Rheumatic Heart Disease Ahu Özet PDF

RheumaticHeartD sease 1 Rheumat c Fever 2 Chron cRheumat cHeartDisease Rheumat c Fever system c acute often recurrent non suppurat ve any age but f rst attack 5 1545 related to pr or A β hemolyt cstreptococc streptococcalant gens cross react on w humanant gens heartvalve glyc...

RheumaticHeartD sease 1 Rheumat c Fever 2 Chron cRheumat cHeartDisease Rheumat c Fever system c acute often recurrent non suppurat ve any age but f rst attack 5 1545 related to pr or A β hemolyt cstreptococc streptococcalant gens cross react on w humanant gens heartvalve glycoprote ns myocard al smooth m Sarcolemma card ac myos n t ssueglycoprote ns n jo nts Jones cr ter a 2 major or 1 major 2 m norneeded major m gratorypoly arthr t s n large jo nts card t s subcutaneous nodules erythemamarg natum Sydenham chorea m nor pr or strep nfect on elevated strep ant gens fever arthra g a elevated acute phase reactants key pathology Aschoff bod es An tschkow cells macroscop c f nd ngs d ffuse nflammat on pancard t s MacCallum plaques f br nousserof br nous per card t s verrusae Chron cRheumat cHeartD sease deform ng f brot c valvulard sease m tral valvestenos s permanentdysfunct on somet mes fetal card ac fa lure leaflet th cken ng Comm sural fus on shorten ngth cken ng fus on of chordal tend nae f sh mouth buttonholestenos s M tral valvestenos s Fa lure most mp consequence of RHD 75 1 m tral 257 m tral aort c tr cusp d nvolvementreally rare pulmonary valvealmost never m tral stenos s atr al d lat onf br llat on thrombus venouscongest on nlung Infect veEndocard t s bacterem a colon zat on n ma nly valves mural endocard um bulky fr ablevegetat ons destroyunderly ng card ac t ssue Subacute Bacter alEndocard t s AcuteBacter al Endocard t s low gradebacter a strep v r ons v rulentbacter astaph aureus pr ory damaged valves undamaged valves largef rmvegetat ons largebutfr ablevegetat ons gradual damage rap dly progress ve acute HF gradualheart fa lure more compl cat ons eros onrupta IU drugabusers 5 aureus prosteth c valve coagulase't staph 5 ep derm t s Compl cat ons valvular nsuff c ency stenos s w card ac fa lure myocard al r ng abscess aort c perforat on nvas on of conduct on system suppurat veper card t s f left s ded embol to bra n heart spleenk dney f r ght s ded embol to lungs focal d ffuse glomerulonephr t s hematur a album nar a renal abscesses fa lure mult ple renal s endocard t s M crothromboembol spl nter subl ngual hemorrhages Janeway les ons erythematous hemorrhag cnontender Osler nodes subcutaneousnodules n pulp ofd g ts foes Roth spots ret nal hemorrhages Non Bacter althrombot c Endocard t s small masses of f br n plateletsetc on valves smaller vegetat on compared to loosely attached to valves sembol nfarcts bra n heart L bman Sacks Endocard t s n SLE smallvegetat on on both s des c rculat ng ant phosphol p dant bod es causester levegetat ons m croscop cally vascul t s subsequentdeform ty due to f bros s Carc no d HeartD sease nvolveendocard um valves on r ght nact vat on of seroton n bradyk n n nlungs v a MAO carc no dsyndrome ep sod cflush ngcrampsnauseavom t d arrhea f brous nt mal th cken ng myocard al D sease a feature of schem cheartd sease congen talheart d sease rheumat cheartd sease hypertens veheartd sease cor pulmonale myocard t s card omyopath es Myocard t s nflammat on componentofsystem cd sease solated d sorder causes nfect on mmune unknownsarco dos sg antcell myocard t s Fr edler'smyocard t s v ral most common ben gn self l m ted n deb l tated mmünosupressed pallor or yellow sh spots on myocard um Heal ng w thout scar f bros s d lated card omyopathy Id opath cG gant Cell myocard t s broad spectrum asymptomat c recovery w o sequelae heart fa lure sudden card ac death m tate MI progress to d late card omyopathy card omyopathy result from pr mary abnormal t es n myocard um mostly d opath c 3 types d lated 901 hypertroph c restr ct ve D latedCard omyopathy progress ve card ac hypertrophy d lat on contract ledysfunct on causes myocard t s v ral tox c effects of alcohol d opath c pregnancy assc genet c fam l al DCM ncrease n we ght 2 3 d lat on of chambers normal orb ventr cular wall th ckness mural thromb thromboembol sm funct onalregurg tat on myocytes are hypertroph c small subendo cord al scars heal ng of schem c necros s Restr ct ve card