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Cardiovascular Pathology > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the definition of congestive heart failure?

A

When cardiac output < venous return and heart is unable to meet the demands of the animal (an endpoint of multiple causes/diseases when compensatory mechanisms have been exhausted)

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2
Q

What are some of the causes of left ventricular failure?

A

Myocarditis
Myocardial degeneration
Aortic stenosis
Mitral valve insufficiency
Shunts

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3
Q

What are the effects of left ventricular failure?

A

Chronic passive pulmonary congestion
Edema of interstitium followed by alveolar lumen -> cough
Fibrosis of alveoli/pleural surface
Surfactants + air + edema = frothing
Reduction in cardiac output -> ischemia, renal issues

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4
Q

What are some of the causes of right ventricular failure?

A

Heartworms
Tricuspid valve insufficiency
Pulmonic stenosis
Left ventricular failure/Increased pulmonary resistance
Cardiac tamponade

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5
Q

What are the effects of right ventricular failure?

A

Systemic and portal venous system congestion, veins distended
Enlarged, congested liver (nutmeg liver) and spleen (nodules/fibrotic metaplasia), function OK
Congestion of stomach/intestines (+/- diarrhea)
Renal complications/functional loss
Epistaxis in horses

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6
Q

Fluid accumulation varies from species to species. Where is fluid most likely to accumulate in the cow, horse, cat and dog with right heart failure?

A

Cow and horse: dependent subcutaneous edema
Dog: peritoneal effusion (ascites)
Cat: thoracic effusion (hydrothorax)

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7
Q

What is the definition of cardiac hypertrophy?

A

Reversible enlargement of cardiomyocytes (volume, myofibrils) with no increase in cell number

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8
Q

Can myocardial muscle fibers undergo hyperplasia?

A

Myocytes have little capacity for cell division post-birth, so no

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9
Q

What are the three requirements necessary for the myocardium to undergo hypertrophy?

A

Time
Adequate blood supply/nutrition
Healthy myocardium

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10
Q

Define concentric cardiac hypertrophy.

A

An increase in the mass of the ventricle without accompanying increase in end diastolic volume (decrease in ventricular lumen volume) characterized by increased wall thickness.
Right side = broad at base, Left side = elongated, Bilateral = rounded

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11
Q

What are some causes of concentric cardiac hypertrophy (be specific)?

A

Caused by pressure overload:
Aortic stenosis (Left ventricular hypertrophy)
Pulmonic stenosis (Right ventricular hypertrophy)
Pulmonary hypertension (Right ventricular hypertrophy)

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12
Q

Define eccentric cardiac hypertrophy. What can cause eccentric cardiac hypertrophy?

A

Increase in myocardial mass accompanied by an increased end diastolic volume (ventricular lumen volume increased). Weight of ventricular myocardium may be only sign.
Caused by volume overload:
Valvular insufficiency
Congenital defect with shunt
Increased blood volume

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13
Q

What is cardiac dilatation?

A

Stretching of myofibers in response to increased workload that eventually leads to decreased cardiac output. Occurs instead of hypertrophy in cases where the conditions for hypertrophy are NOT met:
Insufficient time
Inadequate blood supply/nutrition
Unhealthy myocardium

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14
Q

What is the most likely effect on the blood flow of Atrial septal defect?

A

(L to R) Pulmonary hypertension +/- R to L -> cyanosis/death

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15
Q

What is the most likely effect on the blood flow of Ventricular septal defect?

A

(L to R) Pulmonary hypertension -> R to L -> cyanosis/death

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16
Q

What is the most likely effect on the blood flow of Tetralogy of Fallot?

A

(transpositional) RV directly to aorta -> cyanosis/death

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17
Q

What is the most likely effect on the blood flow of Persistent ductus arteriosus?

A

(L to R) Pulmonary hypertension +/- R to L -> cyanosis/death

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18
Q

What four abnormalities are found with Tetralogy of Fallot?

A

Ventricular septal defect
Pulmonic stenosis
Overriding aorta
Right ventricular hypertrophy

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19
Q

What are the effects of pulmonic and aortic stenosis?

A

Pulmonic stenosis -> right ventricular concentric hypertrophy, pulmonic artery dilatation, right heart failure
Aortic stenosis -> left ventricular concentric hypertrophy, LV wall fibrosis, left heart failure

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20
Q

What are the two right to left shunts present within the fetus which bypass the pulmonary circulation?

A

Foramen ovale
Ductus arteriosus

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21
Q

What is a patent ductus arteriosus?

A

Abnormal shunt between pulmonary artery and aorta that should not remain post-birth

22
Q

What are the usual clinical signs found with persistent right aortic arch?

A

Regurgitation after eating, esophageal dilation, megaesophagus

23
Q

What causes the esophagus to be constricted when a persistent right aortic arch occurs?

A

Vascular ring is formed from right aortic arch and ligamentum arteriosum that encircles esophagus and trachea which constricts the esophagus

24
Q

What are some of the synonyms for chronic degenerative valvular disease?

A

Endocardiosis
Chronic valvular failure
Valvular mucoid degeneration
Myxomatous degeneration of the valves

25
Q

What is the pathogenesis of chronic degenerative valvular disease?

