cv masses

Question 1

Thrombosis morphology

Answer 1

formation of a blood clot within intact vessels

Begins at site of endothelial injury, turbulent flow, or stasis

Point of attachment to wall

Lines of Zahn: lamination produced by alternating layers of platelts, fibrin, and RBC, may fragment and create emboli

Virchows Triad in thrombosis (3 primary abnormalities that lead to thrombus formation): endothelial injury, abnormal blood flow, and hypercoagulability

Question 2

Risk factors for cardiac thrombi

Answer 2

abnormal blood flow= abnormal myocardial contraction , arrythmia, dilated cardiomyopathy, myocardial infarction

Hypercoagulability

Endothelial injury (myocarditis or endocarditis)

Question 3

Where do thrombi go depends on heart

Answer 3

in left atrium or left ventricle (embolization to various organs, decreased cardiac output)

in R atrium or ventricle- to lungs, embolization to lungs, decreased cardiac output

Question 4

Embolus/ Emboli

Answer 4

Detached intravascular mass carried by blood to site distant from origin

Types: Thrombus (most common), Fat, air amniotic fluid, tumor

can cause ischemia necrosis in organ to which it travels to

Question 5

Systemic embolism

Answer 5

Origins
Heart (80%): atrium ventricle or valve (80%) (2/3 with LV infarcts, 1/4 with dilated left atria

Atherosclerotic plaque (abdominal aorta, carotid artery

Travel in arterial circulation (lower leg 75%, brain 10%, intestines kidneys, spleen, upper extremities, results in infarct of areas supplied by vessels

Paradoxical embolism: travels thru heart defect into systemic circulation (patent forman ovale

Question 6

Heart tumors

Answer 6

Mets more common than primary neopasms

from lung, melanoma, lymphoma, breast, leukemia

Tumor masses can be diffuse, multinodular or a single dominant mass

Clinic: dependent on size of tumor within heart
Most

Question 7

heart tumors,myxoma

Answer 7

primary neoplasms are usually benign
myxoma- 90% in atria (mainly lefT)
most common cardiac tumor in adults
myxoma in ground substances, IL6 with flu like symptoms

Carney syndrome in 10%

Question 8

rhabdomyoma

Answer 8

most common heart tumor in infants childern

may be hamartomas or malformations rather than neoplasms (Benign)

associated with tuberous sclerosis (TSC1 and TSC2)

clinical: dependent on size/location, involve with either side, obstructive symptoms congestive heart failure’
morph: gross usually multiple firm white nodules, spider cells

Question 9

hemangiomas

Answer 9

5-10% , capillary hemangioma strawberry young, chrry old