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Pathology I > Cardiopathology Lecture 2 > Flashcards

Cardiopathology Lecture 2 Flashcards

1
Q

List the layers of the heart from outer to inner

A
  1. Fibrous pericardium
  2. Parietal pericardium
  3. Parietal cavity
  4. Visceral layer of pericardium (epicardium)
  5. Myocardium
  6. Endocardium
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2
Q

What is pericardial effusion

A

Build of up fluid in pericardial sac

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3
Q

What is cardiac tamponade? What is happening to heart

A

Result from pericardial effusion—> increase presssure on the heart, reduced ventricular filling, backflow of blood—> right and left heart failure and ultimately cardiogenic shock

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4
Q

What kind of shock is cardiac tamponade

A

Cardiogeneic shock

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5
Q

What are the two types of pericardial effusion

A
  1. Hydropericardium
  2. Hemopericardium
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6
Q

What is hydropericardium and what causes it

A

Fluid accumulation in pericardial sac
1. Increased hydrostatic pressure (CHF)
2. Decreased oncotic pressure (hypoproteinemia)
3. Lymphatic obstruction (heart base mass)
4. Increased vascular permeability (pericarditis)

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7
Q

What is hemopericardium and what can cause it

A

Bleeding into pericardial sac
1. Cardiac hemangiosarcoma
2. Trauma: rupture of atria, aorta, or pulmonary artery

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8
Q

What are some causes pericarditis

A

Bacterial infection, traumatic reticulopericarditis (hardware dz), idiopathic

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9
Q

What are some causes of epicardial hemorrhage

A

Anoxia, sepsis, endotoxemia, DIC, coagulopathy, trauma, electrocution

Can be agonal change (at death increase BP-hemorrhage)

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10
Q

What does serous atrophied fat on the heart look like

A

Fat is gelatinous and clear to serous, lymphatics may be prominent

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11
Q

What are some causes of serous atrophy of fat on the heart

A

Chronic prolonged negative energy balance- emactiation

Ex: cancer patients

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12
Q

what is wrong with heart

A

Serous atrophy of fat

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13
Q

What is traumatic reticulopericarditis/ hardware disease

A

Migration of metal object from reticulum directly puncturing pericardial sac

Direct introduction of bacteria from gut

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14
Q

What does the heart look like in acute traumatic reticulopericarditis/ hardware diseae

A

Fibrinosuppurative pericarditis
“Bread and butter” appearance

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15
Q

What cell type is most common with bacterial infections

A

Neutrophils

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16
Q

What is wrong with heart

A

fibrinosuppurative pericarditis

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17
Q

What does chronic reticulopericarditis/ hardware disease look like

A

Constrictive pericarditis, fibrosis of epicardium to pericardium, reduced contraction of ventricles

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18
Q

Selenium and Vitamin E are key components in protecting cells from ___

A

Oxidative damage

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19
Q

Activity and high oxygen demand leave myocardial cells sensitivity to ___

A

Oxidative damage

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20
Q

Selenium and vitamin E deficiencies lead to _____

A

Myocardial degeneration and necrosis

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21
Q

What age group are nutritional deficiencies associated with myocardial disease seen in

A

Young animals

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22
Q

Patient has selenium and vitamin E deficiencies- what did it do to heart/what disease? What species is it common in

A

White muscle disease- necrosis and mineralization
Species: sheep’s and cows

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23
Q

What is wrong with this heart? What caused it? What species is it common in

A

Mulberry heart disease due to selenium and vitamin
E deficiencies

Species: pig

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24
Q

What important role does copper serve with the heart

A

Promotes cross linking of collagen in vessels

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25
Q

What can copper deficiency lead to

A

Weakened vascular integrity, predisposing to vascular aneurysmal dilations or tears

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26
Q

What are some ways in which toxins damage the heart

A

Depress myocardial function, directly injury cardiac cells- degeneration and necrosis, hypersensitivity reactions

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27
Q

What species do ionospheres, coccidiostats, monesin and lasalocid cause toxicity in and what is the result

A

Causes myocardial degeneration and necrosis in horses

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28
Q

What toxicities are associated with anthracycline (doxorubicin, adriamycin)? And what are the drugs used for

