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Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What are the 4 chambers of the emryological heart?

A

Sinus venosus
Primordial atrium
Primordial ventricle
Bulbus cordis

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2
Q

The atria is separated by septum primum and secundum what occurs if these don’t close?

A

Patent foramen ovale

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3
Q

The interventricular septum is separated into 3 portions, what are they?

A

1.Muscular portion
2. Membranous portion
3. Conotruncal ridges

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4
Q

What do the Left and Right 4th aortic arches form?

A

Left – forms the proximal part of the arch of the aorta
Right – forms the proximal part of the right subclavian artery

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5
Q

What are the pericardium, epicardium, myocardium and endocardium?

A

Pericardium = sac around the heart
Epicardium = outer surface of the heart
Myocardium = muscle portion of the heart
Endocardium = Inner lining of the heart

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6
Q

What do myocardiocytes look like histologically?

A
  • centrally-placed nuclei
  • sarcomeric cross-striations
  • ratio muscle fibre: capillaries1:1
  • Purkinje fibres
  • arranged in bundles
  • connective tissue
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7
Q

What are the post-mortem alterations?

A

*blood clotting - red clots in the atria, right ventricle and large
vessels at the base of the heart.
*Rigor mortis - occurs in the left myocardium and produces contracted rigid ventricular walls
*“Chicken fat clots” - sedimentation of erythrocytes, clot consists of colourless fibrin
*Haemoglobin imbibition - Postmortem lysis of erythrocytes produces diffuse red staining of the endocardium.
*Barbiturate crystals - injection of euthanasia solution and other substances can lead to the presence of crystalline deposits.

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8
Q

What are the Pathophysiological mechanisms of
cardiovascular dysfunction (heart failure)?

A

*Pump failure - weak contractility, myocardial disease
*Obstruction of flow -valvular stenoses, vascular narrowing
*Regurgitant flow - valvular dysfunction
*Shunted flow - congenital defects
*Ruptures - heart wall, major vessels
*Conduction disorders

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9
Q

What are the reasons for cardiac syncope?

A

change in heart rate or blood pressure = acute from cardiac disease

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10
Q

What is congestive heart failure?

A
  • Slow, gradual loss of cardiac pumping efficiency
  • Associated with:
    * pressure overload (hypertension or stenosis)
    * volume overload (shunts, valvular regurgitation)
    * progressive myocardial damage
  • Reduced renal blood stimulates RAAS = sodium and
    water retention
  • Increased plasma volume and increase the workload on the
    already failing heart
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11
Q

What are the hearts response to congestive heart failure?

A
  • cardiac dilation
  • hypertrophy
  • decompensation
  • death from cardiac failure
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12
Q

What are the causes, subacute and chronic signs of left sided heart failure?

A
  • Causes: left sided cardiomyopathies, dysfunction of aortic and mitral
    valves.
  • Subacute: pulmonary congestion and oedema
  • Chronic: pulmonary congestion, oedema, fibrosis and haemosiderosis
    (heart failure cells)
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13
Q

What are the causes, subacute and chronic signs of right sided heart failure?

A
  • Causes: right sided cardiomyopathies, pulmonary hypertension,
    dysfunction of tricuspid and pulmonary valves.
  • Subacute: passive systemic congestion, hepatomegaly and
    splenomegaly
  • Chronic: systemic oedema, nutmeg liver
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14
Q

What are the causes of Congenital defects of heart and pericardium?

A
  • Single or multiple gene defects.
  • Toxins (thalidomide, ethanol),
  • Physical agents (irradiation)
  • Nutritional deficiencies (vit A, Zinc).
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15
Q

What are the congenital defect of the heart?

A

*Agenesis of the heart (acardia) - no heart
*Amorphus globosus - abnormal - covered in hair
*Ectopia cordis - heart outside of body cavity
*Patent ductus arteriosus (PDA)
*Atrial septal defects
*Ventricular septal defects
*Pulmonic stenosis
*Subaortic stenosis
*Tetralogy of Fallot
*Valvular haematomas
*Persistent right aortic arch
*Valvular dysplasias
*Endocardial cushion defects

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16
Q

What is a patent ductus arteriosus?

