obstruction
Mitral Prolapse
•Young exercising thin women
•Systolic prolapse of mitral into the left atrium
•Most frequent valvular lesion
•Marfan’s disease (rare association)
•Parachute deformity
•Arrhythmias
•Mid-systolic click, late systolic murmur, and mitral regurgitation
Carcinoid Syndrome
•Cutaneous flushing
•Asthmatic wheezing
•Endocardial Plaque often on the right side
•High level of serotonin (5 HT)
•Recurrent diarrhea
Myocardial Infarction
•ST elevation
•Crushing chest pain at rest
•Troponin I and CPK Early; AST later; and LDH latest
•LDH 1 > LDH 2
•More in men than women
•Most common cause of cardiac death less than 1 hour after MI is ventricular tachycardia.
Heart Failure
•Left-sided; Pulmonary edema
•Right-sided; Hepatomegaly, Nutmeg liver
Rubella
•Patent Ductus Arteriosus
•IgM antibody (anti-rubella) indicates recent primary infection
•Congenital associated with deafness, cataracts, glaucoma, and mental retardation
•Prenatal worse than postnatal
Cardiomyopathies
•Hypertrophic: autosomal dominance, obstructive. AKA. Idiopathic hypertrophic sub-aortic stenosis
•Dilated: Congestive. Associated with ethanol, doxorubicin (adriamycin), mercury and lead poisoning, thyrotoxicosis, hypophosphatemia, hypocalcemia, thiamine deficiency. Left and right congestive failure.
•Restrictive: Impaired diastolic filling. Sarcoidosis, amyloidosis, and carcinoid syndrome
2. VASCULAR PATHOLOGY
Atherosclerosis
•Mural thrombus
•Men more than women
•Hypercholesterolemia
•Abdominal aorta, coronary artery and carotid artery
•Inverse relation to HDL cholesterol
Pulmonary Embolism
•Wasted ventilation in the affected, and over-perfusion of the remaining lung tissue
•Wedge-shaped infarcts
•Immobilized post-op patients
•Deep venous thrombosis
•Lower extremity
Syphilitic Aortic Aneurysm
•Ascending aorta
•Tree bark appearance
•Tertiary syphilis
•Aortic valve insufficiency
Aortic Dissecting Aneurysm
•Cystic medial necrosis
•Longitudinal intraluminal tear
•Ascending aorta
•Marfan’s Syndrome
•Hypertension and Hemopericardium
Idiopathic Hypertrophic
Subaortic Stenosis
•Haphazard Myocardial Arrangement
•Ca++ channel blockers
Wegener’s Granulomatosis
•Paranasal sinuses
•Otitis media
•Necrotizing arteritis and glomerulonephritis
•Granuloma formation
•C-ANCA
•TRT: Methotrexate
Malignant Hypertension
•Young male Afro-Americans
•Accelerated, early death
•Flea-bitten Kidney
Berry Aneurysm
•Circle of Willis
•Bifurcation of cerebral arteries
•Subarachnoidal hemorrhage
Secondary Hypertension
•Renal ischemia, stenosis
•Coarctation of aorta
•Pheochromocytoma
•Hyperthyroidism
•Cushing’s syndrome
•Primary aldosteronism
Thromboangiitis Obliterans
•Buerger’s disease
•Young Jewish men
•Heavy smoking
•Ischemia of extremities
Polyarteritis Nodosa
•P-ANCA
•Small-medium sized arteries