A

Uses: chemo drug to tx lymphosarcoma in dogs
Causes acute myocardial necrosis through oxidative damage, cytokine release, and inhibition of protein synthesis

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29
Q

What toxicities is gossypol associated with and in what species

A

Swine>goats>ruminants and horses fed cottonseed products
Causes myocardial necrosis and degeneration

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30
Q

What toxicities can occur due to plants with excess vitamin D and calcinogenic plants

A

Epidcardial deposits of minerals- necrosis and mineralization due to shoving Ca2+ into heart

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31
Q

How can uremia be toxic to the heart

A

Deposit of urate crystals following acute or repeated episodes of uremia from chronic renal disease that cause ulcerative lesions that are resolved with fibrosis and mineralization

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32
Q

What are some downstream effects of infectious and inflammatory cardiovascular disease

A

Infarcts, ischemia, hypertension, cor pulmonale (pulmonary vascular disease that leads to right heart enlargement)

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33
Q

What are some gross lesions associated with infectious and inflammatory cardiovascular disease

A
  1. Hemorrhage- petechiae and ecchymosis on epidcardium and endocardium of LV
  2. Areas of tan discoloration (necrosis, inflammation, or fibrosis)
  3. Roughened or irregular areas (fibrosis, inflammation)
  4. Irregularly thickened “vegetative” valves
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34
Q

What are 3 important inflammatory routes to heart

A
  1. Hematogenous or embolic dissemination/septicemia (most common)
  2. Direct extension from pleural or mediastinal infections
  3. Foreign body penetration or trauma
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35
Q

what is wrong here

A

Endocardial hemorrhage secondary to acute bacterial septicemia

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36
Q

What are some outcomes of infection, inflammation, +/- necrosis of myocardium

A
  1. Complete resolution
  2. Poor myocardial regeneration capacity
  3. Granulation tissue—> scarring (fibrosis) +/-mineralization
  4. Progressive myocardial damage- DCM
37
Q

What cell type is dominant in pyogenic bacteria myocarditis lesions

A

Suppurative- neutrophils

38
Q

What cell type is dominant in viral infections (WNV) and immune mediated

A

Lymphocytic

39
Q

What histo changes are associated with canine parvovirus, foot and mouth disease

A

Necrotizing

40
Q

What cell type is associated with idiopathic or parasitic myocarditis lesions

A

Eosinophilic

41
Q

What disease are know to manifest as dilation and cause DCM

A
  1. Taurine deficiency in cats
  2. Cobalt toxicity
  3. Myocarditis
  4. Doxorubicin
42
Q

DCM is an important cause of ___ in dogs

A

CHF

43
Q

What species/breeds and age tend to be affected in DCM

A

Young to middle aged giant and large breed dogs

44
Q

What is the boxer specific DCM

A

Arrhythmogenic right ventricular cardiomyopathy

45
Q

What cell type/ myocarditis lesion is this and what diseases would it be affiliated with

A

Eosinophilic myocarditis- idiopathic or parasitic

46
Q

What cell type/ myocarditis lesion is this and what diseases are associated with it

A

Lymphocytic myocarditis- viral infections (WNV) and immune mediated

47
Q

Based on gross image what is wrong

A

DCM

48
Q

What does the gross heart of DCM patients look like

A

Rounded, can have double apex, all chambers of heart may be dilated, ventricles are flabby and thin

49
Q

What is wrong

A

DCM

50
Q

What is wrong

A

DCM
Left: loss of cardiomyocytes, fat, fibrosis
Right: thin and wavy with fibrosis

51
Q

What are the histological changes seen in DCM

A

Fibrosis, fat

52
Q

What species is HCM common in and what age

A

Young adult-middle aged cats

53
Q

What are some causes of HCM

A

Idiopathic or autosomal inheritance in several breeds- especially Maine coons

54
Q

What species and age is thyrotoxic cardiomyopathy common in

A

Older cats

55
Q

What causes thyrotoxic cardiomyopathy

A

Functional adenomatous hyperplasia or adenoma of thyroid (hyperthyroid)