A

Blood between pulmonary artery and aorta = bypass lungs
* blood is shunted from the left to the right side resulting in:
* pulmonary hypertension - RV pressure overload concentric hypertrophy = increased muscle thickness
- LA/ LV - volumen overload and eccentric hypertrophy = increased chamber dilation

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17
Q

What happens with failure of closure of foramen ovale?

A

blood bypass lungs of fetus - can cause low blood oxygen

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18
Q

What are true septal defects?

A

Failure of development of interatrial septum

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19
Q

What breeds are susceptible to failure of the interventricular septum?
What happens in the RV/LV?

A

Bulldog, Springer Spaniel, West highland terriers
RV = pressure hypertrophy
LV = Volume hypertrophy

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20
Q

What are the 3 different types of semilunar valve stenoses?

A
  1. Supravalvular
  2. Valvular
  3. Subvalvular
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21
Q

What is pulmonic stenosis?

A

Valvular defect = pressure overload = R concentric hypertrophy
Seen in Beagle, Bulldog, Chihuahua

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22
Q

What is subaortic stenosis?

A

Subvalvular defect = pressure overload = L concentric hypertrophy
Seen in Pigs and Dogs

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23
Q

What is tetralogy of fallot?

A

Complicated cardiac anomaly with four lesions.
1. Ventricular septal defect (A)
2. Pulmonic stenosis (B)
3. Dextroposition of the aorta (C)
4. Secondarily- Hypertrophy of the right ventricular myocardium
Bulldog and Keeshond.

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24
Q

What are Valvular haematomas common in?

A

AV valve of ruminants

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25
Q

What does Persistent right aortic arch cause?

A
  • The ligamentum arteriosum forms a vascular ring over the oesophagus and trachea.
  • Oesophageal obstruction and proximal dilation (megaoesophagus) → regurgitation
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26
Q

What is Peritoneopericardial diapragmatic hernia?

A

Abdominal viscera in pericardial sac

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27
Q

What does normal pericardial fluid consist of?

A

Clear/ viscous - horse/cow = 100ml
- Dog/cat = 10ml

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28
Q

What is hydropericardium?

A

*Accumulation of clear to light yellow,
watery, serous fluid (transudate: specific gravity < 1.015) in the
pericardial sac.

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29
Q

What is a haemorrhagic pericardial effusion?
What breeds are susceptible?

A

Deposition of small amounts of blood, chronically. Unknown
aetiology. Great Dane, Saint Bernard, German Shepherd.

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30
Q

What is a haemopericardium?

A

Accumulation of large amount of blood. Cardiac tamponade (compression of the heart),
leading to compression and interfering with cardiac filling and
emptying.
* Atrial rupture due to haemangiosarcoma of the right atrium
in dogs
* Rupture of the intrapericardial aorta in horses
* Complication of intracardiac injections

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31
Q

What is pneumopericardium?

A

Air filled pericardial sac

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32
Q

What is chylopericardium?

A

Rupture of thoracic duct, exudate = SG >1.015

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33
Q

What are the causes of Serous atrophy of epicardial adipose tissue?
What are the gross changes?

A

Anorexia, starvation, cachexia, as fat is catabolised to
maintain energy balance
Important change in forensic pathology in cases of emaciation
grossly = Transformation of the white or yellow epicardial fat
deposits e.g. coronary groove, into grey gelatinous material.

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34
Q

What is Epi/pericarditis and its causes?

A

Inflammation of the epi/pericardium
*Foreign body penetration: From reticulum (cattle)
*Local extension of severe inflammatory processes from adjacent structures
(thoracic cavity / lungs / oesophagus)
*Haematogenous spread of viruses / bacteria

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35
Q

What is the difference between fibrin and fibrous tissue?
What is the difference between fibrin and fibrinosuppurative?

A

Fibrin = acute
Fibrous tissue = chronic
Fibrin turns into fibrous tissue over time
Fibrinosuppurative = contains neutrophils = acute

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36
Q

What is hardware disease?

A

Wire perforates rumen + into pericardial sac = bacteria, fibrin + pus

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37
Q

What is visceral gout?

