Cardiovascular Path (1-4) Flashcards
name the pathogenic mechanism that may result in heart disease
this is due to weak contractibility/chamber emptying or impaired filling
pump failure
name the pathogenic mechanism that may result in heart disease
this is due to valvular stenosis, vascular narrowing, systemic or pulmonary hypertension
obstruction to forward blood flow
name the pathogenic mechanism that may result in heart disease
this is due to valvular incompetance
regurgitent blood flow
name the pathogenic mechanism that may result in heart disease
this is mostly a result of congenital defects (septal, vascular)
regurgitant blood flow
name the pathogenic mechanism that may result in heart disease
this can ocur at the level of the heart or a major vessel
rupture
name the pathogenic mechanism that may result in heart disease
these lead to arrhythmia and pump failure
cardiac conduction disorders
name the category of heart disease
due to functional derangement of the heart itself
primary
name the category of heart disease
due to extra-cardiac derangement (system or specific organ)
secondary
this is due to increased volume of blood entering the heart during diastole - ‘volume overload’
increased preload
this is due to increased resistance against which the heart must pump blood during systole - ‘pressure overload’
increased afterload
name 5 mechanisms of the CV system to cope with derangement/increased demand
- cardiac dilation
- cardiac hypertrophy
- increased cardiac rate/output
- blood redistribution to vital organs
- increase in blood volume
name the 2 distinctive patterns of cardiac ventricular hypertrophy
concentric and eccentric
name the type of cardiac ventricular hypertrophy
result of increased afterload;
increase in ventricular mass but no change in end diastolic volume
concentric hypertrophy
name the type of ventricular hypertrophy
result of increased preload;
increase in ventricular mass AND wall stretches so ventricular chamber dilates
eccentric hypertrophy
what does malfunction of the LEFT side of the heart lead to
pulmonary congestion/oedema
what does malfunction of the RIGHT side of the heart lead to
systemic venous congestion
name the type of congenital cardiac defect
pre-existing parental genome defect passed to sperm and/or ova
inherited
(genetic)
name the type of congenital cardiac defect
genomic defect arising in the fertilized zygote
acquired
(genetic)
name 4 examples of acquired cardiac congenital defects
(not genetic)
- infections
- physical (hypoxia, etc)
- nutritional (deficiencies)
- chemica, toxicants
name the 4 broad types of congenital cardiac defects
- septal defects
- abnormalities of great vessels
- abnormalities of valve formation
- persistence of embryonic structures
name the septal defect
most commonly the result of a persistent foramen ovale - small defect sometimes found incidentally in slaughtered adult cattle
atrial defect
(between the atria)
name the 2 main condequences of atrial septal defect (ASD)
- Shunt LA to RA (RA dilation, increased RV preload)
- increased pulmonary overperfusion
name the septal defect
most common congenital cardiac defect in the cat - majority are situated high up the septum (below the aoritc valve, behind the main left AV valve cusp & below the R septal AV cusp)
ventricular septal defect (VSD)
(failure of inter-ventricular septum to join with endocardial cushions)
name the 2 main consequences of ventricular septal defects (VSD)
- shunt LV to RV (increased RV preload)
- pulmonary overperfusion
this is the most common scenario of transposition defects of the roots of the great vessels where the aorta is misplaced to lie over the R ventricle
dextro-rotation
name 2 consequences of L aortic stenosis
- increased LV afterload (LV concentric hypertrophy)
- aortic poststenotic dilation
name 2 consequences of R pulmonic stenosis
- increased RV afterload (RV concentric hypertrophy)
- PA poststenotic dilation
name the 4 congenital defects/abnormal features that occur together to form the Tetralogy of Fallot
- ventricular septal defect (VSD)
- pulmonic stenosis
- RV hypertrophy
- Dextro-rotated aorta
name 2 consequences of patent ductus arteriosis (PDA)
- shunt aorta to pulmonary artery (increased RV afterload and RV concentric hypertrophy)
- pulmonary overperfusion
name the syndrome
this is when non-oxygenated blood flows from the pulmonary artery into the aorta in PDA and results in systemic hypoxia (‘shunt reversal’ due to resistance in pulmonary circulation exceeding that of systemic circulation)
Eisenmenger’s syndrome
of the 6 pairs of branchial arches present in the early embryo, which one normally persists as the aortic arch
left fourth arch (L4)
what is the basic anomaly of persistent branchial arches and the resulting consequence?
