Cardiovascular Pathology-2

This set of flashcards covers vocabulary and key concepts for cardiovascular pathology, including heart failure mechanisms, congenital defects, ischemic heart disease, and cardiac neoplasms based on the lecture transcript.

Cardiomegaly

A condition characterized by increased heart weight or ventricular thickness (hypertrophy) altogether with enlarged chamber size (dilation).

Systolic dysfunction

A mechanism of pump failure where the cardiac muscle contracts weakly, leading to inadequate blood ejection.

Diastolic dysfunction

A mechanism of pump failure where the myocardium cannot relax sufficiently to allow adequate filling of the chambers.

Congestive Heart Failure (CHF)

A condition in which the heart cannot pump blood (or only at elevated filling pressures) to adequately meet the metabolic demands of peripheral tissues.

Frank-Starling mechanism

A physiologic compensatory mechanism where increased volume (preload) stretches myocytes, leading to increased contraction.

Pathologic hypertrophy

Myocardial adaptation to chronic work overload that, unlike physiologic hypertrophy from aerobic exercise, is not followed by an increase in capillary density.

HFrEF (Heart failure with reduced ejection fraction)

Heart failure resulting from progressive deterioration of myocardial contractile function, defined by a left ventricular ejection fraction ($LVEF$) of $40\%$ or less.

HFpEF (Heart failure with preserved ejection)

Heart failure often seen in elderly females with obesity and type 2 DM, characterized by an $LVEF$ of $50\%$ or more.

Forward failure

A clinical feature of CHF characterized by decreased cardiac output and inadequate tissue perfusion.

Backward failure

A clinical feature of CHF characterized by pooling of blood in the venous system, causeing pulmonary edema, peripheral edema, or both.

Cor pulmonale

Isolated right-sided heart failure resulting from pulmonary disease.

Orthopnea

Dyspnea that occurs when an individual is supine and is relieved by sitting or standing.

Paroxysmal nocturnal dyspnea (PND)

A symptom of progressing CHF characterized by sudden, severe episodes of shortness of breath at night.

Heart failure cells

Intra-alveolar hemosiderin-laden macrophages that appear in the lung due to pulmonary capillary congestion and alveolar edema.

Congenital Heart Disease (CHD)

Abnormalities of the heart or great vessels that arise during early embryogenesis ($3$-$8$ weeks) and are present at birth.

Right-to-left shunt

A malformation where blood flows from the right side of the circulation directly into the left side, causing hypoxemia, cyanosis, and potentially paradoxical embolism.

Eisenmenger syndrome

The point at which a chronic left-to-right shunt induces irreversible pulmonary hypertension, causing the shunt to reverse to a right-to-left direction and resulting in cyanosis.

Tetralogy of Fallot (TOF)

The most common cyanotic CHD, featuring (1) VSD, (2) subpulmonic stenosis, (3) overriding aorta, and (4) right ventricular hypertrophy.

Patent ductus arteriosus (PDA)

A congenital defect where high-pressure aortic blood rushes into the pulmonary artery, characterized by a continuous, harsh machinery-like murmur.

Critical stenosis

The threshold for symptomatic ischemia in coronary artery disease, occurring when an atherosclerotic lesion obstructs more than $70\%$ of the vascular cross-sectional area.

Angina pectoris

Paroxysmal chest pain caused by transient ($15$ seconds to $15$ minutes) myocardial ischemia that is insufficient to induce myocyte necrosis.

Prinzmetal variant angina

A pattern of angina caused by coronary artery vasospasm, presenting as episodic chest pain often at rest.

Unstable (crescendo) angina

Angina caused by a non-occlusive thrombus, characterized by prolonged pain ($>20$ minutes) at rest or with minimal activity, carryng a high risk for myocardial infarction.

Myocardial infarction (MI)

The death of cardiac muscles (coagulative necrosis) due to prolonged severe ischemia, often caused by coronary artery atherosclerosis.

Area at risk

The specific anatomic region of the myocardium supplied by an obstructed coronary artery.

Cardiac Troponins (cTnT and cTnI)

Intracellular macromolecules that leak into the blood following sarcolemmal membrane disruption, used as sensitive laboratory biomarkers for detecting MI.

Sudden cardiac death (SCD)

Unexpected death from cardiac causes occurring without symptoms or within one hour of symptom onset, most commonly due to lethal arrhythmias.

Rheumatic fever (RF)

An acute, immunologically mediated multisystem inflammatory disease following group A streptococcal pharyngitis, involving host immune cross-reaction with M-protein.

Aschoff bodies

Distinctive focal inflammatory lesions in the heart during acute RF consisting of T lymphocytes, plasma cells, and Anitschkow cells.

Infective endocarditis (IE)

Microbial infection of the heart valves or mural endocardium leading to vegetations composed of thrombotic debris and microorganisms.

Vegetations

Friable, bulky, and potentially destructive lesions containing fibrin, inflammatory cells, and bacteria that are the hallmark of infective endocarditis.

Myocarditis

A diverse group of pathologic entities in which infectious microorganisms (commonly Coxsackie viruses A and B) or inflammatory processes cause myocardial injury.

Dilated cardiomyopathy (DCM)

A disease characterized by progressive cardiac dilation and systolic dysfunction, leading to an enlarged, heavy, and flabby heart.

Hypertrophic cardiomyopathy (HCM)

A genetic disorder caused by mutations in sarcomeric proteins, characterized by massive myocardial hypertrophy and poorly compliant myocardium leading to abnormal diastolic filling.

Cardiac tamponade

Clinically devastating compression of the heart chambers caused by rapid pericardial fluid accumulation, which restricts cardiac filling.

Myxoma

The most common primary tumor of the adult heart, often associated with McCune-Albright and Carney complex syndromes.

Rhabdomyoma

The most frequent primary tumor of the pediatric heart, associated with Tuberous sclerosis in $50\%$ of cases.