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SYSTEMIC PATHOLOGY - 1 > 3 – Pericardium and Endocardium > Flashcards

3 – Pericardium and Endocardium Flashcards

1
Q

Serous atrophy of fat

A
  • *gelatinous appearance
  • Epicardial fat
  • Bone-marrow
  • Kidney
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2
Q

When does serous atrophy of fat occur?

A
  • When individual has a NEGATIVE energy balance
  • Starvation
  • Chronic inflammation (Ex. Johnes)
  • Severe GI problems
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3
Q

Pericardial hemorrhages common post-mortem finding in animals that suffered

A
  • Hypoxia
  • Sepsis or septicemia
  • Toxemia
  • DIC
  • Coagulopathies
  • Electrocution
  • *terminal finding in large animals
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4
Q

Classification of hemorrhages: according to size

A
  • Petechial
  • Ecchymotic
  • Paint brush
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5
Q

Pericardial effusions

A
  • Accumulation of fluid in the pericardial sac
  • Transudate, blood, exudate
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6
Q

Distention of the pericardial sac: notably enlarge on physical damage to accommodate

A
  • Excess fluid in hydropericardium
  • Non-fatal progressive pericardial hemorrhage in hemopericardium
  • Exudate in pericarditis
  • Enlarged heart in cardiac hypertrophy and cardiomyopathy
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7
Q

Transudate

A
  • Clear fluid
  • Low cellularity
  • Low protein
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8
Q

Exudate

A
  • Turbid
  • High cellularity
  • PMNs (polymultinuclear neutrophils)
  • High protein
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9
Q

Hydropericardium

A
  • Transudate pericardial effusion
  • Pericardial surfaces remain SMOOTH and GLISTENING
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10
Q

Hydropericardium pathogenesis

A
  • Hydrostatic
  • Hypoproteinemia
  • Altered vascular permeability (ex. mulberry heart)
  • *can be due to salt (NaCl) toxicity in chickens
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11
Q

Hydrostatic pathogenesis for hydropericardium

A
  • R heart failure
  • Pulmonary hypertension
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12
Q

Hypoproteinemia pathogenesis for hydropericardium

A
  • Emaciation
  • Protein losing enteropathy/nephropathy
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13
Q

Hemopericardium

A
  • Blood pericardial effusion
  • Predominantly RBCs
  • High protein
  • Caution: blood-tinged fluid occurs normally as a post-mortem finding
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14
Q

Hemopericardium can be caused by

A
  • Atrial or aortic rupture
  • Hemangiosarcoma
  • Cardiac trauma/puncture
  • *acute hemorrhage can cause CARDIAC TAMPONADE->sudden DEATH
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15
Q

Hemangiosarcoma in dog causing hemopericardium

A
  • Dark b/c neoplastic cells form blood-filled vascular channels
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16
Q

Pericarditis

A
  • Exudate pericardial effusion
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17
Q

According to the exudate in pericarditis: classification

A
  • Fibrinous (most common)
  • Suppurative (purulent)
  • Fibrinohemorrhagic
  • Granulomatous
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18
Q

Fibrinous pericarditis

A
  • APPEARANCE: ‘bread and butter’, ‘cor villosum’
  • Most commonly a result of bacterial infection
  • Can be due to extension of a local inflammatory process
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19
Q

Polyserositis (Glasser’s disease)

A
  • Due to GLAESSERELLA PARASUIS
  • Fibrin and fluid in pericardial sac
  • Fibrinopurulent exudate in joints
  • (streptococcus suis type 2 can cause similar lesions in pigs)
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20
Q

Black leg (clostridial myositis)

A
  • Fibrinous pericarditis commonly seen
    o Fibrin strands in pericardial sac
  • Black discolouration of leg muscle
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21
Q

Traumatic reticulopericarditis

A
  • When ruminant eats wire or nails and it pokes forward into the pericardium
  • Dilated and thickened pericardial sac with fibrosis
  • Sac is filled with exudate
  • Epicardial surface is covered by exudate
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22
Q

Chronic pericarditis

A
  • Brisket edema due to heart failure (compressive)
  • Distended pericardial sac
  • Sac filled with fibrin and blood
  • Organized fibrin on epicardium
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23
Q

Chronic constrictive pericarditis

A
  • Heart is encased in a dense fibrous or fibrocalcific scar
  • May obliterate pericardial space
  • *in extreme cases=resembles a plaster mold (‘concretio cordis’)
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24
Q

Examples of endocardial diseases

A
  • Endocardial fibrosis
  • Endocardial mineralization
  • Valvular cysts
  • Endocarditis
  • Myxomatous degeneration
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25
Q

Acquired (secondary) fibrosis

A
  • Focal or generalized
26
Q

What is the most common cause of focal acquired fibrosis?

A
  • Abnormal blood turbulences in atria or ventricles caused by ‘jet lesions’
27
Q

“jet lesions”

A
  • Occur when mechanical injury caused by turbulence damage to the endocardium
  • Commonly seen in valvular insufficiencies (see them on the atrial endocardium)
28
Q

What is the most common cause of diffuse acquired fibrosis?

