hypertrophic CM
- Restrictive CM
Pericardial Disease
- Effusion:
- Accumulation of fluid within pericardial cavity
- Serous: CHF, renal failure
- Exudate: acute and chronic inflammatory states
- Haemo-pericardium:
- Accumulation of blood within pericardial space
- The amount and rapidity of accumulation is important:
- Slow: over 500ml fluid may be tolerated
- Rapid: >200ml fluid causes cardiac tamponade
Chest Pain
- Smothering, pressing, aching, or heaviness
- May radiate to jaw, shoulder, arms, or upper abdomen
- May have dyspnea and sweating
- Unstable angina:
- Chest pain that falls into one of several patterns
- Chest pain that is more severe, prolonged, or frequent in a patient with previous stable angina
- Chest pain of new onset associated with minimal exertion
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Description
This quiz covers the complications of cardiovascular disease, including congestive heart failure, sudden cardiac death, and hypertensive cardiovascular disease.
