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Pathology I > Cardiopathology Session 1 > Flashcards

Cardiopathology Session 1 Flashcards

1
Q

Describe the blood flow through the heart

A
  1. Vena cava
  2. Right atrium
  3. Tricuspid valve
  4. Right ventricle
  5. Pulmonic valve
  6. Pulmonary artery
  7. Lungs
  8. Pulmonary veins
  9. Left atrium
  10. Mitral valve
  11. Left ventricle
  12. Aortic valve
  13. Aorta
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2
Q

What is the ratio of ventricular wall thickness right to left? And why?

A

Right to left ventricular wall thickness ratio 1:3

Left much bigger because systemic pressure greater than pulmonary and has to pump blood to whole body

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3
Q

What are the 2 important functions of valves

A
  1. Open correctly so that blood can empty from the chamber
  2. Close properly so that blood doesn’t flow backwards
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4
Q

What is the electrical pathway through the heart

A

SA node—> AV node—> bundle of his—> Purkinje fibers

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5
Q

What are some clinical signs of heart disease

A

Coughing, increase respiratory effect, exercise intolerance/fatigue/collage, murmur, arrhythmia, fluid build up, cyanosis

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6
Q

What is a murmur

A

Sound of blood turbulence

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7
Q

What are the 3 results of heart failure

A
  1. Accumulation of blood behind failing chamber
  2. Decreased blood to peripheral tissues
  3. Decreased blood to heart itself
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8
Q

What are the two types of heart failure

A
  1. Sudden vs gradual
  2. Right vs left sided
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9
Q

What is sudden/acute myocardial failure

A

Sudden and severe pump and flow failures

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10
Q

What are the clinical signs of sudden/acute myocardial failure

A

Syncope: loss of consciousness, collapse

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11
Q

What type of shock is typical of sudden/acute myocardial failure

A

Cardiogenic shock- inability to pump as much blood as body needs

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12
Q

What is gradual/chronic myocardial failure

A

Less severe pump and flow failures and will induce cardiovascular compensatory changes

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13
Q

What are the compensatory changes associated with gradual myocardial failure

A
  1. Chamber dilation
  2. Myocardial hypertrophy
  3. Increased HR
  4. Increased peripheral resistance
  5. Increased blood volume
  6. Redistribution of blood flow
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14
Q

What is the goal in compensating for gradual/chronic myocardial failure

A

To get as much blood to vital organs as possible

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15
Q

Eccentric hypertrophy is a ___ overload

A

Volume

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16
Q

What type of lesions/defects are associated with eccentric hypertrophy

A

Valve lesions and septal defects

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17
Q

How does the heart change in eccentric hypertrophy

A

Increased ventricular lumen (dilation) with increased wall thickness (initially)

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18
Q

Concentric hypertrophy is ___overload

A

Pressure

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19
Q

What problems are associated with concentric hypertrophy

A

Stenotic valves and obstructions

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20
Q

How does the heart change in concentric hypertrophy

A

Decreased ventricular lumen with increased wall thickness

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21
Q

Right sided heart failure is congestion of ____circulation

A

Systemic

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22
Q

Where can congestion also occur in the body due to right sided heart failure

A

Hepatic and splenic congestion—> chronic leads to fibrosis

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23
Q

In large animals which of the 4 causes of edema results in edema in right sided heart failure and where is found

A

Increased hydrostatic pressure, edema in ventral subcutaneous

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24
Q

In dogs and cats which of the 4 causes of edema is causing edema in right sided heart failure and where is edema

