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Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Systemic response to injury

A

Increased HR
Increased peripheral vascular resistance
Increased blood volume
Redistribution of blood flow

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2
Q

Cardiac response to injury

A

Dilation (increase in chamber volume)
Hypertrophy (increase in myocardial mass)

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3
Q

Congestive heart failure

A

Gradual loss of pumping efficiency due to cardiac disease or increased workload

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4
Q

Sequelae of congestive heart failure

A

Decreased blood flow to tissues —> ischemia
Pooling of blood behind failing chambers —> congestion

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5
Q

Sequelae of Right-sided heart failure

A

Chronic hepatic congestion (“nutmeg liver”)
Ascites
Subcutaneous edema

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6
Q

Sequelae of Left-sided heart failure

A

Pulmonary congestion and edema

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7
Q

Sequelae of Right-/left-sided heart failure

A

Hydrothorax

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8
Q

Myocardial hypertrophy

A

Increase in size of cardiac myocytes (leads to increase in myocardial mass)

Usually secondary to increased workload (reversible)

Irreversible if primary

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9
Q

Concentric myocardial hypertrophy

A

Due to pressure overload
Increase in wall thickness
Decrease in chamber volume

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10
Q

Eccentric myocardial hypertrophy

A

Due to volume overload
Increase in chamber volume (dilation)
Normal or decreased wall thickness

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11
Q

Categories of cardiomyopathies

A

Hypertrophic
Dilated
Restrictive

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12
Q

Hypertrophic cardiomyopathy

A

Primary disease
Common in cats

Gross lesions: cardiomegaly, thick LV wall, decreased LV volume (concentric hypertrophy), +/- LA dilation/thrombosis

DDx: thyrotoxic cardiomegaly

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13
Q

Thyrotoxic cardiomegaly

A

Secondary to hyperthyroidism
Common in cats

Thyroid gland hyperplasia —> inc thyroid hormone production —> inc production of myocardial contractile proteins —> myocardial hypertrophy

Potentially reversible

DDx hypertrophic cardiomyopathy

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14
Q

Dilated cardiomyopathy

A

Primary disease in some dogs and cattle
Secondary disease in dogs and cats due to nutritional imbalances (taurine deficiency)

Gross lesions: enlarged rounded heart, dilated chambers/thin walls (eccentric hypertrophy)

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15
Q

Arrhythmogenic right ventricular cardiomyopathy

A

Variant of dilated cardiomyopathy
Primary disease in dogs (boxers) and cats (rare)

Sequelae/manifestation: ventricular arrhythmias, syncope (fainting), heart failure, sudden death

Gross lesions: RV myocytes —> adipose tissue (or fibroadipose tissue), RV normal or dilated

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16
Q

Restrictive cardiomyopathy

A

Rigid ventricular walls —> impaired ventricular filling

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17
Q

Causes of restrictive cardiomyopathy

A

Feline left ventricular endocardial fibrosis (LVEF)
Excessive moderator bands
Congenital endocardial fibroelastosis (Burmese cats)
Endocardial fibrosis in some aged rats

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18
Q

Feline left ventricular endocardial fibrosis

A

Fibrosis restricts ventricular filling

Cause: Sequelae of endomyocarditis (idiopathic inflammation following a stressful event)

Gross lesion: thick opaque endocardium

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19
Q

Excessive moderator bands

A

Endothelial lined bands of Purkinje fibers and collagen traverse left ventricle

Restrict ventricular filling

Congenital defect manifesting later in life

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20
Q

Myocardial necrosis

A

Cardiac myocytes cannot regenerate

Irreversible injury —> myocyte necrosis —> inflammation —> healing by fibrosis

Gross lesion: myocardial pallor, dry +/- gritty texture (dystrophic mineralization), depressed fibrotic scars

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21
Q

Causes of myocardial necrosis

A

Nutritional (vit E, selenium deficiency)
Toxic
Ischemia (myocardial infarcts)
Genetic (muscular dystrophy in golden retrievers)
Traumatic

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22
Q

Nutritional myopathy

A

Vit E/selenium deficiency —> decr in antioxidant activity —> oxidative membrane damage —> myocyte necrosis

Gross lesions: tan foci of myocardial necrosis and mineralization

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23
Q

White muscle disease

A

Nutritional myopathy in ruminants
Also affects skeletal muscle

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24
Q

Mulberry heart disease

A

Nutritional myopathy in pigs
Vascular necrosis/thrombosis +/- hepatic necrosis

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25
Q

Myocarditis

A

Inflammation of myocardium

Gross lesion: similar to myocardial necrosis

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26
Q

Infectious causes of myocarditis

A

Viral: canine parvovirus 2, encephalomyocarditis virus, FMDV, West Nile virus

Bacterial: Clostridium chauvoei (blackleg)/piriforme (Tyzzer’s), Corynebacterium pseudotuberculosis (caseous lymphadenitis), Histophilus somni

