Heart (Condensed) 2026

Heart failure where the heart cannot pump out blood

Systolic heart failure

Heart failure where the heart cannot fill itself with blood

Diastolic heart failure

Main effect of right-sided heart failure

Systemic/portal venous congestion

Type of heart failure associated with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea; most common cause of right-sided heart failure

Left-sided heart failure

Isolated right-sided heart failure caused by primary pulmonary disease

Cor pulmonale

Gestational period during which most congenital heart diseases arise

3rd to 8th weeks AOG

Most common genetic cause of heart diseases

Trisomy 21 (Down syndrome)

Common feature of left-to-right shunts (acyanotic CHD)

Increased pulmonary blood flow

Phenomenon wherein a left-to-right shunt converts into a right-to-left shunt with cyanosis

Eisenmenger phenomenon. Chronic increased pulmonary blood flow → pulmonary vascular remodeling → pulmonary pressure increases greater than the systemic pressure → shunt reversal

Most common CHD in adults; associated with fixed, widely split S2 with pulmonary stenosis-like murmur

Atrial septal defect

Most common type of ASD

Secundum (90%)

Flap-like opening between the RA and LA; most often closes within 2 years

Foramen ovale

Complication associated with patent foramen ovale

Paradoxical embolism

Most common CHD overall

Ventricular septal defect - Mostly the membranous type (90%)

CHD that causes a continuous machinery like murmur

Patent ductus arteriosus

Most common cyanotic CHD

Tetralogy of Fallot (TOF)

Components of Tetralogy of Fallot (4)

Large VSD, Right ventricular outflow tract obstruction, Aorta overriding the VSD, Right ventricular hypertrophy

Main determinant of prognosis in Tetralogy of Fallot

Pulmonic stenosis

Cyanotic heart disease caused by failure of the conotruncal septum to develop in a spiral fashion, causing ventriculoarterial discordance

Transposition of the Great Arteries (TGA)

Maternal condition associated with increased risk of Transposition of the Greater Arteries in their infants

Diabetes

Cyanotic heart disease caused by the failure of formation of conotruncal septum

Persistent truncus arteriosus (PTA)

Earliest detectable feature of myocyte necrosis in myocardial infarction (½ to 4 hours post-MI)

Sarcolemmal membrane disruption

Duration of cardiac ischemia that produces loss of contractility

1-2 minutes

Duration of cardiac ischemia that produces irreversible injury

20-30 minutes

Portion of myocardium that suffers first in myocardial infarction because it is the farthest from the epicardial coronary artery

Subendocardium

Most common vessel affected in myocardial infarction

Left anterior descending artery (LAD): 40-50%. Followed by right coronary artery > left coronary artery

Period of reversible injury in myocardial infarction

0 minutes to 1/2 hour

Time of detection of cardiac troponins (cTn I or T) in myocardial infarction

3-12 hours

How long do cardiac troponins remain elevated before returning to normal in MI?

5-14 days

Peak of elevation of cardiac troponins in MI

24 hours

Paradoxically increased myocardial damage with restoration of blood flow after obstruction; caused by free radical generation

Reperfusion injury

Most common cause of death within 3-7 days after MI

Myocardial rupture. Most common: free wall rupture, which leads to cardiac tamponade

Most common cause of death within the first 24 hours after MI

Arrhythmias

Acute pericarditis that occurs 2-10 weeks after myocardial infarction; due to antibodies against injured pericardium

Dressler syndrome

Most common cause of sudden cardiac death

Coronary artery disease

Most common mechanism of sudden cardiac death

Lethal arrhythmia - Asystole or ventricular fibrillation

Wide QRS complex that follows a short RR interval preceded by a long RR interval; usually associated with atrial fibrillation

Ashman phenomenon

Two common causes for aortic stenosis

Age-related calcification of normal aortic valves, Congenital bicuspid aortic valves

Most common cause of aortic regurgitation (AR)

Dilation of the ascending aorta - Secondary to hypertension and/or aging

Most common cause of mitral stenosis (MS)

Rheumatic heart disease

Most common cause of mitral regurgitation (MR)

Mitral valve prolapse

Head bobbing synchronous with arterial pulses, occurring in aortic regurgitation

De Musset sign

Floppy mitral valve leaflet that prolapses into the left atrium during systole

Mitral valve prolapse

Granuloma of rheumatic inflammation; composed of T cells, plasma cells, and Anitschkow cells

