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CVSOH BVSc3 > Cardiac system pathology > Flashcards

Cardiac system pathology Flashcards

1
Q

What is volume overload?

A

Adaptation to compensate for abnormal increase in blood volume within the heart chambers

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2
Q

What is pressure overload?

A

Adaptation to compensate for increase in resistance in blood flow

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3
Q

What are some causes of volume oveload?

A

Shunts

Valvular insufficiencies

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4
Q

What are some causes of pressure overload?

A

Increased pulmonary/systemic pressure

Stenosis (narrowing) of ventricular outflow

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5
Q

What does volume overload cause?

A

Eccentric hypertrophy

Also atrial dilation

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6
Q

Is volume overload a problem with diastole or systole?

A

Diastole - increased end diastolic volume

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7
Q

What does eccentric hypertrophy look like?

A

Ventricular wall is thickened but due to enlargement of the chamber it can appear normal when stretched

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8
Q

What causes atrial dilation to occur due to volume overload?

A

Left atrioventricular valve insufficiency- blood goes backwards into atrium

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9
Q

What does pressure overload cause?

A

Concentric hypertrophy

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10
Q

What is concentric hypertrophy?

A

Thickened ventricular walls - new sarcomeres forming in parallel to generate more force to eject blood

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11
Q

Is concentric hypertrophy an issue with diastole or systole?

A

Systole - excessive afterload causing increased systolic wall stress
More pressure needed during systole

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12
Q

What is pulmonic stenosis?

A

Narrowing of the pulmonary valve opening

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13
Q

What does pulmonic stenosis cause?

A

Pressure overload and concentric hypertrophy

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14
Q

What does concentric hypertrophy look like?

A

Thickened ventricular wall

Lumen normal or reduced in size

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15
Q

Why is myocardial hypertrophy bad?

A

Insufficient blood supply
Cardiomyocyte death/fibrosis
Reduced ventricular wall compliance

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16
Q

What congenital malformations cause left to right shunting of blood?

A

Patent ductus arteriosus
Atrial/ventricular septal defect
Endocardial cushion defects

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17
Q

Where does the blood shunt from in a patent ductus arteriosus?

A

Aorta into the pulmonary artery

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18
Q

What are secondary effects of patent ductus arteriosus?

A

Pulmonary oedema
LHS systolic murmur
Volume overload - more blood draining from lungs
Pressure overload - pulmonary hypertension

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19
Q

Where is an atrial septal defect located?

A

Foramen ovale

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20
Q

Where is a ventricular septal defect located?

A

Ventricular muscle

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21
Q

What are potential secondary effects of ventricular septal defect?

A

Left to right shunt
Murmur
Left side volume overload
Right side volume and pressure overload

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22
Q

What are endocardial cushion defects?

A

Poorly formed walls separating the chambers of the heart – blood mixes easily

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23
Q

What are the different locations of stenosis?

A

Supravalvular
Valvular
Subvalvular - tissues beneath valve in ventricle

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24
Q

What is the most common location/cause of pulmonic stenosis?

A

Valvular - leaflet thickening, fusion/ hyperplasia of valve annulus

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25
Q

What is the most common location/cause of aortic stenosis?

A

Subvalvular - plaques, ridges of connective tissue

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26
Q

What is atrioventricular valve dysplasia?

A

Irregular leaflet & Chordae Tendineae

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27
Q

What are some consequences of atrioventricular valve dysplasia?

A

Irregular leaflets & Chordae Tendineae

Fusion of leaflet

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28
Q

What is transposition of aorta/pulmonary artery?

A

Switching of Aorta/ Pulmonary artery

Presence of ventricular septal defect allows for blood mixing

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29
Q

What is an overriding aorta?

A

Aorta right above the VSD – Aorta able to receive blood from both ventricles

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30
Q

What is the name for the condition with 4 congenital heart defects all at once?

A

Tetralogy of Fallot

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31
Q

What are the 4 conditions of Tetralogy of Fallot?

A

VSD
Pulmonary stenosis
Overriding Aorta
RV hypertrophy

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32
Q

What are the 3 different types of pericarditis?

A

Fibrinous
Suppurative(purulent)
Constrictive

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33
Q

What animals is fibrinous pericarditis mostly found in?

A

Farm animals

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34
Q

What is fibrinous pericarditis mostly associated with?

A

Bacterial septicaemia and haematogenous infections

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35
Q

What are the main features of fibrinous pericarditis?

A

Fibrin strands attached or free floating within pericardial sac

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36
Q

What causes suppurative pericarditis?

A

Infection with pyogenic bacteria causing purulent/ fibrinopurulent exudate

37
Q

What is constrictive pericarditis?

A

Formation of severe adhesions from organized fibrous granulation tissue within the pericardium

38
Q

What is hydropericardium?

A

Excess volume of clear fluid within the pericardial space

39
Q

What can cause hydropericardium?

A

Causes of generalised oedema
Toxaemia
Neoplasms - cardiac haemangiosarcoma

40
Q

Where does cardiac haemangiosarcoma arise from?

A

Right atrium/auricle blood vessels

41
Q

What is haemopericardium?

A

Accumulation of pure blood in pericardial cavity

42
Q

What can cause haemopericardium?

A

Rupture of atrium or blood vessel
Clotting defect
Neoplastic disease

43
Q

What is cardiac tamponade?

A

Rapid accumulation of fluid in the pericardial sac which compresses/restricts heart expansion

44
Q

What are the consequences of cardiac tamponade?

A

Impaired cardiac filling
Reduced CO
Heart failure
Cardiogenic shock

45
Q

What are the 3 main types of cardiomyopathy/myocardial diseases?