A

uric acid - excreted from kidneys - common in exotics
pericardial gout = white gritty deposits

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38
Q

What causes mineralisation of the endocardium?

A

*excessive amounts of vitamin D
*intoxication by calcinogenic plants (solanum, cestrum, trisetum sp.) in cows.
*Hyperparathyroidism
* renal failure
* Johne ́s disease

39
Q

What causes fibrosis?

A

*chronic dilated hearts
*healed ulcerative endocarditis in dog (uraemia)
*jet lesions (valvular stenosis / regurgitation).

40
Q

What valves are more likely to have valvular endocardiosis + what happens?

A

Mitral>Tricuspid>Aortic>Pulmonary
Degeneration of valvular collagen - valves shortened, thickened + appear smooth and shiny.
Valve insufficiency leads to congestive heart failure

41
Q

What is left ventricular endocardial fibroelastosis?

A

Defect in myocardial lymph drainage = chronic oedema + fibroelastic tissue proliferation

42
Q

What are the most common causes of endocarditis?

A

Bacteria>Parasites>Fungi

43
Q

What does right cardiac endocarditis cause?

A

*Stenosis of right valve
*chronic hepatic congestion
*pulmonary embolism

44
Q

What does left cardiac endocarditis cause?

A

*Stenosis of left valve
*chronic pulmonary congestion
*systemic embolism (kidney)

45
Q

What causes ulcerative endocarditis?

A
  • Uraemia (acute renal insufficency) induce endocardial ulceration in dogs.
46
Q

What does endocarditis lead to?

A

Embolic showers - multifocal purulent, lesions scattered randomly throughout an organ

47
Q

What causes traumatic rupture of the myocardium?

A

Perforating trauma - bullet

48
Q

What causes spontaneous trauma of the myocardium?

A

*Insufficiency of mitral valve
*chronic left atrial dilation

49
Q

What causes of cardimegaly?

A

*Hypertrophy
*Dilation
*Cardiomyopathy

50
Q

What causes ventricular hypertrophy?

A
  • Secondary - compensatory response to increased workload - reversible
  • Primary - irreversible idiopathic hypertrophic cardiomyopathy
51
Q

What is eccentric ventricular hypertrophy?
What is the cause?

A

Enlarged ventricular chambers + Decreased wall thickness
Produced by volume overload

52
Q

What is concentric ventricular hypertrophy?
What is the cause?

A

Small ventricular chambers + thickened walls
Produced by pressure overload (hypertension)

53
Q

What are causes of right ventricular hypertrophy?

A

Dirofilariosis and congenital pulmonic stenosis in dogs
High altitude disease (pulmonary hypertension) in cattle
Chronic alveolar enphysema in horses (heaves)

54
Q

What is Cor pulmonale?

A

abnormal enlargement of the right ventricle of the heart as a result of disease of the lungs or the pulmonary blood vessels.

55
Q

What are causes of left ventricular hypertrophy?

A

Systemic hypertension (chronic renal failure)
Congenital subaortic stenosis

56
Q

What is ventricular dilation?

A
  • Myocardium cannot undergo hypertrophy because of insufficient time, inadequate nutrition or diseases.
  • Terminal lesion in many cardiac diseases.
  • Compensatory response to achieve increased cardiac output.
  • Dilation allows stretching of cardiac muscle cells to increase contractile force and an increase in stroke volume is the result.
57
Q

What are the 3 different cardiomyopathies?

A
  • hypertrophic cardiomyopathy
  • dilated cardiomyopathy
  • restrictive cardiomyopathy
58
Q

What does hypertrophic cardiomyopathy look like grossly?
What species are they common in?

A
  • Hearts are enlarged
  • Prominent concentric hypertrophy of the left ventricle, interventricular septum
  • Dilation of the left atrium.
    *common in young adult to middle aged cats - uncommon in dogs
59
Q

What does dilated cardiomyopathy look like grossly?
What species are they common in?

A
  • Biventricular dilation
  • White thickened endocardium
  • Increased heart weight, >1% heart:body weight ratio.
    *Common in middle aged dogs + cats w low tissue taurine conc.
60
Q

What cows are susceptible to bovine dilated cardiomyopathy?
What are the signs?

