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Pathology > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Cardiac myocytes lack

A

plasticity

(limited ability to respond to stress)

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2
Q

Mature cardiac muscle response to injury

A
  • healing is by fibrosis
  • Atrophy-reversible
  • Hypertrophy-reversible
  • Degeneration-sublethal
  • Necrosis-lethal
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3
Q

Histopath of heart

A

unlikely to result in specific dx

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4
Q

Heart failure

A
  • endpoint rather than specific disease
    • dec myocardial contractility
    • decreased compliance (fibrosis)
    • dysrythmias/arrythmias
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5
Q

Endocardium

A
  • Innermost layer of heart
  • lines
    • ventricles
    • atria: thicker in atria than ventricles (can look white grossly)
    • extends over chordae tendinae
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6
Q

Vascular supply of the heart

A
  • left and right coronary artery arising from aorta
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7
Q
A
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8
Q

Epicardium

A
  • outermost layer contiguous at cardiac base with pericardium
  • entire inner surface of pericardial cavity lined by mesothelium
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9
Q

Systematic examination of the heart

A

Follow normal blood flow

RA - RV - MPA - LA - LV - aorta

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10
Q

Routine sections for histopath (2)

A
  • papillary muscle
  • mitral valve
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11
Q

Artifacts

A
  • Post mortem clots: red ‘currant jelly’ clots not attached to endocardium
  • Chicken fat clots in horses
  • Red staining endocardium: RBC lysis (hemoglobin imbibition)
  • Euthaniasia solution after a cardiac stick
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12
Q

SA node

AV node

R and L bundle branches

A
  • junction of cranial vena cava and RA (free wall)
  • bundle of HIs: beneal septal leaflet of right AV valve w/in interventricular septum
  • ramify over ventricle as purkinje fiber: subendocardial
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13
Q

Cardiac compensation

A
  • dilation
  • hypertrophy
  • inc heart rate
  • inc in peripheral resistance
  • inc in blood volume
  • redistribution of blood flow

*failure of compensation: decompensation (heart failure)

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14
Q

DIlation

A
  • structural compensation
  • maintains connections and architecture
  • stretching of myofibers
  • often degenerative
  • result of chronic overload
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15
Q

hypertrophy

A
  • structural compensation
  • inc in mass not cell number
  • results from pressure overload
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16
Q

Mechanical compensation

A
  • inc HR
  • inc peripheral resistance
  • inc in blood volume
  • redistribution of blood flow
    • baroreceptors: look for pressure drops and compensate with VOLUME
    • not pumping well, poor pressures
  • shunting
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17
Q

Cardiac hypertrophy

A
  • compensatory mechanism that requires
    • time
    • healthy myocardium
    • adequate myocardial nutrition/oxygenation
18
Q

Causes of Right ventricular hypertrophy

A
  • pulmonary hypertension
  • congenital abnormalities
  • tricuspid (Right AV) incompetence
  • mechanical obstruction: dirofilarisis
19
Q

Cor pulmonale

A
  • right ventricular hypertrophy from long-term pulmonary hypertension
20
Q

Causes of Left ventricular hypertrophy

A
  • systemic hypertension
    • renal dz
  • congenital abnormalities
    • aortic stenosis
  • mitral incompetence
  • Endocrine disease
    • hyperthyroidism
    • acromegaly
21
Q

Clinical Syndromes of Cardiac Decompression

A
  • Cardiac Syncope; acute cardiac failure
  • Congestive Heart Failure; chronic loss of pumping ability
22
Q

Cardiac Syncope; acute cardiac failure

A
  • Arrythmias, massive necrosis, v-fib, heart block
  • extreme changes in blood pressure and heart rate
  • symptoms - collapse, loss of consciousness
23
Q

Congestive Heart Failure; chronic loss of pumping ability

A
  • Clinical sign and not a disease
  • Forward failure: decrease flow to peripheral tissue
  • Backward failure: Accumulation behind the failing chamber
24
Q

Cycle of cardiac decompensation

A
  • Cardiac Decompensation: Hypoxia
    • renal: inc renin release (RAAS)
    • renal: stimulates erythropoesis (EPO)
      • polycythemia -> in blood viscosity
  • Aldosterone release inc sodium and water retention
  • Plasma volume inc Hypervolemia and edema
  • Result: failing heart must pump more, thicker fluid
25
Q

Aldosterone release increases….

