More heart pathology from day 2 Flashcards
Carcinoid heart disease is fibrous thickening of the endocardial surfaces accompanying carcinoid syndrome. What do you see with the smooth muscle?
What is shown in the movat stain image on the right?
What is the key thing that metastatic carcinoid tumors secrete?

Smooth muscle proliferation
the histological slide shows intimal thickening with myocardial elastic tissue underlying the acid mucopolysaccharide-rich lesion.
Secrete serotonin (5HT)
What is a key consideration for those who are fitted with a cardiac valve prostheses?
Requires anticoagulation therapy to deal with mechanical hemolysis.
What are soem complications of cardiac valve prostheses?
Thrombosis/thromboembolism
Anticoagulant-related hemorrhage
Prosthetic valve endocarditis
Structural deterioration (intrinsic)
- wear
- fracture
- poppet failure in ball valves
- cuspal tear
- calcification
What complication is shown here?

Thrombosis of a mechanical prosthetic valve
What complication is shown here?

Calcification with secondary tearing of a porcine bioprothetic heart valve
What is going on with this heart?

Dilated cardiomyopathy
What is going on with this heart?

Restrictive cardiomyopathy
What is wrong with this heart?

Hypertrophic cardiomyopathy
What does cardiomyopathy arise from?
Primary abnormality in the myocardium.
What are most cases of cardiomyopathy d/t?
Primarily idiopathic, genetic or acquired secondary as part of systemic or multiorgan disorder
90% of cardiomyopathies are of what type?
Dilated - Large, flabby heart
Hypertrophic hearts are only 6-8% of cases, and show what?
Markedly thickened left ventricle. (His example shows hypertrophy in both ventricles, I suppose left is just more significant/common)
Restrictive cardiomyopathy is relatively uncommon. What sort of disorders lead to this?
Infiltrative disorders
By what means do we assess the etiology of cardiomyopathy?
Endomyocardial biopsy
In dilated cardiomyopathy LVEF is less than 40% of normal. What is the mechanism of heart failure?
Impaired contractility leads to systolic dysfunction
What are some causes of dilated cardiomyopathy?
Genetic; alcohol; peripartum; myocarditis; hemochromatosis; chronic anemia; doxorubicin (Adriamycin); sarcoidosis; idiopathic
In hypertrophic cardiomyopathy the LVEF 50-80% nl is around 40-65%. What is the mechanism of heart failure in this condition?
Impairment of compliance
(diastolic dysfunction)
What are some causes of the hypertrophic cardiomyopathy phenotype?
Genetic; Friedreich ataxia; storage diseases; infants of diabetic mothers
In restrictive cardiomyopathy the LVEF is ssomewhere between 25% and 90%. What is the mechanism of heart failure?
Impairment of compliance - leading to diastolic dysfunction
What are some examples of things that cause restrictive cardiomyopathy?
Amyloidosis; radiation-induced fibrosis; idiopathic
What cardiac infections are associated with heart muscle diseases?
Viruses
\Chlamydia
Rickettsia
Bacteria (go fucking figure)
Fungi
Protozoa
Dilated cardiomyopathy is an insidious, slowly progressive, intractable congestive heart failure. What are the important etiologic associations?
- Myocarditis d/t coxsackie B and other enteroviruses
- ETOH both directly through toxicity and indirectly through Thiamine deficiency. (Beriberi Disease)
- Peripartum Cardiomyopathy
- Iron Overload
- Familial (genetic) via an autosomal dominant pattern most commonly. Presenting first in kids
1.
Dilated cardiomyopathy is frequently seen between 20 and 50 years of age in familial DCM. What do most of these patients have?
What is somewhat unique about this type of whatever the answer above is?
Symptomati congestive heart failure (CHF)
Poor response to traditional CHF treatments
In DCM, what do outcomes look like one LVEF is below 25%
- ½ die in 2 years or less
- only 25% survive >5 years
This is the most common indication for cardiac transplantation