Aschoff bodies

Caterpillar cells of ARF; activated plump macrophages

Anitschkow cells

Major criteria for acute rheumatic fever (ARF); Jones criteria (5)

J: Joint (Migratory polyarthritis), ♡: Carditis, N: Subcutaneous nodules, E: Erythema marginatum, S: Sydenham chorea

Minor criteria for ARF (4)

Fever, Arthralgia, Elevated ESR/CRP, Prolonged PR interval

Mitral valve abnormality commonly associated with rheumatic heart disease (RHD); associated with the fish mouth deformity

Mitral stenosis

Microbial infection of the heart valves or mural endocardium

Infective endocarditis

Most common valves affected by infective endocarditis (2)

Aortic and mitral

Valves commonly affected in infective endocarditis in IV drug users

Right valves (e.g., tricuspid valve)

Type of heart valves affected by acute infective endocarditis

Normal heart valves - More tissue destruction

Type of heart valves affected by subacute infective endocarditis

Previous damaged/diseased heart valves - Less tissue destruction with evidence of repair (granulation tissue)

Small erythematous or hemorrhagic, macular; nontender lesions on the palms and soles in infective endocarditis

Janeway lesions

Small, tender subcutaneous nodules in the pulp of the digits or proximally in the fingers in infective endocarditis

Osler nodes

Oval retinal hemorrhages with pale centers in infective endocarditis

Roth spots

Bioactive substance implicated in carcinoid heart disease

Serotonin - Produced by carcinoid tumors in the setting of massive liver metastatic burden

Heart valve affected in carcinoid heart disease

Right heart valves (tricuspid and pulmonic). The left side of the heart is relatively protected because the pulmonary vasculature metabolizes the bioactive mediators in carcinoid.

Four clinical features that characterize carcinoid syndrome

Flushing, Diarrhea, Dermatitis, Bronchoconstriction

Etiology of non-bacterial thrombotic (marantic) endocarditis (NBTE)

Hypercoagulable state

Endocarditis caused by SLE, due to immune complex deposition on either or both sides of the valve leaflets

Libman-Sacks endocarditis (LSE)

Most common pattern of cardiomyopathy; enlarged, heavy, flabby heart with dilation of all chambers

Dilated cardiomyopathy

Most common etiology of dilated cardiomyopathy

Genetic (e.g. titin truncation); dystrophin loss (as in Duchenne/Becker muscular dystrophies)

Commonly ingested toxin associated with dilated cardiomyopathy

Alcohol - Due to acetaldehyde or thiamine deficiency

Also known as Broken Heart Syndrome; left ventricular contractile dysfunction after extreme psychological stress

Takotsubo cardiomyopathy

Cardiomyopathy associated with "ninja-star"-like nuclei; caused by titin mutations

Dilated cardiomyopathy

Most common type of cardiomyopathy associated with sudden, otherwise unexplained death in young athletes; (+) banana-like configuration of the left ventricular cavity

Hypertrophic cardiomyopathy (HCM)

Type of cardiomyopathy associated with amyloidosis, sarcoidosis, radiation-induced fibrosis, and storage diseases

Restrictive cardiomyopathy

Abnormally configured protein that accumulates in the hearts of elderly individuals with amyloidosis

Transthyretin

Most common primary tumor of the adult heart

Myxomas

Disease with GNAS1 activating mutation associated with development of cardiac myxomas

McCune Albright syndrome

Three clinical features of McCune Albright syndrome

Precocious puberty, Cafe au lait spots, Polyostotic fibrous dysplasia

Most common site of cardiac myxomas

Left atrium

Most common primary tumor of the pediatric heart

Rhabdomyoma

Two loss-of-function mutations associated with rhabdomyomas

TSC1 (hamartin)/TSC2 (tuberin)

Beck's triad of pericardial effusion

Increased jugular venous pressure, Arterial hypotension, Muffled heart sounds

Most common cause of hemorrhagic acute pericarditis

Malignant tumor

Clinical feature of adhesive mediastinopericarditis, causing exaggerated drop in systolic BP (>10 mmHg) during inspiration

Pulsus paradoxus. Mechanism: inspiratory traction on the pericardium compresses the heart, leading to decreased cardiac filling, and decreased cardiac output and pressure