A

Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy

46
Q

What is a cardiomyopathy?

A

PRIMARY structural and functional changes affecting the myocardium that no obvious cause is evident (eg. not secondary to congenital defects)

47
Q

What is dilated cardiomyopathy?

A

Reduced myocardial contractility and chamber dilation

48
Q

What type of function does dilated cardiomyopathy affect?

A

Affects systolic function - cant contract, reduced CO

49
Q

What is hypertrophic cardiomyopathy?

A

Ventricular hypertrophy - thickened ventricle walls

Reduced wall compliance

50
Q

What type of function does hypertrophic cardiomyopathy affect?

A

Affects diastolic function - ventricles cant fill so reduced end diastolic volume

51
Q

What is a consequence of hypertrophic cardiomyopathy?

A

Left atrial enlargement

Left sided congestive heart failure

52
Q

What is hypertrophic cardiomyopathy related to?

A

Ventricular hypertrophy

53
Q

What is restrictive cardiomyopathy?

A

Endocardial/ myocardial fibrosis Reduced ventricular wall compliance
Increased ventricular stiffness

54
Q

What are the anatomical features of dilated cardiomyopathy?

A

Thin ventricular walls

Stretched AV valve annulus

55
Q

What is the most common cause of heart disease in cats?

A

Hypertrophic cardiomyopathy

56
Q

Where does segmental hypertrophic cardiomyopathy primarily affect?

A

Basal regions of the ventricular septum

57
Q

What is the main species affected by each type of cardiomyopathy?

A

Dilated - Dogs
Hypertrophic - cats
Restrictive - cats

58
Q

What are 2 functional effects of hypertrophic cardiomyopathy?

A

Dynamic obstruction of the left ventricular outflow tract - narrowing
Systolic anterior motion of the mitral valve

59
Q

Which type of cardiomyopathy is less common?

A

Restrictive cardiomyopathy

60
Q

What is the most common cardiac disease in dogs?

A

Valvular endocardiosis (NOT ENDOCARDITIS)

61
Q

What is valvular endocardiosis?

A

Distortion of valve leaflets - valvular insufficiency

Slowly progressive degenerative condition

62
Q

What predisposes to valvular endocardiosis?

A

Small/medium dog breeds

Cavalier king Charles spaniel

63
Q

What is another name for valvular endocardiosis?

A

Myxomatous mitral valve disease

64
Q

Which valve is the most commonly affected valve in valvular endocardiosis (MMVD) in dogs?

A

Left atrioventricular valve - mitral valve

65
Q

Which valve is the most commonly affected valve in valvular endocardiosis (MMVD) in horses?

A

Aortic and left AV/mitral valve

66
Q

What are the gross features of valvular endocardiosis (MMVD) ?

A

Thickened leaflet

Smooth pink nodules

67
Q

What are the consequences of valvular endocardiosis (MMVD)?

A 
Left ventricular eccentric hypertrophy - volume overload
Left atrial dilation - regurgitation
Murmur
Jet lesion
Chordae tendineae rupture
Atrial rupture
68
Q

What is valvular endocarditis?

A

Inflammation of the endocardium - heart valves

69
Q

What animals are most commonly affected by valvular endocarditis?

A

Farm animals

70
Q

What causes valvular endocarditis?

A

Bacteria and trauma leading to inflammation and fibrin deposition

71
Q

What are the gross features of valvular endocarditis?

A

Raised irregular yellow plaques

72
Q

What are the consequences of valvular endocarditis?

A

Valvular insufficiency - volume overload
Valvular stenosis - pressure overload
Septic embolism

73
Q

What is cardiac failure?

A

Failure to:
Eject sufficient blood to meet requirements
Recieve enough blood to adequately drain systemic/pulmonary systems

74
Q

What is acute heart failure?

A

Rapid onset of new/worsening symptoms of HF

75
Q

What is a consequence of acute heart failure?

A

Cardiac syncope - big changes to BP and HR

Causes collapse and unconsciousness

76
Q

What are the two types of chronic heart failure?

A

Forward and backward failure

77
Q

What is forward failure?

A

Inadequate CARDIAC OUTPUT and decreased perfusion of peripheral tissues

78
Q

What is a consequence of forward heart failure?

A

Cardiogenic shock

79
Q

What is backward failure?

A

Failure to deal with VENOUS RETURN causing congestion of venous and capillary beds

80
Q

What are the consequences of backward heart failure?

A

Congestion and oedema

81
Q

What type of heart failure does left sided heart failure cause?

A

Backward failure to lungs - pulmonary congestion and oedema

Forward failure to body- ischaemia/hypoxia

82
Q

What type of heart failure does right sided heart failure cause?

A

Backward failure to body - systemic congestion and oedema

83
Q

What are the symptoms of left sided heart failure?

A

Dyspnoea and cough

Shock, hypotension

84
Q

What are the symptoms of right sided heart failure?

A

Ascites
Pleural effusion
Peripheral oedema
(All from backwards failure)

85
Q

What is the main symptom of right sided heart failure in dogs?

A

Ascites - fluid in body cavities

86
Q

What is the main symptom of right sided heart failure in cats?

A

Pleural effusion

87
Q

What is the main symptom of right sided heart failure in ruminants and horses?

A

Peripheral oedema

88
Q

What is a cardiac biomarker for cardiomyocyte damage?

A

Cardiac troponin I

89
Q

What is a cardiac biomarker for cardiomyocyte stretching?

A

NT-pro BNP

CVSOH BVSc3 (60 decks)

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