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heart pathology


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What valve is usually involved in endocarditis?
What valve indicated drug use if it is involved?
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
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.

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