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13 - Pathology: Heart 3


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Most common complication of RF
Mural Thrombosis
Most common cause of Mitral Valve Chorditis
Rheumatic Fever
Bacterial Endocarditis is most common on this side of the Heart?

Left Side

*except in IV drug user its the Right side
Explain the progression of Infective Endocarditis
1. Initial damage to valve
2. Fibrin and Platelets deposition
3. Bacteria stick to fibrin
4. PMN's are attracted
5. Deformity of Valve
Libman-Sacks Endocarditis is associated with ________
SLE (lupus)
What is Libman-Sacks Endocarditis?
STERILE vegetations on Mitral and Tricuspid Valves
Order in frequency of microbial causes of Infective Endocarditis
BActeria > Fungi > Chlamydia > Rickettsiae
How are Fungi Endocarditis usually acquired?
Do Viruses usually cause endocarditis?
No, they usually cause Myocarditis
Explain the difference between Acute and Subacute Endocarditis
Acute: highly virulent microbes, death within days to weeks

Subacute: low virulence, slowly evolving
Acute Infective Endocarditis microbes (2)
1. S. aureus
2. S. pyogenes
Subacute Infective Endocarditis microbes
Staph viridans
Staph Epidermidis
4 Complications of Endocarditis
1. local destruction of valves -> insufficiency
2. Embolism
3. Immune Complexes -> Glomerulonephritis
4. Persistent Bacteremia
Alternate name for Non-bacterial Thrombotic Endocarditis (NBTE)
Marantic Endocarditis
NBTE are _______vegetations composed of.....(3)

In what instances are NBTE encountered?
Paraneoplastic Syndrome: Cancer patients with mucin-producing tumors of Colon and Pancreas
Complications of NBTE (2)
1. precursor to Bacterial Endocarditis
2. Emboli
What part of the Valve does NBTE usually affect?
the line of the closure of the valve
Valve most often affected in Libman-Sacks Endocarditis

*Libman-Sacks is associated with SLE*
Ankylosing Spondylitis is associated with _________
Aortic Insufficiency
Polyarteritis Nodosa is associated with ________
Mitral Valve Prolapse is associated with these diseases
Marfan syndrome
Ehlers Danlos

*Myxomatous degeneration of mitral valve leaflets
The stress on the valve from Mitral Valve Prolapse regurgitation can eventually cause ________
Calcification of valves
4 Complications of Mitral Valve Prolapse
1. Mitral insufficiency
2. Infective endocarditis
3. Sytemic Emboli
4. Arrhythmias
Heart Murmur associated with Mitral Valve Prolapse
Mid-Systolic Click
T/F: the majority of people with Mitral Valve Prolapse are asymptomatic
Carcinoid Heart Disease involves the __1__ of the __2__ side of the Heart
1. Endocardium/valves
2. Right
Valves most commonly affected in Carcinoid Syndrome
Tricuspid > Pulmonary

**Left Ventricle is rarely involved**
This correlates with the severity of lesion in Carcinoid Syndrome
Serotonin levels in plasma
Carcinoid Syndrome symptoms
1. Flushing of the skin
2. Diarrhea
Most common cause of Myocarditis
-Coxsackie A/b
Protozoa that can cause Myocarditis and the Disease its called
Trypanosoma Cruzi

Chagas Disease
Consequences of Hyperthyroidism
Consequences of Hypothyroidism
"flabby heart"
Deficiency that is associated with Peripheral Vasodilation leading to High-Output Cardiac Failure and Peripheral Edema
Thiamine Deficiency = Wet Beriberi
3 main types of Cardiomyopathy
1. Dilated
2. Hypertrophic
3. Restrictive
Dilated Cardiomyopathy presents with _____ failure
Alternate name for Dilated Cardiomyopathy
4 possible causes of Dilated Cardiomyopathy
1. Genetic
2. Viral
3. Immuonologic
4. Toxic: Alcohol -> Thiamine deficiency
Clinical finding in Dilated Cardiomyopathy
All 4 chambers are dilated and hypertrophied
Hypertrophic Cardiomyopathy:
-hypertrophy of the Ventricles impedes _______
Diastolic Filling = diastolic dysfxn
What is the usual cause of Hypertrohpic Cardiomyopathy?
Genetic: mutation involving Beta-cardiac Myosin Heavy Chain
Part of Heart that is usually Hypertrophied the most in Hypertrophic Cardiomyopathy
Interventricular Septum which causes obstruction of blood flow out the Aortic Valve
Ventricular myocardium is infiltrated with extraneous material that decreases their compliance
Restrictive Cardiomyopathy casues dysfunction in _______
Systolic and Diastolic phases
5 Causes of Restrictive Cardiomyopathy
1. Amyloidosis
2. Endomyocardial Fibrosis
3. Sarcoidosis
4. Hemochromatosis = iron overload
5. Pompe Disease in Infants


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