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Veterinary Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

2 components of the cardiovascular system

A
  • Blood
  • Heart & vessels
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2
Q

Functions of the cardiovascular system

A
  • Circulation
  • Thermoregulation
  • Fluid homeostasis
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3
Q

3 layers of the heart wall

A
  1. Epicardium (visceral pericardium)
  2. Myocardium
  3. Endocardium
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4
Q

Flow of electrical impulses through the heart

A
  1. SA
  2. AV
  3. HIS bundle
  4. Bundle branches
  5. Purkinje fibers
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5
Q

Systemic compensatory mechanisms in response to injury

A
  • Increased heart rate
  • Increased peripheral vascular resistance
  • Increased blood volume
  • Redistribution of blood flow
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6
Q

Cardiac compensatory mechanisms in response to injury

A
  • Dilation
  • Hypertrophy
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7
Q

Increase in heart chamber volume

A

Dilation

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8
Q

Increase in myocardial mass via increased cell size

A

Hypertrophy

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9
Q

Gradual loss of pumping efficiency due to cardiac disease or increased workload
Results in decreased blood flow to tissues (ischemia) and pooling of blood behind failing chambers (congestion)

A

Congestive Heart Failure (CHF)

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10
Q

Right-sided heart failure results in:

A
  • Chronic hepatic congestion (“nutmeg liver”)
  • Ascites
  • Subcutaneous edema
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11
Q

Left-sided heart failure results in:

A

Pulmonary congestion and edema

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12
Q

Right/Left sided heart failure results in:

A

Hydrothorax

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13
Q

Myocardial Diseases

A
  • Hypertrophic cardiomyopathy (HCM)
  • Thyrotoxic cardiomegaly
  • Dilated cardiomyopathy (DCM)
  • Arrhythmogenic right ventricular cardiomyopathy (ARVC)
  • Restrictive cardiomyopathy (RCM)
  • Feline left ventricular endocardial fibrosis (LVEF)
  • Myocardial necrosis
  • Nutritional myopathy
  • Myocarditis
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14
Q

Increase in size of cardiac myocytes, leading to increased overall mass

A

Myocardial hypertrophy

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15
Q

True/False

Secondary myocardial hypertrophy is usually reversible

A

True

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16
Q

True/False

Primary myocardial hypertrophy is usually irreversible

A

True

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17
Q

Type of myocardial hypertrophy caused by pressure overload, resulting in increased wall thickness and decreased chamber volume

A

Concentric

sarcomeres added in parallel -> wider

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18
Q

Type of myocardial hypertrophy caused by volume overload, resulting in increased chamber volume and normal or decreased wall thickness

A

Eccentric

sarcomeres added in series -> longer

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19
Q

Disorder of myocardium

A

Cardiomyopathy

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20
Q

3 main types of cardiomyopathy

A
  • Hypertrophic
  • Dilated
  • Restrictive
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21
Q
  • Common in cats (esp. young to middle-aged males)
  • Due to genetic mutation (MYBPC3) in Mainecoon and Ragdolls
  • Gross Findings: cardiomegaly, concentric hypertrophy of LV (thickened wall & decreased volume), +/- LA dilation & thrombosis
A

Hypertrophic Cardiomyopathy (HCM)

DDx for HCM is thyrotoxic cardiomegaly due to hyperthyroidism in cats

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22
Q
  • Primary in some dogs breeds and cattle
  • Secondary to nutritional imbalances in dogs & cats
  • Gross Findings: cardiomegaly, eccentric hypertrophy of entire heart (dilated chambers & thin walls), enlarged rounded heart
A

Dilated Cardiomyopathy

ARVC is a variant of DCM found in Boxers

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23
Q
  • Primary heritable variant of DCM in Boxers
  • Rare in cats
  • Predisposition to ventricular arrythmias, syncope, heart failure, sudden death
  • Gross Findings: RV myocytes replaced by adipose (or fibroadipose) tissue, RV normal or dilated, similar gross appearance to DCM
A

Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)

“Boxer Dog Cardiomyopathy”

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24
Q
  • Rigid ventricular walls causing impaired ventricular filling
  • Includes multiple forms:
    - LVEF
    - Excessive moderator bands
    - Congenital endocardial fibroelastosis in Burmese cats
    - Endocardial fibrosis in aged rats
A

