Cardiac Path 1 (Pericarditis/Myocarditis)

Question 1

• A term used to describe inflammation of the pericardium (either visceral or parietal layers)
• inflammation of one usually causes an inflammation of the other

Answer 1

Pericarditis

Question 2

_________ is most often associated with other infections of the heart, such as a Myocarditis, or infections involving the thoracic cavity (Tuberculosis).

Answer 2

Pericarditis

Question 3

Which disease can be caused by:

• bacteria, viruses and rarely fungi
• metabolic waste products that accumulate in the blood in chronic renal failure leading to Uremia

Answer 3

Pericarditis

Question 4

Pericarditis-

Trauma and radiation injury may also cause a ________ inflammation, along with open heart surgery

Answer 4

Sterile inflammation

Question 5

Pathologically, _________ is always associated with exudation of fluid into the pericardial sac

Answer 5

Pericarditis

Question 6

The fluid in the pericardial sac is clear yellow in __________ pericarditis, as in viral infections

Answer 6

serous pericarditis

Question 7

Pericarditis:

• Purulent exudate is a hallmark of ________ infections
• This type of infection can be caused by which organisms?

Answer 7

Bacterial infections–>This is called Bacterial (suppurative) pericarditis

Caused by pus forming bacteria such as Staph or Strept

Question 8

Pericarditis:

________ exudate is associated with more severe damage, such as in Rheumatic Fever or in early bacterial infections

Answer 8

Serofibrinous

Question 9

In a _________ pericarditis, the surface of the heart is covered with shaggy, yellowish layers of fibrin that bridges the space between the two layers of the pericardial sac, obliterating the cavity

Answer 9

Fibrinous

Question 10

In which pericarditis do the epicardium and pericardium resembe bread and butter taken apart?

Answer 10

Fibrinous pericarditis

Question 11

Which Pericarditis?

Answer 11

Fibrous (Adhesive) Pericarditis

Question 12

Definition of what?

• An acute inflammation of the myocardium typically caused by viruses.
• Can occur as a primary disease or due to a secondary disorder (I.e. Rheumatic Myocarditis due to Rheumatic Fever, Lupus, or other autoimmune diseases)

Answer 12

Myocarditis

Question 13

In Myocarditis, over 80% of cases are caused by viruses, most often due to ________

-Can also be caused by fungi and parasites

Answer 13

******Coxsackie B virus *******

Question 14

What is the most common cause of Myocarditis?

Answer 14

****Coxsackie B virus****

(This will be an exam question!)

Question 15

Can bacteria cause Myocarditis?

Answer 15

Bacterial Myocarditis is relatively rare, usually due to a secondary disorder (i.e. Diphtheria, Meningococcus, and Staph Endocarditis).

Question 16

What condition?

Other causes include a radiation reaction, hypersensitivity reactions (i.e SLE, Scleroderma, RF) and Sarcoidosis.

Answer 16

Myocarditis

Question 17

In viral myocarditis, where does the virus invade in order to survive?

Answer 17

The viruses cannot survive outside the cells, so they invade the myocardium to survive

Question 18

What causes myocardial disease (Myocarditis) in the following way:

• In the myocardial cells, _____ damage the vital cell organelles and cause cell death
• This weakens the myocardium and contributes to heart failure.
• Also, the myocardium is invaded by T-Lymphocytes that are attracted there by the _____. The T-lymphocytes secrete lymphokines such as Interleukins and TNF.

Answer 18

Viruses

Question 19

The ______ are supposed to kill the virus, but they also destroy the virus-infected myocardial cells, also contributing to the heart failure.

Answer 19

Lymphokines

Question 20

Which condition do pathologists describe the pathology as “Tiger Effect”

Answer 20

Viral myocarditis

Question 21

Which condition has the following pathology?

-The pathology relates to pale and congested areas with mild hypertrophy, along with biventricular dilatation and generalized hypokinesis of the myocardium.(Tiger Effect)

Answer 21

Viral myocarditis

Question 22

The hearts of patients dying of Myocarditis are usually _____ and ______

Answer 22

Flabby and dilated

Question 23

Histology of what condition:

• a patchy, diffuse interstitial infiltrate principally composed of T-Lymphocytes and macrophages.
• The inflammatory cells often surround individual myocytes with focal or patchy acute myocyte necrosis.

Answer 23

The histology of viral myocarditis

Question 24

Clinically, the symptoms of viral myocarditis usually begin ______ after the infection.

Answer 24

A few weeks

Question 25

clinical presentation of_______ :

• mild fever
• shortness of breath
• malaise
• signs of heart failure (if severe or chronic)–> tachycardia, peripheral cyanosis, pulmonary edema

Answer 25

Myocarditis

Question 26

Does myocarditis affect men or women more?

Answer 26

2x more males than females

Question 27

What is the prognosis of myocarditis

Answer 27

Despite extensive inflammation, most recover from acute myocarditis

-although a few die from CHF or arrhythmias.

Question 28

How do you diagnose Myocarditis?

Answer 28

Endomyocardial Biopsy

Question 29

How do you treat myocarditis?

Answer 29

no specific treatment for viral myocarditis, and supportive measures are needed.