39. Endocarditis, endocardosis and their consequences

Question 1

What is endocarditis?

Answer 1

Endocarditis
– Mostly bacterial: E. rhusiopathiae,
streptococci, staphylococci, klebsiella,
C. pyogenes (rarely parasital, fungal)
– valvular - parietal endocarditis
– acute - chronic (vegetative - verrucosus)
– mitral > aortic > tricuspid > pulmonary

Question 2

What are the consequences of endocarditis?

Answer 2

Consequences of endocarditis
– acute cardiac failure
– chronic cardiac failure
– septic thromboembolism

Question 3

Answer 3

Aortic valve valvulitis: slightly
thickened and displays small
vegetations – “verrucae”

Question 4

Answer 4

Endocarditis simplex → endocarditis verrucosa → endocarditis thromboulcerosa (valvular thrombus formation, white thrombus)

Question 5

Answer 5

Stenotic mitral valve,
fusion of commissures,
thickening and
calcification of the cusps
(→ endocarditis
fibroplastica)
Endocarditis
thromboulcerosa

Question 6

Describe the endocardial fibrosis?

Answer 6

Endocardial fibrosis
– diffuse, acquired
• dilation of the cardiac cavities,
DCMP, debilitating diseases
– focal, acquired
• valvular insufficiencies, „jet
lesions”
– diffuse or focal, congenital
• aortic or tr. pulmonalis stenosis
cattle

Question 7

Endocardial Mineralisation?

Answer 7

Endocardial mineralisation
–frequently occurs together with fibrosis
–mainly in the left atrium, aorta
• Secondary: on the basis of previous lesions (uraemia!)
• Vitamin E/Selenium deficiency (lamb)
• Vitamin D intoxication (iatrogenic, alimentary)
• Primary:
problems of
mineral
metabolism

Question 8

Answer 8

Diffuse, severe
calcification of the
left atrium, dog

Question 9

Endocardiosis?

Answer 9

Endocardiosis
– more frequent in old, small bodied male dogs
– (61% above 12 years!): poodle, dachshound, chihuahua
– Mitral > mitral-tricuspid > tricuspid > bicuspid valves
– unknown etiology
– macroscopic changes
• thickened, shortened, non-transparent, (greyish) white, smooth valvulae
• thickened chordae tendinae, sometimes they can rupture
– microscopic changes
• atrial endothelial proliferation
• subendothelial fibroblast and macrophage proliferation
• extracellular accumulation of proteoglycanes, hialuronic acid, chondroitinsulphate (hyalinosis)
• swollen, fragmented, hyalinized collagen fibres

Question 10

Answer 10

Endocardiosis dog