Restrictive Cardiomyopathy (RCM)

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25
Q
  • Most common variant of RCM
  • Endocardial fibrosis restricts ventricular filling
  • Results from endomyocarditis (idiopathic inflammation)
  • Gross Findings: thick opaque endocardium in LV

form of restrictive cardiomyopathy

A

Feline Left Ventricular Endocardial Fibrosis (LVEF)

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26
Q
  • Variant of RCM often found in cats
  • Congenital defect that manifests later in life
  • Gross Findings: bands of purkinje fibers and collagen in LV

form of restrictive cardiomyopathy

A

Excessive Moderator Bands

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27
Q

Cardiomyopathy sequale

A
  • Arrhythmia -> syncope, sudden death
  • Thrombosis -> thromboembolism -> ischemia, infarcts
  • Congestive heart failure -> death
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28
Q

True/False

Cardiac myocytes are able to regenerate

A

False

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29
Q

True/False

Small areas of myocardial necrosis generally do not cause any problems

A

False

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30
Q

True/False

Necrotic myocardiocytes are hypereosinophilic & fragmented

A

True

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31
Q

Is this acute or chronic myocardial necrosis?

A

Acute

myocardial pallor, dry +/- gritty texture, dystrophic mineralization

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32
Q

Is this acute or chronic myocardial necrosis?

A

Chronic

firm, depressed (sunken) myocardial scar (fibrosis)

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33
Q

Causes of myocardial necrosis

A
  • Nutritional
  • Toxic
  • Ischemic
  • Genetic
  • Traumatic
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34
Q

True/False

Heart attacks are common in animals

A

False

uncommon in animals due to low incidence of coronary artery disease

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35
Q

Examples of myocardial toxins

A
  • Ionophores
  • Cantharidin
  • Gossypol (cottonseed oil)
  • Doxorubicin
  • Poisonous plants
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36
Q

True/False

Vitamin E / selenium decifiency is a cause of nutritional myopathy

A

True

“White Muscle Disease in ruminants, Mulberry Heart Disease in swine

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37
Q

Vitamin E / selenium deficiency sequale

A

decreased antioxidant activity -> oxidative membrane damage -> myocyte necrosis

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38
Q

Inflammation of the myocardium

A

Myocarditis

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39
Q

Causes of myocarditis

A

Often infectious:
* Viral (CPV-2, encephalomyocarditis virus, FMDV, WNV)
* Bacterial (Clostridium chauvoei, C. piliforme, Corynebacterium pseudotuberculosis, Histophilus somni)
* Fungal (Aspergillus)
* Parasitic (Toxoplasma gondii, Sarcocystis, Neospora, Trypanosoma cruzi, Theileria parva, cysticercosis)

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40
Q
A

Granulomatous myocarditis in a dog

from Aspergillus terreus infection

41
Q
A

Suppurative myocarditis in a cow

from Histophilus somni infection

42
Q
  • Idiopathic degeneration of valvular collagen
  • Common in small, aged dogs (e.g. Cavalier King Charles)
  • Mitral valve most commononly affected
  • Gross Findings: thickened nodular valve margins, smooth, glistening, opaque
  • Microscopic Findings: loose fibroblastic tissue, NON-INFLAMMATORY
A

Endocardiosis

“Myxomatous Valvular Degeneration”

43
Q

Endocardiosis sequale

A
  • Valvular insufficiency -> regurgitation, heart murmur
  • Atrial volume overload -> eccentric hypertrophy +/- CHF
  • Atrial subendocardial fibrosis -> jet lesion
  • Atrial thrombosis -> thromboembolism +/- infarcts
  • Chordae tendinae rupture
  • Atrial rupture -> hemopericardium
44
Q

The arrow is an example of:

A

Atrial Jet Lesion

commonly seen in endocardiosis

45
Q

The arrows are examples of (2 lesions):

A

Atrial Thrombosis & Chorda Tendinea Rupture

commonly seen in endocardiosis

46
Q

Inflammation of endocardium

A

Endocarditis

47
Q
  • Inflammation of endocardium
  • Usually bacterial
  • Tricuspid valve lesions most common in cattle
  • Mitral valve lesions most common in other species
  • Gross Findings: thrombi vegetations on valvular endocardium
  • Microscopic Findings: fibrin, bacteria, neutrophils
A