omyopathy d opath c rad at on f bros s amylo dos s sarco dos s metastat c tumors n ventr cular compl ance mpa red ventr clef ll ng n d astole ventr cles normal s ze cav t es not d lated Ischem cHeartD sease mbalance between demand supply of 02 related to As acute changes n atheroma rarely due to vase spasm Cl n c MI ang na pector s IHD sudden card ac death causes stable ang na 75 1 stenos s unstable ang na plaque rupture thrombus tromboembol MI plaquerupture total thrombot c occlus on sudden card ac death severemult vesseld seaseplaque rupture thrombus thromboembol Myocard al Infarct on acute schem c necros s coagulat on necros s mate to female rat o 3 1 r sk factors HT hypercholesterolem a smok ng DM hypert poprote nem a Subendecord al nfarct on Transmurat Infarct on least well pursued area most common stenos s due to As acute plaque changes coronary flow completelyobstruct vethrombos s Cl n cal Features pa n reflected pulsefast weak back wall nfects nausea vom t ng 40 1 of leftventr cle have necros s card ogen cshock In ECG ST changesclar tyof O wave nvers on oft Compl cat ons contract le dysfunct on LU fa lure hypotens on pulmonary vascular congest on pulmonary edema card ogen c shock arrhythm as myocard al rupture per card t s mural thrombus ventr cular aneurysm pap llarymuscledysfunct on progress ve late heart fa lure IHD schem ccard omyopathy progress to CHF w no ev dence of local zed nfarct on extens veatheroscleros s no nfarct hypertrophy d lat on Sudden card acDeath causes IHD congen tal abnormal t es aort c valvestenos s m tral valve prolapse myocard t s card omyopathy pulmonary HT Congen tal HeartD sease CHD most common heartd sease n ch ldren n premature common causes mult factoral nher tance pr marygenet c factors env ronmental factors maternal r sk factors 345hr prev ous ch ld w CHD poorlycontrolled DM rubella nf asp r n ntake d phenylhydanto n ntake SLE system ccompl cat ons secondarypolycythem a w clubbedf ngers n cyanot cCHD metastat c abscess may occur A r sk for nfect ve endocard t s Dextrocard a heart on r ght s de less than 11 of populat on solated or s tus nversus Left to R ght Shunts volume overload n r ght heart pulmonaryHT RV hypertrophy later stage pressure on r ght s than left cyanot cheartd sease Ventr cular septalDefect USD most common congen tald sease of heart smaller defects closespontaneously left to r ght shunt at ventr cular level Atr al SeptalDefect ASDI unnot ced n nfancy ch ldhood unt l pulmonary HT late cyanot cheartd sease r ghtheart fa lure 3 types Ost umsecundum most common n fossa oval s Ost um pr mum low n nteratr al septum may be deft n aort c leaflet of m tral valve m tral nsuff c ency s nus venous type located h gh n nteratr al septum left to r ght shunt n atr al level w pulmonary flow PatentDuctusArter osus PDA ar se from left pulmonary artery jo n aorta d stal to or g n of left subclav an artery major ty solated w th n 1 7 days of b rth constr ct close l gamentum arter osum remnant of the duct closure may bedelayed n hypox a left to r ght shunt R ght to LeftShunt entry of 02blood nto system cc rculat on earlycyanos s Tetralogy of Fallot most common cyanot ccongen tal heartd sease found n 10 1 of ch ldren w heart anomal es morphology VSD pulmonary stenos s RV hypertrophy aorta to the r ght Aort c Coarctat on narrow ng of aorta common form of obstruct vecongen tal heart d sease males 2x females w Turnersyndrome more than half accompan edby a b cusp daort c valve aort c valve stenos s ASD USD or m tral regurg tat on 2 forms nfant le preductal hypoplas a of aort c arch prox mal to PDA cyanos s of lower half ofbody w o ntervent on d e n neonatal adultpostductal d screter dgel ke nfold ngof aorta adj.to l gamentum arter osum asymptomat c Gaseous Per card t s caseat on n per card al sac ma n louse tuberculos s as consequence f brocak f c chron c construct veper card t s Adhes ve Med ast noper card t s follow suppurat veou caseous card acsurgery or rad at on per card al sac obl terated great stra n on card acfunct on n systole card ac hypertrophy d lat on Constr ct ve Per card t s heart encased n densef brous or f brocalc f c scar l m tat on n d astol c expans on restr ct card ac output per card al sac Concret o cord s no card ac hypertrophy or d lat on congest ve Heart Fa lure unable to pump blood at a rate suff c ent to meet demand