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04. Cardiovascular Pathology > 10. Myocardial diseases > Flashcards

10. Myocardial diseases Flashcards

1
Q

Definition of myocarditis

A

Inflammation of the myocardium due to infectious agents or autoimmune conditions

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2
Q

Causes of myocarditis

A
  1. Infection
    - Viral (Coxsackieviruses A & B, enteroviruses, CMV, HIV , influenza, parvovirus, EBV)
    - Bacterial (Corynebacterium diphtheria, Neisseria meningitidis, Borrelia burgdorferi, Chlamydia, Rickettsiae)
    - Fungal
    - Parasitic (Chagas disease, toxoplasmosis, trichinosis)
  2. Immune-mediated
    - Post-viral
    - Post-streptococcal (rheumatic fever)
    - Systemic lupus erythematosus
    - Drug hypersensitivity (methyldopa, sulfonamides)
    - Transplant rejection
  3. Others
    - Sarcoidosis
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3
Q

Morphology of myocarditis

A
  1. [Gross] Enlarged heart, dilated cardiac chambers, flabby myocardium, mottled appearance
  2. [Histology] Variable according to specific causative agent, evidence of fibrosis in healing
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4
Q

Pathological effects & complications of myocarditis

A
  1. Precipitous onset of heart failure & sudden death

2. Development of dilated cardiomyopathy

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5
Q

Definition of cardiomyopathy

A

Heart disease arising from an abnormality in the myocardium, often producing abnormalities in cardiac wall thickness & chamber size accompanied by mechanical &/or electrical dysfunction

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6
Q

Causes of cardiomyopathy

A
  1. Inherited cardiomyopathy (e.g. muscular dystrophy)
  2. Secondary cardiomyopathy
    - Multisystem disease (diabetes, thyroid disease, amyloidosis, hemochromatosis)
    - Inflammatory/infectious diseases (myocarditis, Chagas disease)
    - Toxic/metabolic (alcohol, cocaine, chemotherapy, lithium, phenothiazines, chloroquine)
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7
Q

Patterns of cardiomyopathy

A
  1. Dilated (congestive) cardiomyopathy
  2. Hypertrophic cardiomyopathy
  3. Restrictive cardiomyopathy
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8
Q

Definition of dilated cardiomyopathy

A

Characterized by progressive cardiac dilation & systolic (contractile) dysfunction

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9
Q

Causes of dilated cardiomyopathy

A
  1. Genetic (e.g. Duchenne Muscular Dystrophy)
  2. Alcohol
  3. Myocarditis
  4. Drugs
  5. Idiopathic
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10
Q

Pathological effects & complications of dilated cardiomyopathy

A
  1. Progressive heart failure
  2. Mitral regurgitation (secondary mitral insufficiency)
  3. Mural thrombus formation & embolization
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11
Q

What does dilated cardiomyopathy mimics?

A

Ischemic, valvular, congenital & hypertensive heart diseases

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12
Q

Definition of hypertrophic cardiomyopathy

A

Characterized by myocardial hypertrophy, poorly compliant left ventricular myocardium leading to a diastolic dysfunction (impaired diastolic filling), & in about 1/3 of cases, intermittent ventricular outflow obstruction due to an enlarged ventricular septum

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13
Q

Causes of hypertrophic cardiomyopathy

A
  1. Genetic (genes coding for sarcomeric proteins, typically autosomal dominant inheritance with age-related penetrance)
  2. Alcohol
  3. Storage diseases
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14
Q

Pathological effects & complications of hypertrophic cardiomyopathy

A
  1. Left atrial dilation & mural thrombus formation
  2. Pulmonary venous hypertension, exertional dyspnea
  3. Ventricular arrhythmias
  4. Sudden cardiac death (one of the most common
    causes of sudden death in young athletes)
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15
Q

What mimics hypertrophic cardiomyopathy

A

Hypertensive heart disease, aortic stenosis

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16
Q

Definition of restrictive cardiomyopathy

A

Characterized by a primary decrease in ventricular compliance, resulting in a diastolic dysfunction

17
Q

Causes of restrictive cardiomyopathy

A
  1. Amyloidosis
  2. Radiation fibrosis
  3. Endocardial fibrosis (fibrosis of ventricular endocardium & subendocardium that extends from the apex upwards, often involving tricuspid & mitral valves; unknown etiology)
  4. Endocardial fibroelastosis (fibroelastic thickening of mural endocardium with or without valvular involvement; demonstrates a left-sided predominance, most common in first 2 years of life)
  5. Idiopathic
18
Q

What does restrictive cardiomyopathy mimics?

A

Constrictive pericarditis

04. Cardiovascular Pathology (11 decks)

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