Endocarditis

“Vegetative Valvular Endocarditis”

48
Q

True/False

Vegetative endocarditis is caused by idiopathic inflammation following a stressful event, leading to thrombosis

A

False

caused by chronic sustained bacteremia & endocardial damage

49
Q

Endocarditis sequale

A
  • Valvular insufficiency -> CHF
  • Bacteremia -> septic thromboemboli to heart, kidney, brain
  • Infarcts
  • Inflammation
50
Q
A

Endocardial Mineralization

51
Q

Causes of endocardial mineralization

A
  • Vitamin D Toxicosis (oversupplementation, cholecalciferol rodenticides, calcinogenic plants)
  • Johne’s Disease (Mycobacterium avium ssp. paratuberculosis)
  • Uremia in dogs
52
Q

True/False

There are two continuous serous layers that enclose the pericardial cavity:
1. Visceral layer = epicardium, adherent to heart
2. Parietal layer = pericardial sac, associated with fibrous outer portion

A

True

53
Q
  • Fluid accumulation in pericardial cavity
  • Named according to fluid composition
  • Clinical significance depends on whether fluid accumulates slowly or rapidly
A

Pericardial Effusion

Hydropericardium, Hemopericardium, Pericarditis (inflammatory exudate)

54
Q

Heart compression due to rapid increase in pressure in pericardial cavity. Can lead to cardiogenic shock & death.

A

Cardiac Tamponade

55
Q

Routes of pathogen entry during pericarditis

A
  • Hematogenous (e.g. septicemia)
  • Direct Penetration (e.g. hardware disease)
  • Local Extension (from myocardium, pleural cavity, mediastinum)
56
Q

Is this acute or chronic pericarditis?

A

Acute

57
Q

Is this acute or chronic pericarditis?

A

Chronic

58
Q

This is the heart of a severely emaciated dog, why does it have a translucent gelatinous appearance?

A

Serous Atrophy of Pericardial Fat

59
Q

True/False

Serous atrophy of pericardial fat is a common finding in obese animals

A

False

indicator of emaciation

60
Q

True/False

In the normal postnatal heart, the right side of the heart is HIGH pressure & the left side of the heart in LOW pressure

A

False

right (pulmonary) = LOW pressure
left (systemic) = HIGH pressure

61
Q

Examples of systemic to pulmonary shunts (LEFT to RIGHT)

A
  • Patent Ductus Arteriosis (PDA)
  • Foramen Ovale failure to close
  • Ventricular Septal Defect (VSD)

may have reversal of flow (RIGHT to LEFT) later in disease

62
Q

What congenital anomaly does this depict?

A

Patent Ductus Arteriosus (PDA)

63
Q

What congenital anomaly does this depict?

A

Ventricular Septal Defect (VSD)

64
Q

Pulmonic Stenosis (PS) leads to:

A

Pressure overload in right ventricle, concentric RV hypertrophy

65
Q

Subaortic Stenosis (SAS) leads to:

A

Pressure overload in left ventricle, concentric LV hypertrophy

66
Q

Mitral or Tricuspid Valve Dysplasia leads to:

A

Valvular insufficiency (regurgitation), volume overload in atria, eccentric atrial hypertrophy

stenosis less common

67
Q

Raised fibrous ring below aortic valve, concentric LV hypertrophy

A

Subaortic Stenosis (SAS)

68
Q

Malformed mitral valve leaflets, eccentric LA hypertrophy

A

Mitral Valve Dysplasia

69
Q

Examples of malpositioned great vessels

A
  • Persistent right aortic arch (PRAA)
  • Transposition of aorta & pulmonary artery
  • Persistent truncus arteriosus
  • Double outflow right ventricle
70
Q

Single blood vessel from RV & LV

A

Persistent Truncus Arteriosus

71
Q

Aorta arises from RV instead of LV

A

Double Outflow Right Ventricle

72
Q
  • Vascular ring anomaly that entraps esophagus and trachea
  • Aortic arch on right, ligamentum arteriosum on left
  • Can result in megaesophagus, regurgitation, aspiration pneumonia
A

Persistent Right Aortic Arch (PRAA)