A
  • Sub-endocardial fibrosis secondary to prolonged cardiac dilation
29
Q

Primary endocardial fibroelastosis

A
  • Occurs as hereditary disease in humans and Burmese cats (no underlying cardiac disease)
  • Pathogenesis is uncertain
30
Q

Gross lesions and microscopic lesions of endocardial fibrosis and fibroelastosis

A
  • Endocardium appears thickened=due to abnormal deposition of collage and elastic fibers
    o smooth or corrugated surface
31
Q

Clinical relevance of endocardial fibrosis and fibroelastosis

A
  • Severe generalized fibrosis can impair ventricular filling during diastole and reduced SV leading to congestive heart failure
32
Q

Subendocardial fibrosis

A
  • Increased collagen deposition
    o secondary to prolonged blood turbulence caused by a congenital heart defect
  • Grossly: diffusely white, thickened endocardium
33
Q

Endocardial mineralization

A
  • Abnormal deposition of calcium or mineral in the endocardium
34
Q

Types of endocardial mineralization

A
  • Metastatic
  • Dystrophic
35
Q

Metastatic endocardial mineralization

A
  • High levels of circulating Ca2+ in hypercalcemic states
36
Q

Dystrophic endocardial mineralization

A
  • Secondary calcification in INJURED endocardium
37
Q

What are the most common causes of endocardial mineralization in domestic animals?

A
  • Hypervitaminosis D
  • Chronic granulomatous diseases
  • Uremia (uremic endocarditis)
38
Q

Hypervitaminosis D (endocardial mineralization)

A
  • When give excess vitamin D
  • Ex. ingest Vitamin D analogs=present in some rodenticides or toxic plants
39
Q

Toxic plant examples for VItamin D analogs

A
  • Solanum malacoxylon
  • Cestrum diurnum
  • Trisetum flavescens
40
Q

Chronic granulomatous diseases (endocardial mineralization)

A
  • Ex. bovines with paraTB or TB
    o Endocardial and arterial mineralization
41
Q

Valvular cysts

A
  • Particularly common in calves
  • ‘incidental finding’
  • Can regress or disappear
  • No clinical significance
42
Q

Cysts are classified as

A
  • Lymphocyst
  • Hematocyst
43
Q

Lymphocyst

A
  • Content is clear fluid
44
Q

Hematocyst

A
  • Content is blood
45
Q

Myxomatous valvular degeneration (endocardiosis)

A
  • Most common cardiac lesion found at necropsy in mature dogs
  • Incidence increases with age
  • Typically affects mitral valve
  • NODULAR THICKENING of valve with a smooth, shiny surface
    o May see hooding of leaflets toward the atrium (valve prolapse)
  • May or may not cause valvular dysfunction and clinical signs
46
Q

Endocardiosis and ruptured chordae tendineae

A
  • Rupture causes eversion of leaflet into atrium
  • Test by filling ventricle with water and compressing the heart, if rupture=1 or more chordae will whip out during ‘manual systole’
47
Q

Endocarditis

A
  • Inflammation of the endocardium
  • Occurs in all species
  • Most frequently caused by BACTERIA (less extent by fungi and parasites)
  • Classify based on location and gross appearance
48
Q

Endocarditis based on location

A
  • Valvular endocarditis (valves)
  • Mural endocarditis (ventricular or atrial wall)
49
Q

Endocarditis based on gross appearance

A
  • Vegetative
  • Ulcerative
50
Q

Vegetative endocarditis

A
  • Cauliflower-like mass of exudate and fibrin attached to a heart valve OR endocardium
51
Q

Ulcerative endocarditis

A
  • Endocardium is ulcerated
  • Ex. dogs with uremia
52
Q

What is a common sequel to endocarditis?

A
  • Thromboembolism
    o Mitral or aortic endocarditis often cause renal infarcts
    o Tricuspid and pulmonic endocarditis cause pulmonary infarcts or embolic pneumonia
53
Q

Vegetative valvular endocarditis

A
  • Common in farm animals (pigs and cattle) suffering from BACTEREMIA
  • Occasionally seen in dogs and cats
54
Q

What are the most common bacteria isolated from endocarditis in horses?

A
  • Streptococcus equi
  • Actinobacillus equuli
55
Q

What are the most common bacteria isolated from endocarditis in cattle?

A
  • Trueperalla (Arcanobacterium) pyogenes
56
Q

What are the most common bacteria isolated from endocarditis in pigs?

A
  • Erysipelothrix rhusiopathiae
  • Streptococcus suis type II
57
Q

What are the most common bacteria isolated from endocarditis in dogs?

A
  • Staphylococcus aureus
58
Q

What are the most common bacteria isolated from endocarditis in cats?

A
  • Bartonella
  • Streptpococcus sp.
59
Q

Vegetative mass on tricuspid valve in cow causing

A
  • Right sided heart failure
  • Hydrothorax
  • ‘nutmeg liver’
60
Q

Vegetative valvular endocarditis: histopathology

A
  • Bacterial colonies
  • Neutrophils and cell debris
  • Connective tissue and macrophages
61
Q

What is the lesion that indicates embolism?

A
  • Multiple embolic foci (white dots surrounded by a red halo)
62
Q

What can all be seen in a dog with uremia with chronic renal failure?

A
  • Endocarditis
  • Mineralization
  • Fibrous tissue (scar) formation

SYSTEMIC PATHOLOGY - 1 (24 decks)

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