56
Q

What is the weight of the heart if hypertrophic and thyrotoxic cardiomyopathy

A

> 20 grams

57
Q

What is the gross appearance of heart in HCM or thyrotoxic cardiomyopathy

A

Thickening of left ventricle and interventricular septum

LA may be dilated

58
Q

What does the histology look like in HCM

A

Myocyte disarray, hypertrophy of myocytes, and fibrosis

59
Q

___ develops over time with HCM and TCM

A

CHF

60
Q

What is a major sequelae of HCM or TCM

A

Left atrial thrombosis and caudal abdominal aorta thromboembolism in 10-20% (saddle thrombi)

61
Q

What is wrong

A

HCM or TCM

62
Q

what is wrong

A

HCM or TCM- giant cardiomyocytes and not all going same direction

63
Q

What is wrong here and what caused it

A

saddle thrombi caused by HCM or TCM

64
Q

What is the primary cause of endocarditis

A

Bacterial

65
Q

What is the main bacterial agent causing endocarditis in pigs

A

Erysipelothrix rhusiopathiae

66
Q

What is the main bacterial agent causing endocarditis in cattle

A

Trueperella pyogenes

67
Q

What are the main bacterial agents that can cause endocarditis in many species

A

Streptococcus, E. Coli, staphylococcus

68
Q

What is the pathogens is of endocarditis

A
  1. Infection
  2. Multiple bouts of bacteremia/sepsis + factors affected virchow ‘s triad
  3. Fibrin and bacteria adhere to disrupted valve surface
  4. Mass of fibrin, bacteria, inflammatory cells, and granulation tissue grow +/- portions of mass dislodge
  5. Septic emboli in distant sites causing infarcts and new abscess formation
  6. Valve dysfunction and or septic shock
  7. Death
69
Q

What is wrong

A

Endocarditis

70
Q

What is wrong

A

endocarditis

71
Q

Grossly what does endocarditis look like

A

Friable grey/black/tan masses adhered to the surface of valves (vegetative), margins of valves are rough and irregular (eroded and necrotic)

72
Q

Where is the most common site of endocarditis

A

Mitral valve then aortic valve (left side)

73
Q

In cattle where is the most common site for endocarditis

A

Tricuspid valve

74
Q

What is endocardiosis

A

Myxomatous valvular degeneration, valvular insufficiency

75
Q

What age and breeds tend to get endocardiosis

A

Middle to old age toy to medium sized dogs

76
Q

What is the most common cause of CHF in old dogs

A

Endocardiosis

77
Q

What is the most common cause of new murmur in older dogs

A

Endocardiosis

78
Q

What is wrong

A

Endocardiosis

79
Q

What is wrong

A

endocardiosis

80
Q

What valve is endocardiosis most common in

A

Mitral valve

81
Q

What are some associated lesions/sequelae of endocardiosis

A
  1. Atrial dilation and rupture
  2. Jet lesions- endocardial fibrosis caused by turbulence- white tissue above valves
    3.rupture of chordae tendineae
82
Q

What is wrong here

A

endocardiosis

83
Q

What are group is feline endomyocarditis/ endocardial fibrosis most common in

A

Young cats <4yrs

84
Q

When does feline endomyocarditis/ endocardial fibrosis most commonly occur

A

After stressful events

85
Q

What happens in feline endomyocarditis/ endocardial fibrosis

A

Inflammation of left ventricular outflow tract

86
Q

What do cats with feline endomyocarditis/ endocardial fibrosis typically present with

A

Interstitial pneumonia

87
Q

What does the gross heart look like in cats with feline endomyocarditis/ endocardial fibrosis

A

Nothing or enlarged heart with white to grey discoloration of left ventricular endocardium and aortic outflow tract

88
Q

What does histology look like in cat with feline endomyocarditis/ endocardial fibrosis. Acute and chronic

A

Acute: mixed inflammation in endocardium and adjacent myocardium

Chronic: marked fibroplasia and/or granulation tissue

89
Q

What is wrong here

A

feline endomyocarditis/ endocardial fibrosis

Pathology I (23 decks)

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