CV Pathology Flashcards

I, II, III, IV and V

1
Q

Define dilation

A

a response to an increased workload. This can be transient (e.g. when performing exercise) or persistent

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2
Q

Define hypertrophy

A

the reversible increased in the mass of the heart cells without increasing in number.

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3
Q

What are the two types of hypertrophy ?

A

concentric (pressure overload)
- no increased in ventricular volume
eccentric (volume overload)
- increase in ventricular volume

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4
Q

Name the three arteriovenous connections present in embryology

A

ductus arteriosus
foramen ovale
ventricular holes

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5
Q

What are the sequelae of left-to-right shunting

A

volume overload of the pulmonary circulation –> left sided eccentric hypertrophy

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6
Q

Clinical signs of left-to-right shunting

A

exercise intolerance
syncope
dyspnoea
sudden death
murmur (“washing machine”)

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7
Q

Define patent ductus arteriosus

A

a connection between the pulmonary artery and the aorta

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8
Q

Define arterial septal defects

A

a connection between the two atria, allowing blood to pass between them

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9
Q

Define ventricular septal defects

A

can happen anywhere along the septum, can be perimembranous or muscular. causes insufficiency

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10
Q

Define stenotic diseases

A

diseases affecting the semilunar valves
may be pulmonic or aortic (or subaortic)
increases afterload

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11
Q

Define dysplastic valvular diseases

A

involve the AV valves
increases preload

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12
Q

What is a transposition complex and name the most common

A

malpositioning of arterial trunks
overriding aorta most common (aorta straddles septum and recieves blood from both ventricles)
may also see partial transposition, overriding pulmonary artery and complete transposition

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13
Q

Define and give the characteristic features of primary myocardial disease

A

idiopathic diseases to the myocardial fibre.
characterized by cardiomegaly (increased %BW of heart), increased ventricular wall thickness and mural thrombosis

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14
Q

Define DCM

A

dilated cardiomyopathy
leading to systolic dysfunction
grossly, atria and ventricle dilation and non-specific histo

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15
Q

Define HCM

A

hypertrophic cardiomyopathy
–> diastolic dysfunction due to impaired ability to relax
leads to ventricular outflow tract obstruction, causing turbulence
grossly, asymmetrical hypertrophy of left ventricle, subtle histo

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16
Q

Define RCM

A

restrictive cardiomyopathy
–> diastolic dysfunction due to restriction in the ability of the ventricles to fill
grossly, fibrosis, moderator bands and dilated atria with normal ventricles

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17
Q

Define ARVC

A

arrhythmic right ventricular cardiomyopathy
–> ventricular arrhythmias due to a nerve block
grossly, hypertrophy of ventricle and dilation of atrium
distinctive histology of fibro-fatty replacements of cardiomyocytes

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18
Q

Name some secondary causes of cardiomyopathies

A

hormone
nutritional
toxin
infectious agents
inflammation

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19
Q

What are the sequelae of secondary cardiomyopathies ?

A

altered myocyte metabolism (most commonly hyperthyroidism in cats)

myocyte death (myocardial necrosis, white band visible in the muscle (sometimes “white muscle” disease), neurological disease/nutritional (Vit E/selenium)/toxins cause

myocarditis.
- necrotizing
- suppurative
- pyogranulomatous
- eosinophilic
- lymphoplasmacytic

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20
Q

How do cardiomyocytes react to injury ?

A

regeneration is rare as the cells a post-mitotic
loss results in fibrosis
remaining myocytes have the ability to compensate via hypertrophy

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21
Q

Clinical Signs of conduction disorders

A

ECG abnormalities, syncope, sudden death

22
Q

Define endocardiosis

A

the degenerative disease of the hearts mitral valve (left AV valve). responsible for 75% of all heart diseases in dogs

Myxomatous Valve Degeneration (MVD) :
- most common cause of Cv diseases in dogs
- genetic predisposition for small dogs
- grossly, thickened and shortened valves with a smooth endocardial surface.
- if clinically significant, will see “jet lesions” of fibrosis in the left atrium
- histologically, myofibroblastic proliferation and deposition of acid mucopolysaccharides within valvular stroma

23
Q

What is the sequelae of endocardiosis ?

