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Sys Path > Pericardium and Endocardium > Flashcards

Pericardium and Endocardium Flashcards

1
Q

What is the pericardium?

A

double layered serosal mb that covers the heart & most proximal segment of great vessels

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2
Q

What is the epicardium?

A

thin layer of pericardium firmly attached to heart

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3
Q

What is in pericardial sac and what does it do?

A

pericardial sac contains small traces of fluid which act as lubricant to prevent friction btwn pericardium & epicardium

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4
Q

What are signs of serous atrophy of fat?

A

epicardial fat & fat in bone marrow will appear gelatinous, loss of normal fat on epicardium & kidney, prominent normal lymphatic vessels on heart.

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5
Q

What is serous atrophy of fat caused by?

A

could be due to chronic disease, chronic renal or hepatic failure, or neoplasia

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6
Q

what are pericardial hemorrhages?

A

common post-mortem findings in animals that have suffered hypoxia, sepsis of septicemia, toxemia, DIC, coagulopathies, & electrocution. also common terminal finding in large animals

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7
Q

3 sizes of hemorrhages from smallest to largest?

A

petechial, ecchymotic, & paint brush

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8
Q

What are the 3 types of pericardial effusion?

A
  1. transudate -> hydropericardium (clear fluid, low cellularity, low prot)
  2. blood -> hemopericardium (predominantly RBCs, high prot)
  3. exudate -> pericarditis (turbid, high cellularity, PMNs, high prot)
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9
Q

What causes the pericardial sac to enlarge to accommodate for?

A
  1. excess fluid in hydropericardium
  2. non-fatal progressive pericardial hemorrhage in hemopericardium
  3. exudate in pericarditis
  4. enlarged heart in cardiac hypertrophy & cardiomyopathy
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10
Q

What is hydropericardium?

A

low protein transudate in pericardial sac.

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11
Q

What is the appearance of hydropericardium?

A

pericardial surfaces remain smooth & glistening

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12
Q

pathogenesis of hydropericardium?

A
  1. hydrostatic: R heart failure, pulmonary hypertension
  2. hypoproteinemia: emaciation, protein losing enteropathy/nephropathy, etc.
  3. altered vascular permeability: mulberry heart
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13
Q

What is hemopericardium?

A

accumulation of blood in pericardial sac

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14
Q

what causes hemopericardium?

A

atrial or aortic rupture, hemangiosarcoma, cardiac trauma/puncture

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15
Q

What cause hemopericardium cause?

A

cardiac tamponade -> sudden death

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16
Q

When does hemopericardium occur that is not a concern?

A

blood tinged fluid occurs as post-mortem finding

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17
Q

What are the post mortem signs of hemopericardium?

A

enlarged cardiac silhouette & notably distended pericardial sac filled w/ blood

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18
Q

Why does a hemangiosarcoma appear dark?

A

neoplastic cells form blood-filled vascular channels

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19
Q

Types of pericarditis according to exudate

A
  1. fibrinous (most common)
  2. suppurative (purulent)
  3. fibrinohemorrhagic
  4. granulomatous
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20
Q

what is fibrinous pericarditis?

A

usually result of systemic bacterial infection. fibrinous exudate covers epicardium & pericardium. morphologic appearance is often referred to as “cor villosum”, “shaggy heart”, or “bread & butter”

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21
Q

Glasser’s disease?

A

Polyserositis (meningitis, polyarthritis, pericarditis, pleuritis, peritonitis, etc.). Caused by Glaesserella (Haemophilus) parasuis.
Will see fibrin, fluid, & fibrinopurulent exudate w/in body chambers.

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22
Q

What causes similar lesions in pigs to Glasser’s disease?

A

Streptococcus suis

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23
Q

What is black leg?

A

Clostridial myositis. Caused by Clostridium chauvoei. Signs are fibrinous pericarditis, black discolouration of leg muscle, & fibrin strands in pericardial sac

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24
Q

What is hardware disease?

A

Traumatic reticulopericarditis. ingestion of wire or nails that accumulate in reticulum and can perforate the pericardial sac, contaminating it w/ bact. Pericardial sac becomes filled w/ exudate, and the sac itself becomes dilated & thickened by fibrosis. Epicardial surface covered by exudate.

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25
Q

Signs of chronic pericarditis

A
  1. brisket edema due to R heart failure (compressive)
  2. distended pericardial sac
  3. pericardial sac filled w/ fibrin & blood, & organized fibrin on epicardium
26
Q

What is chronic constrictive pericarditis?

A

heart encased in dense fibrous or fibrocalcific scar that may obliterate pericardial space (constrictive pericarditis limiting diastolic expansion (reduced ventricular filling) & CO). in extreme cases it can resemble plaster mold (“concretio cordis”)

27
Q

What are 5 endocardial diseases?

A

1.endocarditis
2. valvular cysts
3. endocardial mineralization
4. endocardial fibrosis
5. myxomatous degeneration

28
Q

What do normal heart valves look like & what should you do for proper gross examination?

A

Thin & translucent; gently wash them

29
Q

What is acquired (secondary) fibrosis?

A

can be focal or generalized (diffuse) & most common causes are:
1. Focal: abnormal blood turbulences in atria or ventricles jet lesions
2. Diffuse: sub-endocardial fibrosis secondary to prolonged cardiac dilation

30
Q

What are jet lesions?

A

occur w/ mechanical injury caused by turbulence damage endocardium. Commonly seen in valvular insufficiencies

31
Q

What is primary endocardial fibroelastosis?

A

occurs as hereditary disease in humans & Burmese cats in which there’s no underlying cardiac disease. pathogenesis is uncertain.