constriction of the oesophagus, megaoesophagus (with regurgitation of undigested food)
name the persistent branchial arch
most common manifestation; vascular ring forms between the ductus arteriosus/ligamentum arteriosum (L6) & this persistent arch
R aortic arch (R4)
name the 2 main morphological presentations of atrioventricular valvular dysplasia
- web-like valve formations with no clear leaflets
- short cordae tendinae with small papillary muscle masses
name the congenital cardiac condition
narrowing of the ascending aorta
(rare in bovine only)
coarctation of the aorta
name the congenital cardiac condition
heart is normal but is situated abnormally in the body
-highest incidence in cattle & pigs: heart is situated pre-sternally in lower cervical region or in abdomen
Ectopia cordis
name the congenital cardiac condition
L ventricular endocardium is diffusely thickened with fibro-elastic tissue, R side may or may not be affected
-affected animal found dead at 2-3 months old with no previous clinical signs
Endocardial fibro-elastosis
name the congenital cardiac condition
absence or incompleteness of the pericardial sac
congenital anomalies of pericardium
this is a thin, fibrous and inelastic sac with an internal serous membrane lined by flattened mesothelial cells that encloses the heart and roots of the great vessels
pericardium
name the non-inflammatory fluid accumulation
this is true serous transudate, usually the result of congestive heart failure
hydropericardium
name the non-inflammatory fluid accumulation
accumulation of whole blood in the pericardium; usually associated with rupture of large vessels or dilated atria due to AV valve regurgitation
hemopericardium
name the non-inflammatory fluid accumulation
relatively common in dogs; presents as slowly developing R sided heart failure followed by left side
idiopathic pericardial hemorrhagic effusion
name the pathogenesis of pericarditis
secondary to septicemia (cattle, pigs)
hematogenous spread
name the pathogenesis of pericarditis
foreign bodies from oesophagus or reticulum (cattle - hardware disease); or fractured rib (dogs, cattle, horses)
traumatic penetration of pericardium
name the 2 types of inflammatory exudation common with pericarditis
- fibrinous (increased vascular permeability)
- suppurative (pyogenic bacteria)
name the 4 possible outcomes/sequalae of chronic pericarditis cases
- resolution
- adhesion
- constriction/atrophy
- myocarditis
name the outcome of chronic pericarditis being described
without further functional/morphological consequences
resolution
name the outcome of chronic pericarditis being described
fibrin from the exudate forms adhesions between the epicardium and pericardium which may become fibrous
adhesion
name the outcome of chronic pericarditis being described
if condition is insidious, gradual tamponade and cardiac atrophy may occur
constriction/atrophy
name the outcome of chronic pericarditis being described
usually associated with traumatic reticulopericarditis in cattle; extension of pericarditis into myocardium
myocarditis
this constitutes the bulk of tissue in the heart
myocardium
name the myocardial pathology
an increase in size of cells which may result from a physiological response (increased exercise) or a pathological one (valvular stenosis, systemic hypertension of renal disease, etc)
(functional overload)
myocardial hypertrophy
name the myocardial pathology
may occur where the disease process is too rapid to allow cardiac compensation; may herald the onset of failure in a previously compensating heart
(functional overload)
dilation
name the myocardial pathology
replacement of muscle bundles by adipocytes with no degeneration (congenital in sheep, calves, pigs)
(metabolic disturbance)
fatty infiltration
name the myocardial pathology
the first manifestation of cell injury consisting of intracellular accumulation of fluid;
injury causes energy production to decrease and membrane pumps to fail due to lack of ATP
(metabolic disturbance)
hydropic degeneration
name the myocardial pathology
fat accumulates within cardiomyocytes due to inability to metabolise normally;
may also result from myocardial hypoxia or toxicity