A

valvular insufficiency (regurgitation)
occurs when there is a volume overload
eccentric hypertrophy, dilating the previous chamber and causing these “jet lesions”
mural thrombi may also form attached to the heart wall

24
Q

Define endocarditis

A

inflammation of the inner lining of the heart

25
What is endocarditis commonly caused by ?
bacteria. commonly, Strep. Staph. E. coli often associated with extracardiac infections
26
Gross appearance of endocarditis
friable, yellow-to-grey-to-red masses of fibrin with a roughened surface ("cauliflower-like"), may extend into the mural endocardium in the form of plaques
27
Define hydropericardium
excess clear fluid within the pericardial cavity may be caused by decreased oncotic pressure, decreased lymphatic drainage, increased hydrostatic pressure and increased vascular permeability
28
Define hemopericardium
pure blood in the pericardial cavity occurs with the rupture of BVs
29
What are the sequelae for fluid in the pericardial cavity ?
cardiac tamponade (compression of the heart resulting in impaired atrial and ventricular filling)
30
Define serous atrophy of fat in the heart
lipid is replaced by a proteinaceous fluid grossly, what should be white fat becomes gelatinous and translucent occurs with NEBAL
31
Define pericarditis and give some causes
Inflammation of the pericardium infectious, as an extension of pleuropneumonia traumatic, i.e. from traumatic reticuloperitonitis
32
Define congestive heart failure
the end-point of a number of conditions. for whatever reason, the heart compensatory mechanisms are exhausted, resulting in a decreased CO
33
What happens (generally) in congestive heart failure and how do we aim to treat this ?
the body becomes congested due to an inability of CO to match venous return the RAAS system gets activated by low BP or BV, and aims to increase BP and BV. this adds to and worsens congestion solution = diuretics (decrease venous return)
34
Define the problems with LEFT sided congestive heart failure
back up into the pulmonary system lung congestion and oedema lungs will be wet, heavy and non-collapsible will see haemosiderin-laden macrophages (heart failure cells) CS : dyspnoea with exercise, increased resp effort, cough, crackles on inspiration, froth in airways, syncope, weakness
35
Define the problems with RIGHT sided congestive heart failure
back up into the vena cava system leading to increased systemic venous pressure and passive congestion the big organs that are draining into the vena cava will have a back up of blood (splenomegaly, hepatomegaly and intestinal oedema)
36
Name the most common primary cardiac neoplasms
Hemangiosarcoma (right auricle and atrium) Heart base tumours (most common in paraganglioma, neuroendocrine cell tumours)
37
Name the most common secondary heart neoplasms
Round cell neoplasms (most common) lymphomas
38
Define thrombosis
coagulation as a pathology
39
Name the 3 components of Virchow's triad
endothelial injury hypercoagulability abnormal blood flow
40
Name the gross and histo appearance of a chronic thrombus
onion-like appearance of layers built up over time alternating layers of platelets, fibrin and RBCs +/- mineralization and fibrosis
41
Name the gross and histo appearance of an acute thrombus
dull red, more classic clot-like appearance not that exiting on histo
42
Define fibrinoid necrosis
endothelial damage, characterized by accumulation of serum proteins and fibrin in the vessel wall
43
Define arteriosclerosis
"hardening of the arteries" loss of artery elasticity often insignificant but can promote thrombi due to blood flow disruptions
44
Define atherosclerosis
fibrofatty plaques (atheromas) in the wall of the vessel
45
Define an aneurysm
focal dilations of any vessel. tend to be idiopathic. can be dissection, true or false
46
Define vasculitis
inflammatory cells within and around the wall of vessels with concurrent damage to the wall
47
name some common infectious aetiologies of vasculitis
EAV orbiviruses EIA ASF CSF Rickettsia Aspergillus Heartworm
48
name some common non-infectious aetiologies of vasculitis
autoimmune or drug hypersensitivit
49
Define lymphoedema
defective transport OR abnormal vessel development OR blockage leads to fibrosis, skin folds and ulceration
50
Define an intestinal lymphangiectasia
impaired protein absorption in the GI leads to protein losing enteropathy
51
Define lymphangitis
inflammation of lymph vessels