A
  • Holstein 2-3y/o
    *peripheral oedema, jugular distension,
    *fluid accumulations in the body cavities.
    *enlargement of the heart with a rounded “globose” shape
61
Q

What is restrictive cardiomyopathy?

A
  • Walls are rigid and the heart is restricted from stretching and filling with blood properly.
  • Rhythmicity and contractility of the heart may be normal
  • Stiff walls of the heart chambers keep them from adequately filling.
  • Cats with endocardial lesions (inflammation, fibrosis, fibroelastosis) that
    impair the ventricular flow.
62
Q

Causes of Myocardial necrosis? (6)

A
  • Nutritional deficiencies: Vitamin E / Selenium deficiency [calves, lambs, foal]
    mulberry heart disease [pigs]
  • Ischemia: hypoxia
  • Ionophore toxicity: Monensin intoxication
  • Plant intoxication - plants containing heart glycosides (avocado intoxication in sheep / goats)
  • Doxirubicin: Dogs, treatment of lymphosarcoma (depression of cardiac function, direct injury to muscle fibres and hypersensitivity reactions)
  • Secondary to myocarditis
63
Q

What does myocardial necrosis look like grossly and histologically?

A

Grossly - affected areas = pale yellow to white and dry
Histologically - (recent necrosis) fibres appear swollen, hypereosinophilic
(24-48hr) inflammatory cells
(weeks) persistent stromal tissue - fibroblasts, collagen + capillaries

64
Q

What are the causes of myocarditis?

A

*Haematogenous dissemination
*Embolic dissemination
*virus / bacteria / fungi /protozoan + metazoan parasites

65
Q

What are the different types of myocarditis?

A
  • purulent (from vegetative endocarditis)
  • necrotising (toxoplasmosis in dogs and cats)
  • haemorrhagic (black leg)
  • lymphocytic ( parvoviral myocarditis)
  • eosinophilic (sarcocystosis)
  • granulomatous (fungi)
66
Q

What are the protozoan parasites of the heart?

A

Sarcocystis sp. [ruminants / equids / porcine]rarely myocarditis
Toxoplasma sp. [canine possibly lethal]
Neospora sp.

67
Q

What are the metazoan parasites of the heart?

A

Cestodes -Cysticercus sp.
-Hydatid cyst.
Nematodes -Dirofilaria immitis [dogs, cats]
adults: right ventricle / pulmonary arteries
larvae: microfilariae in peripheral circulation
-Angiostrongylus vasorum [dogs]

68
Q

What is the most common tumour of the heart?

A

Haemangiosarcoma

69
Q

What are the 4 parts of the vascular system?

A

Arteries
Capillaries
Veins
Lymph vessels

70
Q

What are the 2 types of arteries?
What are the 3 layers called?

A

Elastic arteries
Muscular arteries - fewer layers of smooth muscle cells without elastic lamina
1.Tunica intima
2.Tunica media
3.Tunica adventitia

71
Q

What are the 3 types of capillaries and where are they found?

A

*Continuous epithelium. = fat, muscle, nervous system
*Fenestrated = Endocrine glands, renal glomeruli, small intestine
*Discontinuous = Liver, bone marrow, spleen

72
Q

What is the structure of veins?

A

thinner walls, adventitia = thickest part, valves to prevent backflow

73
Q

What is an aneurysm and what are the causes?

A
  • Localized dilation of a thinned and weakened portion of a vessel.
  • Usually arteries affected (large elastic arteries),but can occur in veins.

causes
* Copper deficiency in pigs: Copper neccessary for development of elastic tissue.
* Parasitic infestations: Spirocerca lupi in dogs/strongylus vulgaris in horses.
* Disecting aneurysms: Birds. Disruption of intima. Entry of blood into media dissecting along the wall.

74
Q

What are common ruptures in horses?

A

*sudden rupture of ascending aorta - due to trauma from fall - rapid
*rupture of internal carotid artery into adjacent guttural pouch - present as epstaxis

75
Q

What is the common rupture in cattle?

