cardiac pathology Flashcards
Heart failure cells (macrophages)
left sided HF
Nutmeg liver
right sided HF
Most common blood vessel involved in myocardial infarction
Left anterior descending artery
Electron microscope findings 30 minutes after an ischemic event
Microfibril relaxation, glycogen loss and mitochondrial swelling
heaped-up calcified masses
Calcific aortic stenosis
is the most prevalent heart valve disorder in developed countries
Calcific aortic stenosis
is characterized by progressive fibro-calcific remodelling and thickening of the aortic valve leaflets that, over years, evolve to cause severe obstruction to cardiac outflow
Calcific aortic stenosis
there are only two functional cusps, usually of unequal size, with the larger cusp having a midline raphe, resulting from incomplete commissural separation during development
congenitally bicuspid aortic valve
Although BAV(bicuspid aortic valve) is usually asymptomatic early in life late complications
include aortic stenosis or regurgitation, infective endocarditis, and aortic dilation and/or dissection
degenerative calcific deposits in the mitral valve typically develop in the fibrous annulus. Grossly, these appear as irregular, stony hard, occasionally ulcerated nodules (2 to 5 mm in thickness) at the base of the leaflets
Mitral Annular Calcification
Mitral Annular Calcification can lead to:
- Regurgitation by interfering with physiologic contraction of the valve ring
- Stenosis by impairing opening of the mitral leaflets
- Arrhythmias and occasionally sudden death by penetration of calcium deposits to a depth sufficient to impinge on the atrioventricular conduction system.
Because calcific nodules may also provide a site for thrombus formation
patients with mitral annular calcification have an increased risk of embolic stroke, and the calcific nodules can become a nidus for infective endocarditis.
Dilated cardiopathy:
systolic
Hypertrophic cardiopathy
diastolic
Restrictive cardiopathy
Diastolic dysfunction or impaired complianc
is the buildup of extra fluid in the space around the heart. If too much fluid builds up, it can put pressure on the heart. This can prevent it from pumping normally. A fibrous sac called the pericardium surrounds the heart. This sac consists of two thin layers.
Pericardial effusion
the presence of blood within the pericardial cavity, i.e. a sanguineous pericardial effusion. If enough blood enters the pericardial cavity, then a potentially fatal cardiac tamponade can occur.
Hemopericardium
is characteristically produced by noninfectious inflammatory diseases, including rheumatic fever, SLE, and scleroderma, as well as tumors and uremia. An infection in the tissues contiguous to the pericardium— for example, a bacterial pleuritis—may incite sufficient irritation of the parietal pericardial serosa to cause a sterile serous effusion that can progress to serofibrinous pericarditis and ultimately to a frank suppurative reaction.
Serous pericarditis
most frequent types of pericarditis
Fibrinous and serofibrinous pericarditis
Type of pericarditis found in patients with uremia or viral infection. The exudate imparts an irregular apperance to the pericardial surface (bread and butter pericarditis)
Fibrinous pericarditis
Bacterial pericarditis manifests with this type of exudate
Fibrinopurulent
active
infection caused by microbial invasion of the pericardial
space; this can occur through
Purulent or suppurative pericarditis
pericarditis the surface is dry, with a fine granular
roughening
Fibrinous pericarditis
pericarditis a more intense inflammatory
process induces the accumulation of larger amounts of
yellow to brown turbid fluid, containing leukocytes, erythrocytes,
and fibrin. As with all inflammatory exudates, fibrin may
be lysed with resolution of the exudate, or can become organized
serofibrinous pericarditis
pericarditis has an exudate composed of
blood mixed with a fibrinous or suppurative effusion; it is
most commonly caused by the spread of a malignant neoplasm
to the pericardial space
Hemorrhagic pericarditis
Pericarditis. In some cases organization
merely produces plaque-like fibrous thickenings of
the serosal membranes (“soldier’s plaque”) or thin, delicate
adhesions that rarely cause impairment of cardiac function.
Chronic or Healed Pericarditis
may follow infectious
pericarditis, previous cardiac surgery, or mediastinal irradiation.
The pericardial sac is obliterated, and adherence
of the external aspect of the parietal layer to surrounding
structures strains cardiac function
Adhesive mediastinopericarditis
pericarditis the heart is encased in a dense,
fibrous or fibrocalcific scar that limits diastolic expansion
and cardiac output, features that mimic a restrictive cardiomyopathy.
constrictive pericarditis
Chylous pericardial fluid can be caused by
Mediastinal lymphatic obstruction
The most common tumor of the heart.
Metastatic tumor
Major clinical manifestations of this cardiac tumor are due to valvular “ball-valve” obstruction, embolization or a syndrome of constitutional symptoms
Myxoma
Long standing severe right-sided HF leads to fibrosis of centrilobular areas, creating this condition
cardiac cirhosis
Generalized, massive edema is called
Anasarca
These a typically smooth-walled defects near the foramen ovale, usually without associated cardiac abnormalities. Accompanied by right atrial and ventricular dilation, right ventricular hypertrophy and dilation of the pulmonary artery
Ostium secundum ASD
These occur at the lowest part of the atrial septum and can extend to the mitral and tricuspid valves. Abnormalities of the AV Valves are usually present, forming a cleft in the anterior leaflet of the mitral valve or septal leaflet of the tricuspid valve
Ostium primium ASD
Reversal of blood flow through a prolonged (left-to-right shunt) due to pulmonary hypertension, yielding right-sided pressures that exceed those on the left side. This causes unoxygenated blood to go into circulation, causing cyanosis
Eisenmenger syndrome
This arises from the left pulmonary artery and joins the aorta just distal to the origin of the left subclavian artery
Ductus arteriosus
In this condition, some of the oxygenated blood flowing from the left ventricle is shunted back to the lungs. Proximal pumonary arteries, left atrium and ventricle can become dilated
Patent Ductus arteriosus
The most common cause of cyanotic congenital heart disease. Heart is large and “boot shaped” as a result of right ventricular hypertrophy
Tetralogy of Fallot