(metabolic disturbance)
fatty change/degeneration
name the myocardial pathology
necrosis
(metabolic disturbance)
hyaline degeneration
name the myocardial pathology
dietary excess of vitamin D, plants with vitamin D analogs, or calcium therapy in puppies, cattle and reptiles
(metabolic disturbance)
calcification
name the myocardial pathology
occurs in reptiles and birds since uric acid is the nitrogen metabolism’s end product in these species;
uric acid will precipitate in tissues as ‘utrate tophi’ (crystals) under certain circumstances
(metabolic disturbance)
visceral gout
name the myocardial pathology
relatively uncommon in domestic species; when it occurs, it is usually the result of embolism of coronary vessel
myocardial infarction
name the myocardial pathology
inflammation of the myocardium; rarely an isolated primary condition and usually follows generalized infection by bacteral, viral or protozoal agents
myocarditis
what are the 3 classifications of myocarditis
- acute (suppurative)
- acute (non-suppurative)
- chronic
name the classification of myocarditis
result of septic emboli being released from non-cardiac suppurative foci and lodging in heart vasculature
acute (suppurative)
name the classification of myocarditis
results from septicemia or viremia (ex: pasteurellosis, leptospirosis, Foot & Mouth disease, etc)
acute (non-suppurative)
name the classification of myocarditis
there is cardiomyocyte loss, with replacement by fibrous tissue;
may get granulomas in cattle and sheep
chronic
name the myocardial parasite
usually hae thin connective tissue layer around capsule with few eosinophils and lymphocytes present; non-viable cysts tend to calcify
Cysticercosis
name the myocardial parasite
protozoal organisms in cattle and sheep (also pigs, horses and dogs); can only be seen histologically as elongated cysts containing many zoites (Rainey’s corpuscles)
Sarcocysts
name the myocardial parasite
may cause cysts or foci of inflammation in myocardium in generalized infections in dogs and cats;
in sheep: more common to get CNS involvement than heart
Toxoplasmosis (gondii)
name the myocardial parasite
causes severe myocarditis as well as myositis and encephalitis in dogs (as well as general muscle signs and arrhythmias);
also causes abortion in cattle
Neosporosis (caninum)
name the myocardial parasite
causative agent of ‘Chagas’ disease’ in th USA; causes pyogranulomatous myocarditis and myositis
Trypanosomiasis (cruzi)
name the cardiomyopathy
result of lack of vitamin E and/or Selenium;
results in multifocal necrosis of skeletal and cardiac muscle
(nutritional)
‘White muscle disease’
name the cardiomyopathy
occurs in 3-4 month old thriving piglets; considered to result from lack of selenium/vitamin E;
presents as multifocal necrosis of skeletal and cardiac muscle with myocardial hemorrhages
(nutritional)
‘Mulberry Heart’ disease
(pigs)
name the cardiomyopathy
genetic disease due to a point mutation in the skeletal muscle ryanodine receptor;
triggered by stress and halothane anaesthesia;
results in necrosis of cardiac and skeletal muscles (back, loin, thigh, shoulder) - pale, soft, and exudative (PSE)
(congential)
Malignant Hyperthermia
(pigs)
name the cardiomyopathy
more common in older cats; associated with enlargement of thyroid(s) with accompanying hyperfunction of these;
cats are hyperactive/aggressive, hypertensive, tachycardic, and thin (despite voracious appetite);
Left ventricular hypertrophy
(endocrine)
Feline hyperthyroidism
(cats)
name the cardiomyopathy
cases strongly associated with taurine-deficiency in cats;
cardiomegaly, bi-ventricular dilation, pale and flabby hearts
(idiopathic)
Dilated Cardiomyopathy (DCM)
name the cardiomyopathy
common in cats, rare in dogs;
myocardial fibres are hypertrophied and haphazardly arranged (myofiber disarray) accompanied by interstitial fibrosis and arteriosclerosis;
marked cardiomegaly (from L ventricular concentric hypertrophy) with concurrent thickening of interventricular septum ;
thrombus formation in L atrium is common
(idiopathic)
Hypertrophic Cardiomyopathy (HCM)
name the cardiomyopathy
marked myocardial fibrosis or endomyocardial fibrosis of L ventriculr endocardium;