Fungal: Aspergillus

Parasitic: T. Gondii, Sarcocystis, Neospora caninum, T. Cruzi, Theileria, cysticercosis

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27
Q

Endocardiosis

A

Idiopathic degeneration of valvular collagen

Most common in old dogs (small > large)
Mitral > tricuspid&raquo_space;aortic/pulmonic

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28
Q

Morphology of endocardiosis

A

Myxomatous (relating to mucus) valvular degeneration
Loose fibroblastic tissue with mucopolysaccharides
Non-inflammatory

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29
Q

Sequelae of endocardiosis

A

Valvular insufficiency —> incomplete valve closure —> regurgitation of blood
Turbulent flow —> heart murmur
Atrial vol overload —> eccentric hypertrophy —> congestive heart failure
Atrial subendocardial fibrosis —> jet lesion
Atrial thrombosis —> thromboembolism/infarcts
Chordate tendineae rupture
Atrial rupture —> hemopericardium

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30
Q

Jet lesion

A

Sequelae of endocardiosis (due to regurgitation of blood)

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31
Q

Endocarditis

A

Inflammation of endocardium

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32
Q

Causes of endocarditis

A

Usually bacterial (rarely fungal, parasitic)

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33
Q

Manifestation of endocarditis in cattle

A

Tricuspid valve lesions most common

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34
Q

Manifestation of endocarditis in non-bovine species

A

Mitral valve lesions most common

35
Q

Vegetative endocarditis morphology

A

Septic thrombi composed of fibrin, bacteria, neutrophils

May or may not have granulation tissue/fibrosis

36
Q

Pathogenesis of vegetative endocarditis

A

Sustained/recurrent bacteremia and minor endocardial damage at lines of valve apposition

Bacterial proliferation —> inflammation —> additional endothelial damage —> thrombosis

Virchow’s triad (endothelial injury, abnormal blood flow, hypercoagulability —> thrombosis)

37
Q

Sequelae of vegetative endocarditis

A

Valvular insufficiency —> CHF
Septic thromboemboli to heart, kidney, brain, etc —-> ischemia/infarcts, infection/inflammation
Bactermia

38
Q

Endocardial mineralization causes

A

Vitamin D toxicosis
Johne’s disease (Mycobacterium avian ssp paratuberculosis)
Uremia

39
Q

Morphology of endocardial mineralization

A

Gritty white plaques on endocardium (+/- vascular endothelium)

40
Q

Pericardium anatomy

A

Two layers = epicardium (visceral layer) + parietal layer associated with pericardial sac

41
Q

Hydropericardium

A

Serous fluid in pericardial cavity

42
Q

Hemopericardium

A

Blood accumulation in pericardial cavity

43
Q

Pericarditis

A

Inflammatory exudate accumulation in pericardial cavity

44
Q

Cardiac tamponade

A

Heart compression due to increase in pressure in pericardial cavity (i.e., rapid fluid accumulation)

Interferes with cardiac filling —> pooling of venous blood in splanchnic and systemic vasculature

—> cardiogenic shock —> death

45
Q

Routes of pathogen entry

A

Hematogenous
Direct penetration
Local extension

46
Q

Forms of inflammation of the pericardium

A

Fibrinous
Suppurative
Restrictive/constrictive (chronic stage, fibrosis)

47
Q

Serous atrophy of pericardial fat is an indicator of ____

A

Emaciation

48
Q

Gross appearance of serous atrophy of pericardial fat

A

Thin translucent gelatinous adipose tissue

49
Q

Systemic to pulmonary shunt

A

Blood shunted from left (high pressure) to right (low pressure)

Reversal of flow may occur late in disease

50
Q

Causes of congenital shunts

A

Failure of closure of fetal cardiovascular shunts (ductus arteriosus, foramen ovale)

Artrial or ventricular septal defect

51
Q

Abnormal valve development

A

Pulmonic stenosis
Aortic or subaortic stenosis
Mitral or tricuspid valve dysplasia

52
Q

Sequelae of pulmonic stenosis

A

Pressure overload —> concentric RV hypertrophy

53
Q

Sequelae of aortic or subaortic stenosis

A

Pressure overload —> concentric LV hypertrophy

54
Q

Sequelae of mitral or tricuspid valve dysplasia

A

Valvular insufficiency —> atrial volume overload —> eccentric hypertropy
Less commonly, stenosis —> atrial pressure overload

