Pathology of Cardiomyopathies, Hypertension, & Myocarditis Flashcards
Mutations of what protein are most commonly associated with dilated cardiomyopathy?
Titin (truncation of the TTN gene)
What is the mechanism of heart failure due to hypertrophic cardiomyopathy?
Impairment of compliance (diastolic dysfunction)
What is myocarditis?
Myocardial inflammation with necrosis
What is the classic histologic finding of malignant hypertension?
Hyperplastic necrotizing arteriolitis
This is a type of left ventricular contractile dysfunction caused by extreme psychological stress.
Takotsubo cardiomyopathy (broken heart syndrome)
Cardiac hypertrophy leads to an increase in mycoyte size. What other histologic findings may be present?
Multiple and enlarged nuclei due to DNA replication without cell division
What is a classic histological finding of hypertrophic cardiomyopathy?
Myocyte disarray (top is normal)
Mural thrombi are most associated with what type of cardiomyopathy?
Dilated cardiomyopathy
Hemochromatosis may present with what type of cardiomyopathy?
Features of both dilated and restrictive cardiomyopathy (systolic and diastolic impairment)
What are the different types of cardiomyopathy?
Dilated, hypertrophic, restrictive
What cells are present in cases of hypersensitivity myocarditis?
Eosinophils, lymphocytes, macrophages
What characterizes sarcoidosis restrictive cardiomyopathy?
Non-necrotizing granulomas with prominent giant cells
What is peripartum cardiomyopathy?
A type of dilated cardiomyopathy that occurs late in pregnancy or up to 6 months postpartum
In what age group is myocarditis most common?
Children 1-10yo
This patient has a type of myocarditis. What is it?
Giant cell myocarditis - presence of multinucleated giant cells
True/False. Deficits of mental function may present in cases of right-sided heart failure.
True - due to hypoxia of the CNS. This is most common in older patients
This type of cardiomyopathy is characterized by massive fatty infiltration and focal fibrosis.
Arrhythmogenic cardiomyopathy (type of dilated cardiomyopathy)
What cells may be found in the lungs in cases of left-sided heart failure?
Hemosiderin-laden macrophages (heart failure cells) - accumulated iron from phagocytized RBCs
What toxins are most associated with dilated cardiomyopathy?
Alcohol, cobalt, chemotherapeutic drugs
This cause of restrictive cardiomyopathy is linked to nutritional deficiencies and parasitic infections.
Endomyocardial fibrosis
What is the most common cause of sudden cardiac death in young athletes?
Hypertrophic cardiomyopathy
Volume overload causes assembly of new sarcomeres in (series/parallel).
Series - eccentric hypertrophy
Restrictive cardiomyopathy due to this cause presents in the first 2 years of life.
Endocardial fibroelastosis
What histological findings are present with dilated cardiomyopathy?
Enlarged, bizarre, hyperchromatic nuclei (“ninja stars”
Chronic alcohol use is associated with what cardiomyopathy?
Dilated cardiomyopathy
In cases of right heart failure, hepatic and portal vessels become congested and cause hepatosplenomegaly. What is the characteristic term to describe the liver’s appearance in these cases?
Nutmeg liver
Nephrosclerosis occurs during congestive heart failure due to hemodynamic changes. What gross and histologic changes are present?
Thickening, hyalinization of arteries, decreased kidney mass, nodular developement
What is senile cardiac amyloidosis?
A type of restrictive cardiomyopathy due to deposits of amyloid with transthyretin
This type of restrictive cardiomyopathy is associated with extensive eosinophilic infiltrate.
Loeffler endomyocarditis
What are the most common gene mutations associated with hypertrophic cardiomyopathy?
Myosin-binding protein C & B-myosin heavy chain
True/False. Expression of fetal genes occurs during cardiac hypertrophy.
True - fetal forms of myosin, natriuretic peptides, and collagen are present
What virus is most associated with myocarditis in the USA?
Coxsackie viruses A & B
What is the presentation of malignant hypertension?
Rapid rise in blood pressure, renal failure, retinal hemorrhages, papilledema
Pressure overload causes assembly of new sarcomeres in (series/parallel).
Parallel - concentric hypertrophy
What is the mechanism of heart failure due to dilated cardiomyopathy?
Impairment of contractility (systolic dysfunction)
What non-viral pathogen is associated with myocarditis?
Trypanosoma cruzi (agent of Chagas disease)
What is Naxos Syndrome?
Arrhythmogenic right ventricular cardiomyopathy with woolly hair and hyperkeratosis
