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Medicine Cardiovascular > Pathology > Flashcards

Pathology Flashcards

1
Q

Cardiomyopathy

A

Any disease of the cardiac muscle. It often results in changes in the size of the heart and thickness of the heart

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2
Q

Classification of cardiomyopathy

A

Dilated, hypertrophic, restrictive, arrhythmogenic

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3
Q

What is dilated cardiomyopathy

A

Big heart - 2 or 3 times normal size. Heart is flabby and floppy

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4
Q

Causes of dilated cardiomyopathy

A

Genetics, toxins, alcohol, doxurubicin (chemotherapy agent), cardiac infection, pregnancy

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5
Q

Clinical features of dilated cardiomyopathy

A

General picture of heart failure, SOB, poor exercise tolerance, low ejection fraction

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6
Q

What is hypertrophic cardiomyopathy

A

Big solid hearts with thickened myocardium

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7
Q

What sort of dysfunction does hypertrophic cardiomyopathy result in?

A

Diastolic dysfunction - heart can’t relax, eventually resulting in outflow obstruction

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8
Q

Causes of hypertrophic cardiomyopathy

A

Most are genetic

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9
Q

Types of genes responsible for hypertrophic cardiomyopathy

A

Beta myosin heavy chain, myosin binding protein C, alpha tropomyosin

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10
Q

Interventricular septum and LV lumen in hypertrophic cardiomyopathy

A

Bulging interventricular septum and LV luminal reduction

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11
Q

Myocytes in interventricular septum

A

Swirling pattern

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12
Q

What is restrictive cardiomyopathy?

A

Stiff heart causing lack of compliance

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13
Q

What sort of dysfunction does restrictive cardiomyopathy result in?

A

Diastolic due to heart not filling well

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14
Q

What causes biatrial dilatation in restrictive cardiomyopathy?

A

Back pressure

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15
Q

Causes of restrictive cardiomyopathy

A
  • Deposition of something in the myocardium
  • Metabolic byproducts – iron
  • Amyloid
  • Sarcoid – multi system granulomatous disorder
  • Tumours
  • Fibrosis following radiation
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16
Q

What is amyloid?

A

Abnormal deposition of abnormal protein

Waxy pink material

17
Q

Why can’t the body get rid of amyloid?

A

It is insoluble to any of the body’s enzymes

18
Q

Classification of amyloid

A
  • AA – relate to chronic diseases like rheumatoid
  • AL – light chains, abnormal immunoglobulin
  • Haemodynamically associated – beta 2 microglobulin
  • Familial forms: transthyretin
  • Diabetes
  • Alzheimer’s
19
Q

What colour does amyloid stain on a histological slide?

A

“congo-red” and exhibits apple green birefringence

20
Q

Which type of cardiomyopathy is amyloid associated with?

A

Restrictive cardiomyopathy

21
Q

Arrythmogenic right ventricular dysplasia - what is it?

A

Genetic disease - autosomal dominant with low penetrance - which causes the right ventricle to be largely replaced by fat and it appears big and floppy. There is near total replacement of the ventricular wall by fat

22
Q

Symptoms of arrythmogenic right ventricular dysplasia

A

Syncope and ‘funny turns’, arrhythmias

23
Q

What does myocarditis look like?

A

‘Beefy’ myocardium

24
Q

Causes of infectious myocarditis

A
  • Coxsackie A and B
  • ECHO virus
  • Many other viruses
  • Chaga’s diesea (parasitic cause)
  • Lyme’s disease (parasitic cause)
  • HIV (very rare subcause)
25
Q

Non-infectious myocarditis causes

A
  • Immune mediated hypersensitivity reactions
  • Hypersensitivity to infection – rheumatic fever after strep throat
  • Hypersensitivity to drugs – eosinophilic myocarditis
  • Systemic lupus erythematosus
26
Q

Rheumatic fever:

  • How does it affect valves?
  • How does it affect chordae tendinae?
  • Myocardium in rheumatic fever
  • Histology
A
  • Classic mitral stenosis with thickening and fusion of valve leaflets
  • Short, thick chordae tendinae
  • Myocardium patchily inflamed
  • Aschoff bodies
27
Q

Causes of pericarditis

A
  • Infection
  • Immune mediated (rheumatic fever)
  • Idiopathic
  • Uraemic (renal failure)
  • Post MI (Dressler’s syndrome)
  • Connective tissue disease
28
Q

Causes of infectious pericarditis

A

Viruses - especially ECHO virus
Bacterial - extension from elsewhere, produce purulent effusions
Fungi - immunosuppressed patients, post-transplant, produce purulent effusions
TB - caseous material in sac producing constrictive pericarditis

29
Q

Complications of pericarditis

A

Pericardial effusion, tamponade, constrictive pericarditis, cardiac failure, death

30
Q

Causes of non-infectious endocarditis

A

Rheumatic fever, systemic lupus erythematosus

31
Q

Carcinoid tumours

A

Neoplasms of neuroendocrine cells

32
Q

Where can carcinoid tumours be seen?

A

Can see them in any mucosa, common in GI tract and lung

33
Q

Most common tumour of the heart

A

Atrial myxoma

34
Q

Atrial myxoma:

  • Where does it mostly occur?
  • What can it cause?
  • What symptoms is it associated with?
A
  • Right atrium
  • Ball/valve obstruction, tumour emboli, endocarditis
  • Systemic fever and malaise

Medicine Cardiovascular (24 decks)

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