Myocardial Pathology (complete)

Question 1

Name the most common primary cardiac neoplasms in infants/children

Answer 1

Rhabdomyoma

Question 2

Name the most common primary cardiac neoplasms in teens/adults.

Answer 2

Cardiac Myxoma

Question 3

Name the most common location of a cardiac myxoma.

Answer 3

Left atrium

Question 4

What are the possible complications of a cardiac myxoma?

Answer 4

• Fragments can embolize into systemic circulation => lodge in brain, kidneys, other organs
• Can cause syncope and sudden death

Question 5

What are the types of organisms that may infect the myocardium?

Answer 5

• Viruses (coxsackievirus A/B) => inflammation w/ injury to myocardium
• Bacterial
• Fungi
• Parasites (Trichinosis, Chagas Disease)

Question 6

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

Answer 6

Collagen Vascular Disease, SLE, RA, Scleroderma, Systemic Slcerosis

• Heart is involved due to systemic disease processes
• Can involve pericardium, myocardium, endocardium
• Sometimes vasculitis => small infarcts

Question 7

Name at least one medication associated with toxic cardiomyopathy

Answer 7

Adriamycin (a chemo drug)

Question 8

Name at least one non-medication substance associated with toxic cardiomyopathy.

Answer 8

Ethanol

Cobalt from artificial joints

Question 9

Name the disease process where proteins deposit (as beta-pleated sheets) around blood vessels and in the parenchyma of various organs.

Answer 9

Amyloidosis

Question 10

Name a neoplasm commonly associated with this disease process.

Answer 10

Plasma cell neoplasm (e.g. multiple myeloma)

Question 11

Define myocarditis

Answer 11

a

Question 12

Define primary cardiomyopathy

Answer 12

Heart disease resulting from a primary abnormality in the myocardium

Question 13

Define secondary cardiomyopathy

Answer 13

Heart disease NOT resulting from a primary abnormality in the myocardium

• Ischemic disease
• HTN
• Valve-associated

Question 14

For hypertrophic cardiomyopathy, describe the macroscopic appearance of the heart, if the problem is with contraction or relaxation of the myocardium, and the prevalence of genetic mutations associated with that condition.

Answer 14

Impaired RELAXATION

Appearance:
Thickened (3-4x) interventricular septum => bulges into LV

Genetics:
100% of cases due to genetic mutations

Question 15

For dilated cardiomyopathy, describe the macroscopic appearance of the heart, if the problem is with contraction or relaxation of the myocardium, and the prevalence of genetic mutations associated with that condition.

Answer 15

Impaired CONTRACTILITY

Appearance:
Heart is BIG, dilated —- walls may be thick or thin (depends on how long this person has had this)

Genetics:
30-40% of cases associated w/ mutations

Question 16

For restrictive cardiomyopathy, describe the macroscopic appearance of the heart, if the problem is with contraction or relaxation of the myocardium, and the prevalence of genetic mutations associated with that condition.

Answer 16

Impaired RELAXATION (cannot relax during diastole)

Appearance:
Fibrosis or infiltrated myocardium

Genetics: 
Typically acquired (very few genetically linked)

Question 17

List some examples of causes of restrictive cardiomyopathy.

Answer 17

• Amyloid deposition

- Radiation induced fibrosis