73
Q

Congenital anomaly where the heart develops outside of the thoracic cavity

A

Ectopia Cordis

74
Q

Translocation of peritoneal viscera into pericardial sac

A

Peritoneal-Perircardial Diaphragmatic Hernia

75
Q

Congenital anomaly consisting of four concurrent lesions, resulting in RIGHT to LEFT shunt and cyanosis
* pulmonis stenosis
* RV hypertrophy (secondary to PS)
* ventricular septal defect
* aortic dextroposition

A

Tetralogy of Fallot

76
Q

Common incidental cardiac anomaly of ruminants

A

Valvular Hemocysts / Lymphocysts

77
Q

Inflammation of arteries

A

Arteritis

78
Q

Inflammation of many arteries

A

Polyarteritis

79
Q

Inflammation of veins

A

Phlebitis

80
Q

Inflammation of lymphatic vessels

A

Lymphangitis

81
Q
  • Gross Findings: thickened vessels
  • Microscopic Findings: leukocytes +/- fibrin around vessel walls
A

Vasculitis

82
Q

Infectious causes of vasculitis

A
  • Viral (equine viral arteritis, African horse sickness, malignant catarrhal fever, bluetongue, classic swine fever, African swine fever, FIP)
  • Bacterial (Salmonella, Erysipelothrix rhusiopathiae, Haemophilus, Histophilus somni, Rickettsia rickettsia, Borrelia burgdorferi)
  • Fungal (Aspergillus)
  • Parasitic (Strongylus vulgaris, Dirofilaria immitis, Angiostrongylus vasorum)
83
Q

Immune-mediated/idiopathic causes of vasculitis

A
  • Polyarteritis nodosa
  • Idiopathic necrotizing polyarteritis (“Beagle Pain Syndrome”)
84
Q

Hardening of arteries

A

Arteriosclerosis

rarely of clinical significance in animals

85
Q
  • Subset of arteriosclerosis
  • Hardening of arteries accompanied by plaques of fatty material
  • Narrowing or arterial lumen -> ischemia, infarct
  • Occurs in pigs, rabbits, chickens fed high cholesterol diet
  • Associated with hypothyroidism & diabetes mellitus in dogs
A

Atherosclerosis

86
Q

True/False

Heart attacks are common in animals

A

False

87
Q
  • Localized vascular dilation due to thinning or weakening of vessel wall, can lead to fatal rupture
  • Causes include: copper deficiency, Strongylus vulgaris migration, idiopathic
A

Aneurysm

88
Q
  • Benign neoplasm of vascular endothelial cells
  • Sharply demarcated
  • Blood-filled spaces lined by well-differentiated endothelial cells
  • Common in dogs
A

Hemangioma

89
Q
  • Malignant neoplasm of vascular endothelial cells
  • Commonly found on right atrium, liver, spleen, skin, fat around urinary bladder
  • Blood-filled spaces lined by pleomorphic endothelial cells
  • Rupture can lead to hemopericardium, hemothorax, hemoabdomen
A

Hemangiosarcoma

90
Q

Infiltrative endothelial neoplasm affecting ventral abdominal dermis/subcutis in cats, bruised edematous tissue

A

Feline Ventral Abdominal Lymphangiosarcoma

91
Q

Neoplasm originating from aortic body (a chemoreceptor) at base of heart, common in brachycephalic dogs

-may compress great vessels

A

Chemodectoma

92
Q

Bulging tan masses in heart, associated with bovine leukemia virus (BLV) in cattle
* Common sites: right atrium, abomasum, uterus, spinal canal, retrobulbar region, kidney, lymph nodes

A

Cardiac Lymphosarcoma (LSA)

93
Q

Which cell adaptation is primarily responsible for increased myocardial mass in an adult animal?

A

Hypertrophy

94
Q

Concentric hypertrophy occurs when sarcomeres are added in parallel due to what?

A

Pressure Overload

95
Q

Eccentric hypertrophy occurs when sarcomeres are added in series due to what?

A

Volume Overload

96
Q

An inflammatory condition of the endocardium and usually develops secondary to bacteremia and endocardial injury.

A

Endocarditis

97
Q

A non-inflammatory condition of the endocardium (usually seen in dogs) characterized by idiopathic degeneration of the valvular collagen.

A

Endocardiosis

98
Q

This two-word term refers to a life-threatening condition in which the heart is compressed and prevented from adequately filling due to accumulation of fluid in the pericardial cavity:

A

Cardiac Tamponade

Veterinary Pathology (14 decks)

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