A

*rupture of middle uterine artery during parturition, uterine torsion or prolapse

76
Q

Why does arterial hypertrophy occur?

A

sustained increased pressure or volume loads

77
Q

Which layer of the arteries are usually affected? - arterial hypertrophy

A

Tunica media of muscular arteries

78
Q

What are the causes of arterial hypertrophy in different animals?

A

Cats = parasitic infestations
Cows = hypoxia from high altitude
All species = anomalies that shunt blood from left to right

79
Q

What are the causes of arterial medial calcification?

A
  • calcinogenic plant toxicosis,
  • vitamin D toxicosis,
  • renal insufficiency
  • Johne’s disease.
80
Q

What does arterial medial calcification look like grossly?

A

Solid, dense, pipelike structures with raised, solid, white,
intimal plaques.

81
Q

What is fibrinoid necrosis?

A
  • Deposits of an amorphous, homogeneous, eosinophilic
    PAS+ protein material composed of serum proteins and
    fibrinogen.
82
Q

What causes fibrinoid necrosis in pigs/dogs?

A

Pigs = selenium / Vitamin E deficiency
Oedema disease
Dogs = Uraemia

83
Q

What is a thrombosis and what are the predisposing factors?

A

Intravasuclar coagulation
* endothelial damage,
* turbulence or stasis
* hypercoagulative states.

84
Q

What causes hypocoagulabilities, endothelial damage + abnormal blood flow?

A

Hypocoagulabilities = Congenital
Hemoconcentration (DH)
High fat diets
Endothelial damage = Arteritis, parasites (strongylosis in mesenteric arteries
in horses and dirofilariasis in dogs in pulmonary arteries)
Abnormal blood flow = Turbulences, stasis
Caudal aortic thromboembolism
(cats with cardimyopathy)

85
Q

What are the causes of disseminated intravascular coagulation (DIC)?

A
  • Endotoxaemia
  • Viraemia (FIP and canine infectious hepatitis)
  • Dirofilariasis
  • Tumours (hemangiosarcoma and leukemia)
  • Shock, haemolysis, extensive necrosis (burns)
86
Q

What are the consequences of DIC?

A

Extensive clotting depletes coagulation factors, resulting in widespread haemorrhages.

87
Q

What is an embolism?

A

Occlusion of arteries by lodgement of foreign materials such as disrupted fragments of thrombi, neoplastic cells or bacteria.

88
Q

What are the different types of embolisms and causes?

A

-Septic: Originate from lesions of vegetative endocarditis in the lung (right side) or the myocardium, kidneys, spleen, joints, leptomeninges (left side).
-Parasitic =Fragments of dead intravascular parasites following adulticides
-Fat = due to bone fractures
-Fibrocartilaginous = embolism of spinal arteries of dogs = posterior paresis
fibrocartilaginous fragment = movement of spinal vasculature
=infarction of spinal cord
-Thromboembolism = altered blood flow, hypercoagulability, endothelial
damage

89
Q

What is vasculitis (arteritis) and what are the causes?

A

Inflammation of the blood vessels - arteries
* Haematogenous dissemination
* Local extension of suppurative-inflammatory processes,
* Immunomediated processes
* Parasitic infections.

90
Q

What does vasculitis look like grossly?

A

Medium-sized arteries appear thick and tortuous, with associated
haemorrhages, aneurysms and thrombosis

91
Q

What does vasculitis look like microscopically?

A

-Fibrinoid necrosis and inflammation of the intima and media.
-Leukocytes present within and surrounding walls; damage to vessel as
fibrinoid necrosis.
-Endothelial damage causes thrombosis leading to infarction.

92
Q

What is phlebitis + causes?

A

Inflammation of the veins
* Systemic infections (vasculitis): Salmonellosis, collibacilosis, FIP.
* Local infections: Metritis, hepatic abscesses.
* Intravenous injection sites

93
Q

What is omphalophlebitis

A

Inflammation of the umbilical vein
* Common in neonatal farm animals: bacterial contamination of the umbilicus
* Septicaemia, suppurative arthritis, hepatic and umbilical abscesses.

Pathology (7 decks)

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