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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
Q

What does the liver look like with right sided heart failure

A

Nutmeg like liver due to fibrosis, liver is very firm

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26
Q

Left sided heart failure results in congestion in ___circulation

A

Pulmonary

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27
Q

What kind of edema results from left sided heart failure and which of the 4 causes of edema causes this

A

Increase hydrostatic pressure resulting in pulmonary edema

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28
Q

Pulmonary hemorrhage results in ____ which you can use iron stain to visualize ___cells

A

Hemosiderosis
Use iron stain to visualize hemosiderin laden macrophages aka heart failure cells

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29
Q

Which sided heart failure is associated with this liver

A

right sided- nutmeg liver

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30
Q

What is wrong here and what could have caused this

A

Ventral SQ edema caused by right sided heart failure

31
Q

What is wrong here and what caused this

A

pleural effusion due to right sided heart failure

32
Q

What is wrong here and what could have caused this

A

foaming fluid in the trachea due to pulmonary edema/congestion from left sided heart failure

33
Q

What does this histology slide indicate

A

Left sided heart failure- presence of heart failure cells

34
Q

What valves are affected in right sided heart failure

A

Tricuspid and pulmonary

35
Q

What are some examples of diseases that can cause right sided heart failure

A

Tricuspid dysplasia, pulmonic stenosis, Brisket disease

36
Q

What valves are involved in left sided heart failure

A

Mitral or aortic

37
Q

What are some examples of diseases associated with left sided heart failure

A

Mitral myxomatous degeneration (valvular endocarditis), aortic stenosis

38
Q

What are some cardiomyopathies that can effect either or both sides of heart

A
  1. HCM or DCM
  2. Myocarditis or myocardial necrosis
39
Q

What are the changes in the kidney associated with heart failure

A
  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
Q

Myocardial hypoxia results in ___

A

Necrosis—> decreased perfusion through coronary vasculature most commonly effects papillary muscles of the left ventricle and subendocardial areas

41
Q

Decreased perfusion through coronary vasculature most commonly effects where

A

Papillary muscles of the left ventricle and subendocardial areas

42
Q

What are the histology signs of myocardial hypoxia—>necrosis

A

Swelling, hyperesoinophilia, vacoulization, loss of striations, pyknosis, basophilic cytoplasmic granules (calcification), inflammatory infiltrates, fibroblast proliferation and increased collagen (Scarring)

43
Q

What are the 6 mechanisms of cardiovascular failure

A
  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
Q

What occurs during rupture and what are some examples

A

Extravasated blood—> hemorrhage or cardiac tamponade

Ex:trauma, hemangiosarcoma

45
Q

What occurs when there is obstructed flow through the heart and what are some examples

A

Increases volume and pressure behind the obstruction

Ex: narrowed valves or vessels (Stenosis, hypertension, mass effect)

46
Q

What occurs during regurgitant flow and examples

A

Increases volume behind the failing valve
Ex: deformed or damaged valves/chordae tendineae

47
Q

What occurs during blood shunts and some examples

A

Heart defects that allow alterations in flow
Ex: septal detects, patent vessels

48
Q

What occurs during conduction disturbances (arrhythmias)

A

Altered and unsynchronized cardiac contraction

Ex: cardiac glycosides (foxglove, oleander)

49
Q

What occurs during pump failure- primary myocardial injury and examples

A

Weak contraction, incomplete emptying and reduced filling of chambers

Ex: myocardial infection, damage, necrosis, cardiomyopathies

50
Q

____embryological heart defects tend to result in early loss or death

A

Severe

51
Q

___ embryological heart defects may never show clinical signs

A

Mild

52
Q

What are some causes of congenital diseases of the heart

A

Spontaneous, heritable, induced in utero (toxic, hypoxia, radiation, maternal nutritional deficiencies, excess, infectious diseases)

53
Q

What is the endocardial cushion defect

A

Normally Two thicker areas in the cardiac tube from which the heart chambers and valves form, the defect forms one big chamber

54
Q

What is patent ductus arteriosus

A

Failure of closure of the ductus arteriosus between the aorta and pulmonary ligament

Normally forms ligamentum arteriosum

55
Q

How is the murmur sound related to the size of the defect

A

The smaller the defect the louder the murmur

56
Q

How does blood flow in ASD and PFO

A

LA—>RA

57
Q

What kind of hypertrophy occurs in shunts

A

Eccentric hypertrophy—>volume overload

58
Q

What happens to the lungs during volume overload related to shunts

A

Increased pulmonary blood flow, enlarged pulmonary vessel, pulmonary arterial hypertension

59
Q

What is the most common shunt defect across all animals, especially English bulldog, English springer spaniel

A

VSD

60
Q

What is the most common shunt in dogs, specifically small/toy breeds

A

PDA

61
Q

What kind of hypertrophy occurs with stenosis

A

Concentric hypertrophy- pressure overload

62
Q

What valves does stenosis typically occur at and what is the result

A

Pulmonic/subpulmonic and aortic/subaortic

Resulting in hypertrophy of the ventricle that comes right before it

63
Q

What breeds is pulmonic stenosis common in

A

English bulldogs, Boston terriers, boxers, terriers (brachycephalic)

64
Q

What breeds is aortic stenosis common in

A

Large breed dogs (and pigs)

65
Q

What are some results from tricuspid and mitral valve malformation/dysplasia

A

Valvular insufficiency
Volume overload
Hypertrophy of the ventricle that comes right after it

66
Q

What type of hypertrophy occurs due to tricuspid and mitral valve malformation/dysplasia

A

Eccentric hypertrophy- volume overload

67
Q

What species is more likely to get tricuspid and mitral valve malformation/dysplasia

A

Cats

68
Q

What is tetralogy of fallout

A

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
Q

What is the vascular ring anomaly

A

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
Q

What breeds is vascular ring anomaly common in

A

German shepherds, Irish setter, Great Danes

71
Q

What are some common sequela of vascular ring anomaly

A

Regurgitation, aspiration pneumonia, poor weight gain

72
Q

What is the treatment for vascular ring anomaly

A

Cut it

73
Q

What is ectopia cordis and what species is it most common in

A

Heart located anywhere but in the chest

Common in calves

Pathology I (23 decks)

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