32
Q

Gross and microscopic lesions of endocardial fibrosis & fibroelastosis

A

on gross exam, endocardium appears thickened & may show smooth or corrugated surface. endocardial thickening is result of an abnormal deposition of collagen and elastic fibers

33
Q

Clinical relevance of endocardial fibrosis & fibroelastosis?

A

severe generalized fibrosis can impair ventricular filling during diastole & reduce stroke vol leading to congestive heart failure

34
Q

What often causes subendocardial fibrosis?

A

increased collagen deposition in sub-endocardium secondary to prolonged blood turbulence caused by congenital heart defects or other chronic conditions

35
Q

What induces jet lesions on atrial endocardium leading to subendocardial fibrosis?

A

valvular insufficiencies

36
Q

Endocardial mineralization?

A

abnormal deposition of calcium or minerals in endocardium

37
Q

According to pathogenesis, endocardial mineralization could be:

A
  1. Metastatic: high levels of circulating calcium in hypercalcemic states
  2. dystrophic: secondary calcification in injured endocardium
38
Q

Most common causes of endocardial mineralization in domestic animals are:

A
  1. hypervitaminosis D
  2. chronic granulomatous diseases (particularly bovines w/. paratuberculosis or tuberculosis, often show endocardial & arterial mineralization)
  3. uremia (mineralization also seen in uremic dogs (uremic endocarditis)
39
Q

How do animals get hypervitaminosis D?

A

When animals are given excess amounts of vitamin D (iatrogenic hypervitaminosis) OR when animals ingest vit D analogs which are present in some rodenticides or toxic plants ex: solanum malacoxylon, cestrum diurnum, & trisetum flavescens

40
Q

What would you see for subendocardial mineralization?

A

corrugation & thickening of endocardium. mineralization also present in aorta

41
Q

Valvular cysts are particularly common in which animal?

A

calves

42
Q

Valvular cysts

A

considered just incidental finding, cysts may regress & disappear, there is no clinical relevance

43
Q

Classes of valvular cysts?

A
  1. Lymphocyst: when content is clear fluid
  2. hematocyst: when content is blood
44
Q

What is most common cardiac lesion found @ necropsy in mature dogs?

A

myxomatous valvular degeneration (endocardiosis)

45
Q

Myxomatous valvular degeneration (endocardiosis)?

A

typically affects mitral valve, nodular thickening of valve, w/ smooth shiny surface, may or may not cause valvular dysfunction & clinical signs

46
Q

Incidence of myxomatous valvular degeneration (endocardiosis)?

A

incidence increases w/ age:
- 1 yr old (5%)
- 16 yr old (75%)

47
Q

What is another presentation of valves in Myxomatous valvular degeneration (endocardiosis)?

A

may be seen as doming or hooding of leaflets toward atrium (valve prolapse)

48
Q

rupture of chordae tendineae in endocardiosis can cause?

A

eversion of valve leaflet into atrium (prolapse as flail leaflet

49
Q

What to do when you suspect ruptured chordae tendineae?

A

open L atrium, remove blood, fill ventricle & atria w/ water, & rhythmically compress heart. if there is rupture, 1 or more chordae will whip out during the “manual systole”

50
Q

Endocarditis?

A

Inflammation of endocardium; most frequently caused by bact, & to much lesser extent, by fungi or parasites

51
Q

What spp does endocarditis occur in?

A

all domestic spp

52
Q

Classification of endocarditis according to location?

A

According to location:
- valvular (valves)
- mural endocarditis (ventricular or atrial wall)

53
Q

classification of endocarditis according to gross appearance?

A
  • vegetative: cauliflower-like mass of exudate & fibrin attached to heart valve or endocardium
  • ulcerative: when endocardium is ulcerated (dogs w/ uremia)
54
Q

common sequels to endocarditis?

A

thromboembolism: mitral or aortic endocarditis often causes renal infarcts; tricuspid & pulmonic endocarditis cause pulmonary infarcts or embolic pneumonia

55
Q

What spp is vegetative valvular endocarditis found in?

A

particularly common in farm animals (Sw & Bo) suffering from bacteremia. it’s occasionally seen in Ca & Fe

56
Q

most common bact isolated from endocarditis in domestic animals are?

A
  1. Streptococcus equi & Actinobacillus equuli in Eq
  2. Trueperella (Arcanobacterium) pyrogenes in Bo
  3. Erysipelothrix rhusiopathiae & Streptococcus suis type II in Sw
  4. Staphylococcus aureus in Ca
  5. Bartonella & Streptococcus in Fe
57
Q

Vegetative valvular endocarditis on tricuspid valve could lead to?

A

R sided heart failure, hydrothorax, & nutmeg liver

58
Q

Signs of vegetative valvular endocarditis of the aortic valve of Sw?

A

red discoloration of skin of ventral abdomen, legs, & tips of ears.

59
Q

Histopathology of vegetative valvular endocarditis?

A

neutrophils, macrophages, cell debris, bacterial colonies on affected valve

60
Q

What can vegetative valvular endocarditis of pulmonic valve lead to in the lungs?

A

embolic pneumonia. will see multiple embolic foci in lungs

61
Q

Appearance of ulcerative endocarditis in dogs and is linked to what disease?

A

wht-red, thick, & wrinkled areas of endocarditis, mineralization, & fibrous tissue formation caused by uremia in dogs w/ chronic renal failure

62
Q

In vegetative valvular endocarditis what could a colour change in the ears of Sw be due to?

A

Septicemia or thromboembolism from valves (these two conditions usually occur together)

Sys Path (12 decks)

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