55
Q

Malposition of great vessels

A

Persistent right aortic arch
Transpositions of aorta / pulmonary artery
Persistent turn us arteriosus
Double outflow right ventricle

56
Q

Persistent right aortic arch Sequelae

A

Vascular ring forms around esophagus and treacherous —> proximal megaesophagous

—> regurgitation, aspiration pneumonia

57
Q

Lesions of Tetralogy of Fallot

A
  1. Pulmonic stenosis
  2. Ventricular septal defect
  3. RV hypertrophy
  4. Aortic dextroposition
58
Q

Sequelae of tetralogy of Fallot

A

Venous blood shunted R to L —> less oxygenated blood to systemic circulation —> cyanosis

59
Q

Valvular hemocysts / lymphocysts

A

Dilated blood or lymph filled vascular spaces on AV valves

Common in ruminants

INCIDENTAL

60
Q

Vasculitis

A

Inflammation of blood vessels

61
Q

Arteritis

A

Inflammation of arteries

62
Q

Polyarteritis

A

Inflammation of many arteries

63
Q

Phlebitis

A

Inflammation of veins

64
Q

Lymphangitis

A

Inflammation of lymphatic vessels

65
Q

Manifestation of vasculitis

A

Gross: Thickened vessels

Histo: leukocytes in and around vessel walls with endothelial/smooth muscle cell damage; may have fibrin, may have edema, hemorrhage, thrombosis

66
Q

Infectious causes of vasculitis

A

Viral
Bacterial
Fungal
Parasitic

67
Q

Causes of vasculitis

A

Infectious
Immune-mediated
Idiopathic

68
Q

Arteriosclerosis

A

hardening of arteries

Intimate fibrosis —> loss of elasticity, luminal narrowing —> ischemia, infarct

Pigs, rabbits, chickens - if high cholesterol diet, dogs with hypothyroidism or diabetes

69
Q

Atherosclerosis

A

Subset of arteriosclerosis accompanied by fatty plaques in arteries (uncommon in most animals)

70
Q

Forms of vascular degeneration

A

Arteriosclerosis
Atherosclerosis
Arterial mineralization

71
Q

Gross lesion of atherosclerosis

A

Fibrofatty plaques in vessel walls —> thick rigid vessels with narrow lumens

72
Q

Aneurysm

A

Localized vascular dilation due to thinning or weakening of vessel wall

73
Q

Causes of aneurysm

A

Copper deficiency, Strongylus vulgaris migration, idiopathic

74
Q

Endothelial tumors

A

Hemangioma
Hemangiosarcoma
Lymphangioma
Lymphangiosarcoma

75
Q

Perivascular wall tumors

A

Hemangiopericytoma, angioleiomyoma

76
Q

Chemodectoma

A

Tumor of aortic/carotid body

Originates from aortic body (chemoreceptor that detects changes in blood gas/pH)

Most common in brachycephalic dogs (Boston terrier, boxer)

may compress great vessels/atria

77
Q

Rhabdomyomatosis, rabdomyosarcoma

A

Tumor of striated muscle of heart

78
Q

Hemangioma

A

Benign neoplasm of vascular endothelial cells

Gross: Dark red, well defined mass (in dermis/subcutis)

Histo: Blood-filled spaces lined by well-differentiated endothelial cells

79
Q

Hemangiosarcoma

A

Malignant neoplasm of vascular endothelial cells

gross: dark red blood-filled mass on R auricle

Histo: blood-filed spaces lined by PLEOMORPHIC endothelial cells

Common primary sites: RIGHT ATRIUM, liver, spleen, skin/subcutis, fat (around urinary bladder)

80
Q

Feline ventral abdominal lymphangiosarcoma

A

Infiltrative endothelial neoplasm affecting ventral abdominal dermis/subcutis in cats

Edematous, bruised appearance of tissue

81
Q

Canine perivascular wall tumor (hemangiopericytoma)

A

Infiltrative mesenchymal neoplasm

May recur, but rarely metastatic

82
Q

Cardiac lymphosarcoma (LSA)

A

Bulging tan masses in heart

Can occur in any species, potentially multi-organ disease

83
Q

Common sites of lymphosarcoma

A

Right atrium, abomasum, uterus, spinal canal, retrobulbar region, kidney, lymph nodes

84
Q

Cancer associated with bovine leukemia virus

A

Cardiac lymphosarcoma

Pathology (21 decks)

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