Diseases of the Myocardium and Endocardium Flashcards
This is a group of heart disorders in which the major structural abnormality is limited to the myocardium.
Cardiomyopathy
literally meaning “heart muscle disease”
True or False: cardiomyopathy includes conditions of heart muscle impairment (lol it is cardioMYOpathy anyways), like HTN, valvular disorders, and CAD.
FALSE
This type of cardiomyopathy is characterized by ventricular chamber enlargement with impaired systolic contractile function.
Dilated cardiomyopathy
you can’t run fast with a full belly
This type of cardiomyopathy is characterized by abnormally thickened ventricular walls with abnormal diastolic relaxation but usually intact systolic fxn.
Hypertrophic cardiomyopathy
roid rage- never relaxes
This type of cardiomyopathy is characterized by abnormally stiffined myocardium (from fibrosis or infiltrate), leading to impaired diastolic relaxation but systolic contractile fxn is normal.
Restrictive cardiomyopathy
like you’re gagged and bound but still have the nose flap open to breathe.
Which cells are damaged to cause dilated cardiomyopathy?
Myocytes
Though gnetic, inflammatory, toxic, and metabolic factors can cause myocyte damage and thus dilated cardiomyopathy, what is the main etiology?
Idiopathic
What are the 2 main pathological causes of restrictive cardiomyopathy?
- fibrosis of the endomyocardium
2. infiltration of the myocardium by something weird.
What is the most common cause of restrictive cardiomyopathy in nontropical countries?
Amyloidosis
Hypertrophic cardiomyopathy is found in what patient population, which is not caused by a chronic pressure overload?
Young athletes
What is the most common complaint from people with hypertrophic cardiomyopathy?
Dyspnea
What is the biggest concern for people with hypertrophic cardiomyopathy?
V fib and Sudden Cardiac Death
this is when teenagers drop dead on the football field
Which heart sound is found in HCM?
S4
Why is S4 found with HCM? What is the physiological etiology?
The atria are contracting against a siffened LV
Which type of maneuver can differentiate HCM from Aortic Stenosis?
Valsalva (it increases the sound)
decreasing preload makes the sound louder cuz theres less volume in the LV to squeeze out
Which class of drug can u give to HCM patients to reduce O2 demand?
B-blockers
If the pt doesnt respond to B-blockers for the Tx of HCM, what is the next class of drug u can give them?
CCB
You can give antiarrhythmics like amiodarone and disopyramide to aggresively treat what arrhythmia, which is poorly tolerated in HCM?
A fib
What device can u give for HCM pts with a high risk of SCD?
ICD
What % of adults die of SCD from HCM per year?
2-4%
What % of kids die of SCD from HCM per year?
4-6%
Group B Coxsackie and certain enteriovirsues are the main viral causes of what type of disorders?
Myo- and pericarditis
Why do men get more myocarditis cases than women?
<3
Which virus is the most common cause of myocarditis in infants?
Group B coxsackievirus
What is the route of transmission for coxsackievirus to kill infants?
POOOOOOOOP
True or false: mumps, rubella, and influenza can cause myocarditis.
True!
The Sx of myocarditis closely resemble what other disorder?
MI
So if you suspect myocarditis and want to see if the pt is infected with coxsackievirus, how can you Dx it?
swab that shit or hybridize that shit
What is the bug to cause chagas disease?
Trypanosoma Cruzi
What does the reduviid bug do while it’s sucking your blood to give you T. cruzi?
Shit on you. Literally.
didnt need a flashcard for this but it’s for the lols
We don’t realllllly need to worry about Chagas disease here in the country of freedom, because the disease is restricted to what area of the world?
Central and South America
In thr course of Chagas disease, the person may initially be asymptomatic, but progress to what intense changes?
Fever, inflammatory changes
After the initial phase of Chagas disease, what happens in the chronic phase?
Gradual tissue destruction with autoimmune damage
Where does T. Cruzi invade to cause the cardiac Sx in chagas?
myofibrils of the heart –> myocarditis
T. cruzi cause the heart to enlarge, causing heart failure by what malfunction?
Arrhythmias
What are the 4 C’s of Chagas?
Chagas, Cruzi, Cardiac, Children
Which 2 drugs can u give for the Tx of Chagas disease?
Benzinazole or Nifurtimox
“Hey Nif, Ben has Chagas! hahaha”
What is etiology for most cases (20-50%) of dilated cardiomyopathy (DCM)?
Genetic influences
Mutations in what structural components of myocytes can lead to DCM?
cytoskeletal proteins
Which dysfxn can cause DCM and is caused mainly by Coxsackievirus VB and enteroviruses?
Myocarditis
The consumption of what can lead to DCM?
Alcohol
Pooping out what can cause DCM?
A child
Dilatation of all of the chambers in DCM does what to the size and weight of the heart?
Increase
What can form in the chambers due to stasis of blood in DCM?
mural thrombi
DCM pt’s show progressive signs of what heart condition?
CHF
Which gene is mutated in the sarcomeric proteins to cause HCM?
B-myosin heavy chain (B-MHC)
heavy chain for roid heart lol
We said that in HCM there is impaired diastolic filling, but what are the 2 pathologic reasons for this?