leads to loss of compliance and inability to fill adequately during diastole;
marked L atrial dilation with L ventricle of normal dimensions
(idiopathic)
Restrictive Cardiomypathy
name the cardiomyopathy
primarily a familial disease of Boxer dogs, rare in cats;
R ventricular myocardium is replaced by fat and fibrous tissue
(idiopathic)
Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)
name the cardiomyopathy
green-grey color of muscle resulting from myodegeneration and eosinophilic inflammation;
seen in sheep and cattle
(idiopathic)
Eosinophilic myositis
this lines the cardiac chambers and is a component of the valve cusps
endocardium
this is a narrowing of the valve orifice, which occurs more frequently in semilunar valves
valvular stenosis
name 2 main consequences of L-sided semilunar valve stenosis
- L ventricular concentric hypertrophy
- pulmonary congestion/oedema
name 2 main consequences of R-sided semilunar valve stenosis
- R ventricular concentric hypertrophy
- caval venous congestion
this is inadequacy of the valve to maintain an efficient seal against backflow of blood with consequent backward regurgitation during systole
valvular incompetence
name 3 main consequences of L-sided atrioventricular valvular incompetence
- L ventricular eccentric hypertrophy
- peripheral hypoperfusion
- pulmonary congestion
name 2 main consequences of R-sided atrioventricular valvular incompetence
- R ventricular eccentric hypertrophy
- caval venous congestion
name 5 factors involved in the occurence of endocarditis
- valvular trauma due to blood turbulence
- valve tissue ageing
- avascularity of valves
- valve exposure to blood pathogens
- factors due to the pathogens
what species is endocarditis most common in
cattle, pigs, sheep
which valves are more frequently affected in endocarditis
atrioventricular
which side of the heart is most commonly affected in endocarditis (with exception of cattle)
left side
(right in cattle)
name the two common sequelae of endocarditis in cattle (R-side lesion)
- pulmonary embolism
- abscessation
name the two common sequelae of endocarditis with left-side lesions (pig, dog, horse)
- myocardial and peripheral infarction
- infection (especially kidneys)
name the type of valvular endocardiosis
changes seen in L AV valve (mitral valve) most commonly;
lesions on main cusps can be graded from smooth, white discrete nodules to coalescent nodules, to plaque-like thickenings with cuspal distortion and chordal distorsion and/or rupture;
valve cusps have marked accumulation of mucopolysaccharide;
valvular changes cause valve cusp distortion with consequent incompetence and leakage of blood into corresponding atrium during systole
(degenerative vavle disease)
canine myxomatous valvular degeneration
name the type of valvular endocardiosis
changes observed are those of sparse chronic inflammation with fibrous scarring;
most significant lesions affect main mitral and aortic valve cusps;
1. sparse cellular infiltrations in superficial outflow layer of cusp
2. variable villous or papillary eruptions of the outflow endothelium
3. irregular whorls or meshes of collagen fibers in deeper layers
(degenerative valve disease)
equine chronic valvulopathy
name the endocardial condition
isolated foci of necrosis on the L atrial endocardium just above the L AV valve ring in old dogs with uremia
necrotising endocarditis
name the endocardial condition
deposits of calcium and fibrous tissue which may spread into the myocardium; affects L atrium and ventricles in calves
endocardial calcification
name the endocardial condition
incidental - in the AV valve cusps at their attachments to chordae or valve ring (lambs, calves, and horses)
hematocysts and lymph cysts
name the endocardial condition
incidental - melanin deposition on heart valves and mural endocardium of Scottish Blackface sheep and black breeds of cattle
Melanosis
name the endocardial condition
fibrous thickenings of the endocardium adjacent to an incompetent valve (caused by back flow during systole);
lesions may also occur in aorta/pulmonary artery as result of high pressure blood passing through a narrowed stenotic semilunar valve and striking the vessel endothelium
