heart pathology
Terms
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- What valve is usually involved in endocarditis?
- Mitral
- What valve indicated drug use if it is involved?
- Tricuspid
- Can endocarditis be non-bacterial?
- Yes. It can be secondary to metastasis, renal failure (maranctic or thrombotic), fungal
- What type of endocarditis does s. Aureus cause?
- rapid onset, high virulence, tends to occur secondary to infection elsewhere
- What do the vegetations look like
- Large.
- What type of endocarditis does s. viridians cause?
- subacute. Tends to have smaller vegetations.
- What predisposes you to s.viridins endocarditis?
- tends to occur on previously damaged valves, so rheumatic fever. It is commonly seen after dental work.
- What are the 8 sings of endocarditis?
- JR=NO FAME Janeway lesions, Roth's spots, Nail-bed hemorrhages, Osler's nodes, Fever, Anemia, Murmur (new), Emboli
- What do Janeway Lesions look like?
- multiple small flat erythematous lesions on palms and soles
- What are roth spots?
- round white spots on the retina surrounded by hemorrhage.
- What are osler's nodes?
- Tender raised lesions on the fingers and toes.
- What is the etiology of these olser's nodes, roth spots, and janeway lesions?
- Bacterial vegetations flipping off the heart valve and lodging in the periphery.
- What type of bacteria causes rheumatic fever?
- Group A beta-hemolytic strep
- when does it occur?
- Children 5-15 years, four weeks after a bacterial infection
- Is the bacteria responsible for the symptoms?
- No. RF is an autoimmune reaction of a cross-reactive protein that is found in the initial bacterial infection.
- What are the non cardiac clinical signs of rheumatic fever?
- FEVERSS - Fever, Erythema marginatum, valve damage, Elevated ESR, Red-hot joints (migratory polyarthritis), Subcutaneous nodules, and St. Vitus dance (chorea)
- What hear valves are effected?
- Mitral (most frequent), Aortic, Tricuspid (5%) - high pressure valves mainly.
- What is an Aschoff body?
- classic histological sign of RF, found in the myocardium, contained fibrinoid material, fragmented collages, surrounded by giant cells.
- What are the cardiac signs of RF?
- Verrucious vegetations on the valve, pancarditis, possible pericardial effusions and myocarditis (most common cause of death)
- Name four causes of serous pericarditis.
- RAIL - Rheumatic Arthritis, Infection, Lupus, and Uremia
- What is serous pericarditis?
- straw colored, protein rich exudates - non-purulent, and acute
- What are three causes of fibirnous exudates?
- MI, Rheumatic fever, and Uremia
- Cloudy pericardial exudates indicated what?
- Bacterial infection
- What are two causes of Hemorrhagic pericarditis?
- malignancy and TB
- What is hemorrhagic pericarditis?
- Bloody and inflammatory exudates
- What are the clinical signs of pericardial exudates?
- pericardial pain, friction rub, decreased heart sounds, ST elevation throughout, and pulses paradoxes (like cardiac tamponade)
- What are the long term sequela of pericarditis?
- chronic adhesive or constrictive pericarditis
- What is constiricit pericadritis
- Fibrous scarring in the pericardium obliterates the space and constrict the right side of the heart (because it is less able to withstand the pressure)
- What types of pericaditis lead to constrictive pericarditis
- TB and pyrogenic staph infections
- Syphilitic Heart Disease: What part of the heart does syphilis damage?
- The vaso vasorum of the aorta
- Syphilitic Heart Disease: What does this lead to?
- Dilation of the aorta and valve ring
- Syphilitic Heart Disease: What clinical results does this have?
- it can cause an aortic aneurysm or valvular incompetence
- Syphilitic Heart Disease: What parts of the aorta are effected
- ascending and arch
- Syphilitic Heart Disease: What is the appearance or the aorta?
- Called a "tree-bark" appearance.