- reduced chamber size
2. decreased compliance
Which chambers can get enlarged in restrictive cardiomyopathy (RCM)?
both atria
This is a complication of RCM where there is fibrosis of the ventricular endocardium and subendocardium that extrands from the apex upward.
Endomyocardial fibrosis
Children and young adults are susceptible to endomyocardial fibrosis in what region of the world?
Africa
This is a complication of RCM where large mural thrombi can form alongside the endomyocardial fibrosis.
Leoffler endomyocarditis.
In leoffler endomyocarditis, there can be eosinophilic infiltrates where in the body?
periphery and other organs
This is a complication of RCM where there is focal or diffuse fibroelastic thickening, usually of the mural left vantricular endocardium.
Endocardial fibroelastosis
At what age range are u susceptible to endocardial fibroelastosis?
within the first 2 years of life.
This is the condition where there is RV failure and rhythm disturbances (VT or VF), that can lead to sudden death in young people.
Arrhythmogenic RV Cardiomyopathy (ARVC)
ARVC is an AD condition that leads to thinning of the RV due to loss of what cells?
Myocytes
This is a syndrome characterized by ARVC and hyperkeratosis of plantar palmar skin surfaces from the mutation in the plakoglobin gene.
Naxos syndrome
This is the stage of the myocarditis disease where the heart is normal or dilated with inflammatory infiltrate with focal myocyte necrosis.
Acute/active
This is the stage of the myocarditis disease where the ventricular myocardium is flabby, has lesions, and can have mural thrombi.
Advanced stage
In which infection do u see parasitization of scattered myofiberes in myocarditis?
Chagas disease
This is the type of myocarditis where there is interstitial infiltrates (mainly perivascular) of lymphocytes, macrophages, and eosinophils.
Hypersensitivity myocarditis
What are the 2 chemotherapeutic drugs that can cause cardiotoxicity, leading to DCM and HF by peroxidizing lipids in myocyte membranes?
Doxorubicin and daunorubicin
had a joke. cant share. lolooooooooooooool
This is the type of tumor that can cause cardiotoxicity by an overload of Ca++.
Pheochromocytoma
What is the morphology of the heart cells on histo exam in catecholamine-induced cardiotoxicity?
focal myocardial necrosis, contraction bands, sparse mononuclear inflammatory infiltrate
What is the condition where a sudden, intense emotional or physical stress can induce acute left ventricular dysfxn due to myocardial stunning?
bein a little biatch.
jk. Takotsubo cardiomyopathy
This is the cause of cardiotoxicity by deposition of abnormal, insoluble, extracellular fibrillar protein fragments.
Amyloidosis
This is the form of amyloidosis where there is deposition of transthyretin in the chambers of old people.
Senile cardiac amyloidosis
Amyloidosis can usually produces which type of cardiomyopathy (DCM, HCM, RCM)?
RCM
Which 2 conditions can cause an Fe overload, leading to DCM?
Hemochromatosis (genetic) and hemosiderosis (↑ blood transfusions)
What is the morpology of the heart in an Fe overload?
Rusty colored, hemosiderin accumulation, perinuclear sideromes
This is the condition that causes tachycardia, palpitations, and mardiomegaly, with possible supraventricular arrhythmias.
Hyperthyroidism
In hypothyroidism, a decreased CO, increased peripheral resistance, and decreased blood volume can cause what specific heart condition?
Myxedema
What is the morphology of the heart in myxedema from hypothyroidism?
flabby, enlarged, and dilated heart, with myofiber swelling and degeneration.
hypothyroidism people are usually pretty fat. same inside and outside
This is the most common primary tumor of the heart, characterized by clonal abnormalities of c12 and c17 and are from primitive myltipotent mesenchymal cells.
Myxoma
Where in the heart are myxomas common?
fossa ovalis
Which form of a myxoma can move into or through the AV valves during systole? Sessile or pedunculated?
Pedunculated
What is the composition of myxomas?
stellate or globular myxoma cells with vessel-like or gland-like structures.
This is the AD sydnrome characterized by multiple cardiac and extracardiac myxomas, pigmented skin lesions, and endocrine overactivity from mutations in the PRKAR1 gene.
Carney complex familial syndrome
This is a type of tumor composed of mature fat cells and are in the subendocardium, subepicardium, or myocardium.
Lipoma
These are the tumors where there are incidental sea-anemone-like lesions that resemble Lambl excrescences in the aortic valve in the elderly, and can embolize.
Papillary fibroelastoma
This is the most frquent pimary tumor of the hearts in infants and kids, and is assocaited with tuberous sclerosis.
Rhabdomyoma
True or False: rhabdomyomas regress spontaneously.
True
What is the morphology of rhabdomyomas?
small, gray-white masses composed of bizarre enlarged myocytes that make it look like a spider.
Which locations in the body are common to have metastatic tumor involvement of the heart?
lung, boob, melanomas, leukemias, and lymphomas.
What are the silent or nongeneralized features of metastases?
defective ventricular contractility or compliance.
Which tissue does the metastases move through to cause the clinical Sx?
pericardium
