Cardiac

Question 1

A 12 year old boy presents with SOB and palpitations and has a history of a sore throat and fever (3 weeks ago). On exam there is a holocystolic murmur that radiates to the left axilla.

What histopathologic finding would you expect to find on a cardiac biopsy?

Answer 1

Dx is rheumatic fever post-strep.

Histopathology: interstitial fibrosis w/ lymphocytes and macrophages and multinucleate giant cells (green arrow), as well as Aschoff bodies (circled).

Question 2

Name four drugs that can cause a hypersensitivity myocarditis and name which inflammatory cell type would be expected to be seen on cardiac biopsy in this case.

Answer 2

Diuretics like furosemide and hydrochlorothiazide

Antibiotics like ampicillin and azithromycin

Question 3

Name two chemotherapeutic agents that can damage the heart. Which exact heart pathology do these cause?

Answer 3

Anthracyclines doxorubicin and danorubicin cause dilated cardiomyopathy

Question 4

Name three viruses that are able to cause viral myocarditis.

Answer 4

Coxsackie B, adenovirus, parvovirus B19

Question 5

What is the equation to calculate cardiac output using information from a cardiac catheterization?

Answer 5

CO = rate of O2 consumption / arteriovenous O2 difference (Fick equation)