jet lesions
name the type of cardiac neoplasms
arise in the R atrium/auricle and may involve the base of the R ventricle;
usually only presents clinically when hemopericardium > tamponade occurs;
can metastasize to liver, spleen, skin, lungs and brain
(primary)
hemangiosarcoma
name the type of cardiac neoplasm
arise in the chemoreceptor cells in the aortic and pumonary bodies (‘chemodectoma’);
may metastasize and local enlargment results in mechanical displacement on adjacent tissues and pericardial effusion;
brachycephalic dogs are predisposed
(primary)
Heart-base tumors
this term is used to describe heart disease which is a consequence of pulmonary disease;
usually features R heart enlargement following raised pulmonary resistance/hypertension
Cor pulmonae
name 5 causes of Cor pulmonae
- primary chronic lung disease
- pulmonary thromboembolism
- mechanical obstruction of pulmonary arteries
- impairment to respiratory movements
- high altitude/mountain disease
name the artery disease being described
seen as an increase in the tunica media (smooth muscle) and intima of arterioles, and is the response to raised arterial blood pressure or volume
arterial hypertrophy
name the artery disease being described
term encompasses a group of vascular diseases of unknown etiology characterized by **fibrous thickening ** with degeneration of the arterial walls
arteriosclerosis
name the artery disease being described
characterized by accumulation of cholesterol in the vascular wall;
rare in domestic animals
atherosclerosis
name the artery disease being described
amyloid deposits may be found in renal vessels and glomeruli, splenic white pulp arterioles, the space of Disse in liver sinusoids, coronary and meningeal arteries; can be stained with Congo red;
affected organs are pale and firm with waxy texture
amyloidosis
name the artery disease being described
occurs following inflammation, thrombosis or necrotic degenerative lesions (Strongylus vulgaris larval lesions in horses)
Dystrophic calcification
name the artery disease being described
widespread medial calcification; large arteries show plaque-like lesions but small arterioles may be completely encircled;
degeneration and calcification of elastic fibers in tunica media
metastatic calcification
name the artery disease being described
associated with endothelial damage and entry and accumulation of serum proteins, which polymerize along the vessel wall;
seen in diseases with vascular degeneration or with inflammation
fibrinoid necrosis
name the artery disease being described
this term describes inflammation in arterial walls
arteritis
name the artery disease being described
circumscribed, balloon-like dilation of the wall of an artery due to weakening and loss of elasticity;
blood enters wall of vessel to form a bulge;
usually seen as a result of mechanical disturbance
aneurysm
what defines a true aneurysm
all layers of the vessel are involved
name 3 other causes of an aneurysm besides the most common: mechanical disturbance
- parasitism
- nutritional deficiencies
- congenital
name the artery disease being described
firm, dark red aggregate situated in posterior aorta and extending into iliac arteries (embolus);
renal and mesenteric arteries may also be affected;
can rarely embolize to a forelimb (usually the R)
aortic thrombosis
name the artery disease being described
usually associated with damage to the intimal layer leading to a local pro-coagulant environment
thrombosis
name the vein disease being described
this is the inflammation of the veins, frequently accompanies and precedes thrombosis;
jugulars, vena cava, and portal veins most commonly affected
phlebitis
name the vein disease being described
can be a result of injection, or extension from an adjacent area of inflammation - often preceded by phlebitis
thrombosis
name the vein disease being described
spontaneous rupture of pulmonary veins leading to post-exertional ‘nose bleeds’ (false epistaxis);
common in racehorses
exercise-induced pulmonary hemorrhage (EIPH)
name the factors involved in thrombosis (Virchow’s triad)
- damage to endothelium
- altered blood flow
- hypercoagulability of blood