A
  • Sodium and water retention
26
Q

Syndromes of cardiac decompensation

A
  • Congestive heart failure
    • Left Heart Failure
    • Right Heart Failure
27
Q

Right Heart Failure

Causes

A
  • Valvular insufficiency
    • Tricuspid (right AV) valve
    • Pulmonary valve
  • Pulmonary hypertension
    • obstruction of forward flow
  • Cardiomyopathy
28
Q

Right Heart Failure

Sequelae

A
  • Hepatic Congestion (nutmeg liver, hepatomegaly)
    • splenomegaly
  • Ascites (more common in dogs)
  • Hydrothorax (more common in cats)
  • Pleural and pericardial effusion
29
Q

Left Heart Failure

Causes

A
  • Myocardial loss of contractility
    • myocarditis
    • cardiomyopathy
  • Valvular insufficiency
    • mitral (Left AV) valve
    • aortic valve
  • Congenital defects
    • PDA
30
Q

Left Heart Failure

Sequelae

A
  • Pulmonary congestion
  • Pulmonary edema
  • Pulmonary Fibrosis (will cause hypertension)
31
Q

Top ddx for cardiac disease in dogs

A
  • Endocardiosis
  • Congenital disease
  • DCM
  • Hemopericardium
32
Q

Top ddx for cardiac disease in cats

A
  • HCM
  • DCM
  • Hyperthyroidism associated hypertrophy
  • Congenital disease
33
Q

Problem oriented approach

A
  • D: Degenerative
  • A: Anomaly (Congenital)
  • M: Metabolic
  • N: Neoplastic, Nutritional
  • I: Inflammatory, Infectious, Immune-mediated
  • T: Trauma, Toxicity
  • V: Vascular
34
Q

Patent Ductus Arteriosus

A
  • RV and LV hypertrophy
  • L -> shunt usually
  • LA dilation
  • R -> L shunt if severe -> cyanosis
  • Dilation of PA and aorta, jet lesions in pulmonary artery
35
Q

Aortic Stenosis

3 types

A
  • Valvular
  • Subvalvular
  • Supravalvular
36
Q

Subvalvular aortic stenosis

A
  • concentric hypertrophy LV
  • Fibrous endocardial thickening
  • Post stenotic dilation aorta with jet lesions
  • Myocardial necrosis
  • subaortic stenotic ring
37
Q

Pulmonic Stenosis

Sequelae

A
  • Right ventricular hypertrophy
  • Post stenotic dilation of pulmonary artery
  • Muscular hypertrophy of RV outflow tract can complicate stenosis
38
Q

Valvular dysplasia

A
  • Malformation of valve leaflets
  • leaflets may be attached to the septum
  • common in cats and labrador retrievers
39
Q

Septal Defects

A
  • VSD most common
  • Pulmonary hypertension from blood shunting from Left to Right
    • right ventricular hypertrophy
    • inc in pulmonary hypertension can lead to eventual compensatory right to left shunting
40
Q

Ventricular septal defects

A
  • Can be assoc with other cardiac defects
  • Can occur either high or low (high more typical)
  • Left to right shunt -> pulmonary hypertension
  • Severe cases reverse shunting -> cyanosis
41
Q

Tetrology of Fallot

A
  1. Pulmonary Stenosis
  2. Dextroaorta
  3. High Ventricular Septal Defect
  4. Right Ventricular Hypertrophy
42
Q

Abnormalities of Aortic Arch

A
  • Persistent right aortic arch
  • Double aortic arch
  • anomalous subclavian arteries

Pathology (6 decks)

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