Myocardial Pathology

Question 1

most common primary cardiac neoplasms in (a) infants/children and (b) teens/adults

Answer 1

a) rhabdomyoma (benign)

b) cardiac myxoma (benign)

Question 2

most common location and possible complications of cardiac myxoma

Answer 2

This is the most common primary cardiac tumor in adults. Arises most often in the Left atrium as a pedunculated or sessile myxoid lesion. Although benign, they can cause significant problems if fragments embolize or they cause a “ball valve” obstruction of the mitral valve with syncopal episodes and even sudden death. Resected when detected.

Question 3

what types of organisms may infect the myocardium?

Answer 3

viruses (coxsackievirus, ECHO, influenza, HIV, cytomegalovirus), bacteria (chlamydiae, Rickettsiae, etc.), fungi (candida), parasites (protazoa and helminths)

Question 4

Name at least one autoimmune disease that may affect the heart and identify the components of the heart that can be affected

Answer 4

Lupus, scleroderma, RA
Collagen vascular disease/connective tissue disease
1. Variable involvement of pericardium, myocardium, endocardium
2. Can have heart blood vessel-focused attack: vasculitis leading to small infarcts

Question 5

medication associated with toxic cardiomyopathy and name at least one non-medication substance associated with toxic cardiomyopathy

Answer 5

Toxic medication: Adiamycin (chemo drug, cumulative dose-dependent toxicity)
Toxic non-medication: ethanol, cobalt from artificial joint prostheses

Question 6

what is amyloidosis?

Answer 6

• proteins deposited as “beta-pleated sheets” around blood vessels and in the parenchyma of various organs
• organs involved (wax-like consistency) can be: heart, kidneys, nerves, liver, spleen

Question 7

what is a neoplasm commonly associated with amyloidosis?

Answer 7

commonly associated with Plasma Cell Neoplasm/Dyscrasia (multiple myeloma)

Question 8

dilated cardiomyopathy: macroscopic appearance, prob with contraction or relaxation and prevalence of genetic mutation

Answer 8

dilated chambers, impaired contractility, 30-40% have genetic mutations

Question 9

hypertrophic cardiomyopathy: macroscopic appearance, prob with contraction or relaxation and prevalence of genetic mutation

Answer 9

thickened interventricular septum bulges into the LV outflow tract during early systole -> outflow obstruction through aortic valve – hypertrophy and disarray of fibers; cannot relax during diastole, 100% due to genetic mutations

Question 10

restrictive cardiomyopathy: macroscopic appearance, prob with contraction or relaxation and prevalence of genetic mutation

Answer 10

fibrotic or infiltrative; cannot relax during diastole; acquired

Question 11

causes of restrictive cardiomyopathy

Answer 11

Amyloidosis, hemochromatosis, scleroderma, radiation therapy