A

Increase hydrostatic pressure

Cats: pleural effusion
Dogs: peritoneal effusion

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25
What does the liver look like with right sided heart failure
Nutmeg like liver due to fibrosis, liver is very firm
26
Left sided heart failure results in congestion in ___circulation
Pulmonary
27
What kind of edema results from left sided heart failure and which of the 4 causes of edema causes this
Increase hydrostatic pressure resulting in pulmonary edema
28
Pulmonary hemorrhage results in ____ which you can use iron stain to visualize ___cells
Hemosiderosis Use iron stain to visualize hemosiderin laden macrophages aka heart failure cells
29
Which sided heart failure is associated with this liver
right sided- nutmeg liver
30
What is wrong here and what could have caused this
Ventral SQ edema caused by right sided heart failure
31
What is wrong here and what caused this
pleural effusion due to right sided heart failure
32
What is wrong here and what could have caused this
foaming fluid in the trachea due to pulmonary edema/congestion from left sided heart failure
33
What does this histology slide indicate
Left sided heart failure- presence of heart failure cells
34
What valves are affected in right sided heart failure
Tricuspid and pulmonary
35
What are some examples of diseases that can cause right sided heart failure
Tricuspid dysplasia, pulmonic stenosis, Brisket disease
36
What valves are involved in left sided heart failure
Mitral or aortic
37
What are some examples of diseases associated with left sided heart failure
Mitral myxomatous degeneration (valvular endocarditis), aortic stenosis
38
What are some cardiomyopathies that can effect either or both sides of heart
1. HCM or DCM 2. Myocarditis or myocardial necrosis
39
What are the changes in the kidney associated with heart failure
1. Hypoxia 2. Drop in renal BF 3. Vasoconstriction-further drop in BF— juxtaglomerular cells release renin 4. Renin—aldosterone— increase sodium and h20 retention, renin release AII vasoconstriction and increase BP 5. Water retention causes increased circulating volume and preload (CO increases), increased venous filling pressure- fluid accumulates in cavities and interstitium Hypoxia also promotes erythopoiesis and extra medullary organs- polycythemia oxygen carrying capacity goes up with increased blood viscosity—> increase workload—> further decompensation
40
Myocardial hypoxia results in ___
Necrosis—> decreased perfusion through coronary vasculature most commonly effects papillary muscles of the left ventricle and subendocardial areas
41
Decreased perfusion through coronary vasculature most commonly effects where
Papillary muscles of the left ventricle and subendocardial areas
42
What are the histology signs of myocardial hypoxia—>necrosis
Swelling, hyperesoinophilia, vacoulization, loss of striations, pyknosis, basophilic cytoplasmic granules (calcification), inflammatory infiltrates, fibroblast proliferation and increased collagen (Scarring)
43
What are the 6 mechanisms of cardiovascular failure
1. Ruptures 2. Obstructed flow through the heart 3. Regurgitant flow 4. Blood shunts 5. Conduction disturbances (arrhythmias) 6. Pump failure- primary myocardial injury
44
What occurs during rupture and what are some examples
Extravasated blood—> hemorrhage or cardiac tamponade Ex:trauma, hemangiosarcoma
45
What occurs when there is obstructed flow through the heart and what are some examples
Increases volume and pressure behind the obstruction Ex: narrowed valves or vessels (Stenosis, hypertension, mass effect)
46
What occurs during regurgitant flow and examples
Increases volume behind the failing valve Ex: deformed or damaged valves/chordae tendineae
47
What occurs during blood shunts and some examples
Heart defects that allow alterations in flow Ex: septal detects, patent vessels
48
What occurs during conduction disturbances (arrhythmias)
Altered and unsynchronized cardiac contraction Ex: cardiac glycosides (foxglove, oleander)
49
What occurs during pump failure- primary myocardial injury and examples
Weak contraction, incomplete emptying and reduced filling of chambers Ex: myocardial infection, damage, necrosis, cardiomyopathies
50
____embryological heart defects tend to result in early loss or death
Severe
51
___ embryological heart defects may never show clinical signs
Mild
52
What are some causes of congenital diseases of the heart
Spontaneous, heritable, induced in utero (toxic, hypoxia, radiation, maternal nutritional deficiencies, excess, infectious diseases)
53
What is the endocardial cushion defect
Normally Two thicker areas in the cardiac tube from which the heart chambers and valves form, the defect forms one big chamber
54
What is patent ductus arteriosus
Failure of closure of the ductus arteriosus between the aorta and pulmonary ligament Normally forms ligamentum arteriosum
55
How is the murmur sound related to the size of the defect
The smaller the defect the louder the murmur
56
How does blood flow in ASD and PFO
LA—>RA
57
What kind of hypertrophy occurs in shunts
Eccentric hypertrophy—>volume overload
58
What happens to the lungs during volume overload related to shunts
Increased pulmonary blood flow, enlarged pulmonary vessel, pulmonary arterial hypertension
59
What is the most common shunt defect across all animals, especially English bulldog, English springer spaniel
VSD
60
What is the most common shunt in dogs, specifically small/toy breeds
PDA
61
What kind of hypertrophy occurs with stenosis
Concentric hypertrophy- pressure overload
62
What valves does stenosis typically occur at and what is the result
Pulmonic/subpulmonic and aortic/subaortic Resulting in hypertrophy of the ventricle that comes right before it
63
What breeds is pulmonic stenosis common in
English bulldogs, Boston terriers, boxers, terriers (brachycephalic)
64
What breeds is aortic stenosis common in
Large breed dogs (and pigs)
65
What are some results from tricuspid and mitral valve malformation/dysplasia
Valvular insufficiency Volume overload Hypertrophy of the ventricle that comes right after it
66
What type of hypertrophy occurs due to tricuspid and mitral valve malformation/dysplasia
Eccentric hypertrophy- volume overload
67
What species is more likely to get tricuspid and mitral valve malformation/dysplasia
Cats
68
What is tetralogy of fallout
Four abnormalities occur in the heart 1. VSD 2. Pulmonic stenosis 3. Overriding aorta 4. Right ventricular hypertrophy R—>L shunt- dangerous because deoxygenated shunted to systemic circulation
69
What is the vascular ring anomaly
Aortic arch forms on the right side and pulmonary artery on the left. The ductus arteriosum/ ligamentum arteriosus comes across the esophagus and and compresses it—>cranial megaesophagus
70
What breeds is vascular ring anomaly common in
German shepherds, Irish setter, Great Danes
71
What are some common sequela of vascular ring anomaly
Regurgitation, aspiration pneumonia, poor weight gain
72
What is the treatment for vascular ring anomaly
Cut it
73
What is ectopia cordis and what species is it most common in
Heart located anywhere but in the chest Common in calves

Pathology I (23 decks)

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