A

There is a proliferation of fibroblastic tissue in the connective tissue of the valve (spongiosa), deposition of mucopolysaccharides, and weakening of the valvular collagen

26
Q

How can you distinguish chronic degenerative valvular disease from endocarditis, (grossly and microscopically)?

A

-Grossly, CDVD will have glistening, SMOOTH nodular thickenings on valve leaflet margins/chordae tendineae, whereas endocarditis will have irregular YELLOW masses with blood, fibrin, and pus (inflammatory!) that are friable
-Microscopically, CVDV will have thickened spongiosa with loose fibroblasts and accumulation of poorly-staining mucopolysaccharide material whereas endocarditis will have bacterial colonies, fibrin, neutrophils, and granulation tissue
-CDVD more common in dogs, Endocarditis more common in large animals
-Both affect mitral valve most often

27
Q

What are some of the sequelae occasionally associated with chronic degenerative valvular disease of the mitral valve?

A

Valvular insufficiency -> vol overload -> LV eccen hypertrophy -> LH failure -> RH failure
Rupture of chordae tendineae -> acute LH failure -> sudden death
Rupture of chordae tendineae -> chronic LH failure -> pulmonary fibrosis
Rupture of the atrial wall -> yikes

28
Q

Why is the endocardium prone to mineralization and what are some causes?

A

High elastin content predisposes to mineralization
Endocrine disease, Toxicosis

29
Q

What are some of the proposed reasons why valves are more susceptible to inflammation?

A

-Poorly vascularized
-Area of recurrent trauma

30
Q

Rank the valves from more prone to less prone to developing bacterial endocarditis.

A

Mitral > Aortic > Tricuspid > Pulmonary (more pressure = more affected)

31
Q

Is there a species in which the order of susceptibility to valvular bacterial endocarditis is different, how so?

A

Yes, in cattle Tricuspid is most common: Tricuspid > Mitral > Aortic > Pulmonary

32
Q

What are the most common primary sites of infection in cases of bacterial endocarditis for cattle and horses?

A

Cattle: peritoneal or hepatic abscesses, metritis, mastitis
Horses: (rare) septic jugular thrombophlebitis

33
Q

What is the definition of cardiomyopathy?

A

Disorder of heart muscle of unknown or obscure etiology, intrinsic disease that can be acute, subacute or chronic

34
Q

Hypertrophic cardiomyopathy is more common in what species and what is a common and serious sequela?

A

CATS, so much collagen, can’t contract -> concentric hypertrophy +/- left atrial thrombosis -> saddle thrombus -> posterior paresis

35
Q

Dilated cardiomyopathy is more common in what species and what kind of breed? Sequela?

A

Large breed dogs
Increased luminal volume, interstitial fibrosis, left heart failure -> bilateral heart failure

36
Q

What is hydropericardium? How can it occur?

A

Excessive accumulation of serous fluid in the pericardial space
Protein-losing nephropathy or enteropathy

37
Q

What is hemopericardium? How can it occur?

A

Accumulation of blood in pericardial space
Rupture of:
Aorta (horses, turkeys)
Atrium (dogs)
Pulmonary artery
Tumor

38
Q

What is the most severe consequence of hemopericardium?

A

Cardiac tamponade

39
Q

What is the significance of serous atrophy of fat?

A

Indicates inadequate nutrition/starvation

40
Q

What is the usual pathogenesis of fibrinous pericarditis?

A

Hematogenous bacterial infection aka septicemia

41
Q

What are common septicemic pathogens that cause fibrinous pericarditis?

A

FIP in cats, Mycoplasma felis in horses, Pasteurella in cattle/sheep/pigs, Strep, E. coli, Clostridia

42
Q

What is the usual pathogenesis of purulent pericarditis?

A

Sharp object penetrates reticulum, diaphragm, and pericardial sac (bovine traumatic reticulopericarditis) with mixed bacterial growth

43
Q

What is atherosclerosis?

A

Degeneration of artery wall due to buildup of lipids (cholesterol, triglycerides)

44
Q

Define Periarteritis

A

Inflammation of adventitia

45
Q

Define polyarteritis

A

Inflammation of many arteries

46
Q

Define phlebitis

A

Inflammation of a vein

47
Q

Define vasculitis

A

Inflammation of vessels (arteries and veins)

48
Q

Define endarteritis

A

Inflammation of the intima

49
Q

Define Omphalophlebitis

A

Inflammation of the umbilical vein

50
Q

Briefly describe the pathogenesis of equine verminous arteritis.

A

Strongylus vulgaris larvae migrate through mesenteric artery walls -> inflammatory reaction -> aneurysm, thromboembolism, infarct (aka thromboembolic colic)

51
Q

What tumor is most frequently found on the right atrium of dogs and what is the prognosis?

A

Hemangiosarcoma, often metastasizes to lungs or may be part of multicentric hemangiosarcoma
Sequalae: rupture -> hemopericardium -> cardiac tamponade -> death
Poor prognosis

Cardiovascular Pathology (2 decks)

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