Pericardium and Endocardium Flashcards
Serous Atrophy of Fat
-pericardial, visceral and bone marrow fat appear gelatinous
-seen in cachexia
Pericardial Hemorrhage
-common post mortem findings in animals that had hypoxia, sepsis, toxemia, DIC, coagulopathies, and electrocution
Classifications of pericardial hemorrhage
1.Petechial
2. Ecchymotic
3. Paint brush
Pericardial hemorrhage
1. petechial
2. ecchymotic
3. paint brush
Pericardial Effusion and the different types
Filling of pericardium that can compress heart resulting in decreased filling, and CO. Can result in cardiac tamponade
- Hydropericardium= transudate (clear, low cell and proteins)
- Hemopericardium= blood (RBCs, high protein)
- Pericarditis= exudate
(High cells and protein)
Distension of pericardial sac
Enlarges on demand to accommodate
1.excess fluid in hydropericardium
2.non fatal progressive pericardial hemorrhage in hemopericardium
3.exudate in pericarditis
4. Enlarged heart in cardiac hypertrophy and cardiomyopathy
Hydropericardium
Low protein transudate in pericardial sac
Caused by hydrostatic pressure increase from right sided heart failure, hypoproteinemia (loss, decreased intake, or decreased production), altered vascular permeability (DIC, sepsis), or decreased lymphatic drainage (tumours)
Hemopericardium
Accumulation of blood in pericardial sac
caused by atrial or aortic rupture, hemangiosarcoma, cardiac trauma/puncture
What can acute hemorrhage of hemopericardium cause?
Cardiac tamponade= sudden death
Hydropericardium
Hemopericardium
Hemangiosarcoma
Tumoral mass in right atrium
-appears dark because neoplastic cells form blood filled vascular channels
Hemangiosarcoma
Pericarditis
Inflammation of the pericardium
-diffuse, and usually involving both the epicardium and pericardium
Types of pericarditis
*Depends on exudate:
1. Fibrinous
2. Suppurative
3. Fibrinohemorrhaguc
4. Granulomatous
Pericarditis
-inflammation
-rib impressions
Fibrinous pericarditis
-fibrinous exudate covers heart
-called cor villosum, or shaggy heart, or bread and butter
Fibrinous pericarditis
Causes of Fibrinous pericarditis in ruminants vs. pigs
Ruminants: Mannheimimia haemolytica, Clostridium chauvoei, E coli, Streptococcus, Pasteurella multocida
Pigs: Haemophilus parasuis (Glasser’s), Streptococcus suis, Mulberry heart disease, Mycoplasma hyopneumoniae
Polyserositis in Pigs
Glasser’s Disease
-caused by streptococcus suis or Glaesserella parasuis
-will appear as fibrin and fluid in pericardial sac, AND firbinopurulent exudate in joint
Glasser’s Disease
-Polyserositis
Black Leg
-caused by clostridium chauvoei
-appears as fibrinous pericarditis, black discolouration on leg muscle, and fibrin strands in pericardial sac
Black Leg
-Clostridium chauvoei
Traumatic Reticulopericarditis
-Hardware Disease- caused by metal foreign bodies
-results in suppurative pericarditis and thick dilated pericardial sac
Suppurative pericarditis from hardware disease (traumatic reticulopericarditis)
Chronic Pericarditis components
- Brisket edema due to Right heart failure
- Distended pericardial sac
- Pericardial sac filled with fibrin and blood and organized fibrin on epicardium
What can chronic pericarditis lead to?
Can lead to Constrictive pericarditis= heart is encased in dense fibrous scar limiting diastolic expansion and CO
Chronic Pericarditis
Chronic constrictive pericarditis
-dense fibrous capsule resembling a plaster mold!
Endocardial diseases
-Endocardial fibrosis
-endocardial mineralization
-valvular cysts
-endocarditis
-myxomatous degeneration
Primary endocardial fibroelastosis
-hereditary disease in humans and Burmese cats, no underlying cardiac disease
-pathogenesis unknown
Secondary/acquired endocardial fibrosis
Types:
1.Focal-abnormal blood turbulences in atria and ventricles=jet lesions
-valvular insufficiencies
- Diffuse- sub endocardial fibrosis secondary to prolonged cardiac dilation
Subendocardial fibrosis
-endocardium thickened due to abnormal deposition of collagen and elastic fibres
-smooth or corrugated surface
-diffusely white
Clinical relevance of severe generalized fibrosis
Can impair ventricular filling during diastole and reduce stroke volume leading to congestive heart failure
Endocardial Mineralization
Abnormal deposition of calcium or mineral in endocardium
-can be metastatic or dystrophic
Metastatic vs. dystrophic endocardial mineralization
Metastatic: high levels of circulating Ca in hypercalcemic states
Dystrophic: secondary calcification in injured endocardium
Causes of endocardial mineralization
- Hypervitaminosis D
-excess vitamin D or animals ingesting vitamin D analogs (rodenticides or toxic plants) - Chronic granulomatous diseases
-bovine with paratuberculosis or tuberculosis - Uremia
Subendocardial mineralization
Valvular cysts
-common in calves
-incidental findings; cysts may regress and disappear. No clinical significance
-Types
1. Lymphocyst- content is clear
2. Hematocyst- content is blood
Valvular lymphocyst
Valvular Hematocyst
Myxomatous valvular degeneration (endocardiosis)
-most common cardiac lesion found at necropsy of dogs
-incidence increases with age
-typically mitral valve
-nodular thickening of valve with smooth shiny surface
-may or may not cause valvular dysfunction
Myxomatous valvular degeneration (endocardiosis)
Endocardiosis and ruptured chordae tendineae
Endocardiosis (thick nodular valves) can lead to ruptured chordae tendinae
-this leads to eversion of leaflet into atrium
*need to open left atrium, remove blood, fill with water and rhythmically compress heart. If ruptured then one or more tendineae will whip out
Endocarditis
inflammation of the endocaridum
-occurs in all species
-commonly caused by bacteria and sometimes fungi and parasites
Endocarditis classification based on location
- Valvular endocarditis- valves
- Mural endocarditis- ventricular or atrial wall
Endocarditis classification based in appearance
- Vegetative- cauliflower like mass of exudate and fibrin attached to heart valve or endocardium
- Ulcerative-endocardium is ulcerated
Common sequelae of endocarditis
Thromboembolism
-mitral or aortic endocarditis often causes renal infarcts
-tricuspid and pulmonic endocarditis cause pulmonary infarcts or embolic pneumonia
Vegetative valvular endocarditis
Vegetative valvular endocarditis
-common in farm animals (pigs and cattle) suffering from bacteremia
-sometimes in dogs and cats
Possible bacteria causing endocarditis
Horses: Streptococcus equi and Actinobacillus equuli
Cattle: Trueperella pyogenes
Pigs: Erysipelothrix rhusiopathiae and Streptococcus suis type 2
Dogs: Staphylococcus aureus
Cats: Bartonella and Streptococcus sp
Ulcerative endocarditis
-white-red thick wrinkled areas of endocarditis
-mineralization, and fibrous tissues
**formed by uremia in dogs with chronic renal failure
