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Pathology -- Cardiology > Myocarditis and Pericarditis > Flashcards

Myocarditis and Pericarditis Flashcards

1
Q

Two categories myocardial disease

A

Cardiomyopathy

Specific heart muscle disease

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2
Q

How do you diagnose myocarditis?

A

Endomyocardial biopsy

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3
Q

Clinical associations with dilated cardiomyopathy

A

Gradual development of CF

4 chamber hypertrophy with dilation

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4
Q

Causes of Dilated cardiomyopathy

A

Familial Causes
Alcohol
Previous Myocarditis
Pregnancy associated with nutritional deficiency

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5
Q

Clinical picture of a dilated cardiomyopathy patient

A

Slowly developing CHF, progressive and unremitting
May have precipitous decompensation
50% die in 2 years – needs transplant

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6
Q

Morphology of dilated cardiomyopathy

A

2-3X normal size hearts, all chambers
Mural Thrombi Common
Patchy Subendocardial Scars
Functional Mitral Regurg

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7
Q

Histology of dilated cardiomyopathy

A

Hypertrophied myofibers, stretched

Interstitial and endocardial fibrosis

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8
Q

Clinical associations of hypertrophic cardiomyopathy

A

Muscular hyper-contracting heart

HF from decreased chamber size, poor compliance, and lower SV

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9
Q

Causes of hypertrophic cardiomyopathy

A

100% genetic – Sarcomere proteins or mitochondrial energy defects

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10
Q

Problems seen in hypertrophic cardiomyopathy patients

A

Atril fibrillation w/ mural thrombus formation
Infective endocarditis on MV
Intractable CF
Sudden Death

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11
Q

What is IHSS

A

Idiopathic hypertrophic subaortic stenosis

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12
Q

Histology of hypertrophic cardiomyopathy

A

Extensive myocyte hypertrophy (diameter over 40um)

Myofiber disarray, interstitial and replacement fibrosis

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13
Q

Restrictive Cardiomyopathy. Clinical associations

A

Inability of myocardium to expand, contractile fxn normal

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14
Q

Causes of Restrictive Cardiomyopathy

A

Infiltrative diseases like

AMYLOIDOSIS, HEMACHROMATOSIS, LEUKEMIA, STORAGE DISEASES, RADIATION, CONSTRICTIVE PERI

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15
Q

Three kinds or restrictive cardiomyopathy

A

Endocardial fibrosis
Loeffler’s endomyocarditis
Endocardial fibroelastosis

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16
Q

What happens in endocardial fibrosis

A

Children/teens in Africa/Tropics
Fibrosis of endo and subendocardium
Can involve mitral/tri valve
Can lead to mural thrombi

17
Q

What happens in Loeffler’s endomyocarditis

A

No geographic restriction

EOSINOPHILS, leukoctosis

18
Q

What happens in Endocardial fibroelastosis

A

Focal or diffuse, Cartilage-like fibroelastic thickening
First 2 years
W/ other congenital abnormalities

19
Q

Adriamycin can cause…

A

toxicity from lipid peroxidation in the heart
Swelling and vacuolization
Fix by stopping the drug

20
Q

What is seen on the heart with pheochromocytoma

A

Contraction band necrosis

21
Q

Common Infectious causes of myocarditis

A 
Usually viral + immune attack (CocsackieAorB, Echo, Polio)
Chagas Disease
Trichinosis
Diptheria
Lyme
AIDS
22
Q

Noninfectious causes of myocarditis

A

Drug hypersensitivity
Rheumatic Fever
SLE
Sarcoidosis

23
Q

Morphology of myocarditis

A

Diffuse of patchy involvement
Interstitial mono nuclear, predominantly lymphocytic inflammatory infiltrate.
Focal necrosis

24
Q

Describe giant cell myocarditis

A

Widespread inflammatory cellular infiltrate containing multinucleate giant cells, interspersed with lymphocytes, eosinophils, plasma cells, and macrophages with necrosis

25
Q

Six kinds of pericarditis

A 
Serous
Fibrinous/Serofibrinous
Purulent/Suppurative
Hemorrhagic
Caseous
Chronic
26
Q

Serous pericarditis – Important details

A

Non-infectious inflammation (RF, SLE, Scleroderma, Tumors, Uremia)

27
Q

Most frequent type of pericarditis

A

Fibrinous and serofibrinous pericarditis

28
Q

Causes of Fibrinous and serofibrinous pericarditis

A

MI, Dresler’s Syndrome, Uremia, Radiation, Rheumatic Fever, Trauma

29
Q

What is Dressler’s Syndrome

A

autoimmune condition which appears several weeks following MI

30
Q

Most common primary tumor of the heart in children? adults?

A

Kids – Rhabdomyosarcoma

Adults – Myxoma

31
Q

Why is chronic pericarditis a misnomer?

A

Healed stage of acute pericardial inflammation
Results in plaque like thickenings, obliteration of sac in worst forms
Dense fibroadhesions may result in constrictive pericarditis, reduction of CO

32
Q

What is adhesive mediastinopericarditis?

A

Pericardial sac is obliterated and the cardiac structures are adhered to, making the heart work much harder.
Massive cardiac hypertrophy ad dilation

33
Q

Usual cause of adhesive mediastinopericarditis?

A

Chest irradiation

34
Q

Beriberi is associated with…

A

Dilated myocardial disease

Pathology -- Cardiology (13 decks)

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