DISEASES OF THE HEART
DISEASES OF THE ENDOCARDIUM
RHEUMATIC FEVER
Definition
General consideration
Etiology: Age incidence, predisposing factors
Pathogenesis
Acute rheumatic fever
Changes in the heart: Pancarditis; Pericarditis, Myocarditis, Endocarditis
Microscopic picture
Chronic rheumatic heart diseases
Changes in other tissues in RF: Joints, Subcutaneous nodules, Brain, Skin, Pleura and Peritoneum, Blood vessels
Clinical features of acute RF
Causes of death in RF
ENDOCARDITIS
Definition
Types
Infective endocarditis (bacterial endocarditis)
Acute bacterial endocarditis (ABE)
Subacute bacterial endocarditis (SBE)
Non-infective endocarditis
Rheumatic endocarditis
Atypical verrucous endocarditis (Libman-Sacks endocarditis)
Non infective thrombotic endocarditis (Terminal endocarditis)
Infective endocarditis
Predisposing factors
SUBACUTE INFECTIVE ENDOCARDITIS
Etiology
Pathogenesis
Pathological lesions
Complications and effects
Embolic manifestations
Renal lesions
Mycotic aneurysms
Skin lesions
Clinical features and course
Causes of death
End results
Investigations
ACUTE INFECTIVE ENDOCARDITIS
Pathogenesis
Pathological features
Spread of infection
Complications: Local and general
Effects and end results
Clinical features and course
Causes of death
Other types of endocarditis
Non infective thrombotic endocarditis
Libman-Sacks endocarditis
VALVULAR DISEASES
Diseases of mitral valve
Mitral stenosis: Etiology, Gross picture, Microscopic picture, Effects, Complications, Causes of death
Mitral incompetence: Etiology, Effects, Complications, Causes of death
Diseases of aortic valve
Aortic incompetence: Etiology, Effects, Complications, Causes of death
Aortic stenosis: Etiology, Effects, Causes of death
Diseases of tricuspid valve
Tricuspid stenosis: Etiology
Tricuspid incompetence: Etiology, Effects
Diseases of pulmonary valve
Pulmonary stenosis: Causes, Effects
Pulmonary incompetence: Etiology, Effects
DISEASES OF THE MYOCARDIUM
Blood supply of the heart
ISCHAEMIC HEART DISEASE
General consideration and causal factors
Angina Pectoris
Variants of angina
Typical Stable Angina
Variant Angina “Prinzmetal’s angina”
Unstable Angina (cresendo angina)
Chronic ischemic heart diseases
Gross and microscopic features
Myocardial Infarction
Types of Myocardial Infarction
Regional MI
Subendocardial MI
Microscopic infarcts
Pathogenesis of MI
Myocardial response to ischemia
Morbid anatomy and Microscopic features
Morphological changes in MI
Size and rate of development of MI
Clinical feature and course
Outcome of myocardial infarction
Complications of MI
Arrhythmias
Cardiac failure
Mural thrombosis
Venous thrombosis
Rupture of infarcted myocardium
Cardiac aneurysm
Angina pectoris
Recurrence of infarction
Post-infarction Dressler’s syndrome
Subendocardial MI
Other effects of IHD
Sudden death
CARDIOMYOPATHY
Primary Cardiomyopathy: types and causes
Hypertrophic cardiomyopathy
Dilated (congestive) cardiomyopathy
Restrictive (oblitrative) cardiomyopathy
Endomyocardial fibrosis
Endomyocardial fibroelastosis
Secondary Cardiomyopathy
MYOCARDITIS
Definition
Types
Viral interstitial myocarditis
Suppurative myocarditis
Toxic myocarditis
Hypersensitivity reactions
Granulomatous myocarditis
DISEASES OF THE PERICARDIUM
PERICARDITIS
Morphology
Types and causes of pericarditis
Viral and idiopathic pericarditis
Bacterial pericarditis
Tuberculous pericarditis
Other causes of acute pericarditis
Constrictive pericarditis
Hydropericardium
Hemopericardium
CONGENITAL HEART DISEASES
Etiology
Non-cyanotic group
Left to right shunt
Atrial septal defect (ASD)
Ventricular septal defect (VSD)
Patent ductus arteriosus (PDA)
No shunt
Pulmonary stenosis
Aortic stenosis
Coarctation of the aorta
Cyanotic group: (right to left shunt)
Fallot’s trilogy
Fallot’s tetralogy
Eisenmenger’s syndrome
Transposition of great vessels
Complications of congenital heart diseases
TUMORS OF THE HEART
Primary and secondary
HEART FAILUIRE
Definition
ACUTE HEART FAILURE
Causes
Cardiogenic shock
CHRONIC HEART FAILURE
Causes of RSHF
Heart diseases
Lung diseases
Causes of LSHF
Increase workload
Myocardial injury
Myocardial injury
Patho-physiological concepts
Forward failure vs backward failure
Systolic failure vs diastolic failure
Systolic failure (inadequate emptying)
Impaired ventricular contraction
Manifestation of cardiac failure
Congestive (biventricular) failure
Increased volume load
Pressure overload
Diastolic failure (inadequate filling)
Pericardial diseases
Stenosis of mitral or tricuspid valve
Atrial arrhythmias
Decreased myocardial compliance
Severe endocardial thickening