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Y3 Cardiovascular pathology > Cardiovascular pathology 3 > Flashcards

Cardiovascular pathology 3 Flashcards

1
Q

What are the two types of myocardial rupture?

A

Traumatic e.g. bullet wound

Spontaneous e.g. insufficiency of mitral valve causing chronic left atrial dilation

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2
Q

Enlargement of the heart is termed?

A

Cardiomegaly

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3
Q

Describe the 3 forms of cardiomegaly?

A
  • Hypertrophy: increase in the size and weight of the organ due to an increase in the size of each cells
  • Dilation: expansion of the volume of the ventricle lumen
  • Cardiomyopathy: disease of the myocardium
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4
Q

Ventricular hypertrophy acts as what kind of mechnism?

A

Compensatory - physiological response, maintains adequate cardiac output e.g. response to exercise
- A reversible increase in muscle mass

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5
Q

Describe primary and secondary ventricular hypertrophy

A 
Primary = irreversible idiopathic hypertrophic cardiomyopathy, no known cause, disease of the myocardium itself 
Secondary = compensatory response to increased workload
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6
Q

Describe eccentric hypertrophy and how the heart changes

A
  • Heart with normal / enlarged ventricular chambers: heart grows outwards and gets bigger
  • Walls of normal / decreased thickness
  • Myocardium is hypertrophic and has an increased mass
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7
Q

What is the cause of eccentric hypertrophy?

A

Volume overload e.g. valvular insufficiencies, septal defects

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8
Q

Describe concentric hypertrophy and how the heart changes

A

Heart with small ventricular chambers that have thick walls

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9
Q

What is the cause of concentric hypertrophy?

A

Produced by pressure overload e.g. valvular stenosis, systemic hypertension, pulmonary disease (hypertension)

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10
Q

What is Cor pulmonale?

A

A secondary alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system

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11
Q

What are some species specific causes of right ventricular hypertrophy with Cor pulmonale

A

Due to increase flow resistance in pulmonary circulation

  • Dirofilariosis (roundworms) and congenital pulmonic stenosis in dogs
  • High altitude disease in cattle
  • Chronic alveolar emphysema in horses
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12
Q

What are the two causes of left ventricular hypertrophy?

A
  • Systemic hypertension

- Congenital subaortic stenosis

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13
Q

When does ventricular dilation occur?

A

Compensatory response to achieve increased cardiac output

Allows stretching of cardiac muscle cells to increase contractile force and increases stroke volume is the result

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14
Q

What are the 3 primary cardiomyopathies with unknown pathogenesis

A
  • Dilated cardiomyopathy
  • Hypertrophic cardiomyopathy
  • Restrictive cardiomyopathy
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15
Q

What are the 2 clinical signs of a cardiomyopathy?

A

Dyspnoea

Anorexia

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16
Q

Which heart failure lesions occur as a result of cardiomyopathies?

A

Hydropericardium
Hydrothorax
Ascites
Subcutaneous oedema

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17
Q

Which animals are prone to hypertrophic cardiomyopathies, what are the consequences of them in this species?

A
  • Common in young adult to middle aged cats
  • Cats die from left atrial thrombosis and caudal aorta thromboembolism “saddle thrombosis”
  • Uncommon in dogs, may occur in large breeds
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18
Q

How does a hypertrophic cardiomyopathy present grossly?

A
  • Enlarged heart
  • Prominent concentric hypertrophy of the left ventricle and interventricular septum
  • Dilation of the left atrium: as the blood is returned to the heart through the pulmonary vein, it passes into the atrium but the volume of the ventricle is reduced
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19
Q

How does a hypertrophic cardiomyopathy present histologically?

A
  • Prominent disarray of hypertrophic degenerate myocytes
  • Interweaving array of fibres and interstitial fibrosis
  • Fibrous CT between cardiac myocytes
  • Cardiac myocytes have a chaotic structure
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20
Q

Which animals are most prone to dilated cardiomyopathies?

A
  • Middle aged dogs: idiopathic or autosomal recessiveor X-linked mode of inheritance.
  • Cats with low tissue concentrations of taurine
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21
Q

How does a dilated cardiomyopathy present grossly?

A
  • Biventricular dilation
  • White thickened endocardium (subendocardial fibrosis)
  • Increased heart weight
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22
Q

How does a dilated cardiomyopathy present histologically?

A
  • May see no histological lesion

- If there is: interstitial fibrosis, fatty infiltration, myocyte degeneration, attenuated wavy fibres

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23
Q

Describe the pathogenesis of bovine dilated cardiomyopathy

A
  • Well–grown 2-3 year-old Holstein cattle (genetic component)
  • Peripheral oedema and jugular distention
  • Fluid accumulation in body cavities
  • Enlargement of the heart with a rounded shape
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24
Q

Describe the gross appearance and function of restrictive cardiomyopathy

A
  • Walls are rigid and the heart is restricted from stretching and filling properly with blood
  • Rhythmicity and contractility may be normal
  • Stiff chamber walls prevent them from adequately filling
  • Short/irregular chordae tendinae
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25
Q

What is myocardial necrosis?

A

Death from acute cardiac failure, necrosis related arrhythmia when cardiac conduction is disrupted or cardiac decompensation, cardiac dilation and congestive heart failure

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26
Q

How does myocardial necrosis appear grossly?

A

Affected areas are pale, yellow to white and dry.

They can become gritty due to dystrophic calcification

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27
Q

Which areas of the heart are most effected by myocardial necrosis?

A

Papillary muscles and subendocardial myocardium

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28
Q

Give examples of causes of myocardial necrosis

A
  • Nutritional deficiencies e.g. vitamin E
  • Ischaemia: hypoxia
  • Ionophore toxicity: Monensin intoxication
  • Plants containing heart glycosides intoxication
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29
Q

How does myocardial necrosis appear histologically when it is recent necrosis?

A
  • Fibres appear swollen and hypereosinophilic because they have lost their nuclear material
  • Striations on the cardiac myocytes are indistinct, and nuclei are pyknotic
  • Scattered basophilic granules represent calcified mitochondria
  • Shredded appearance because of hypercontraction and the formation of multiple transversely oriented bars of disrupted contractile material (contraction band necrosis)
30
Q

What does pyknotic mean?

A

Pyknotic is the irreversible condensation of chromatin in the nucleus of a cell undergoing necrosis or apoptosis

31
Q

How does myocardial necrosis appear histologically when it is 24-48 hours old?

A

Necrotic areas are infiltrated by inflammatory cells (macrophages, neutrophils) to phagocytose and lyse the necrotic cellular debris

32
Q

How does myocardial necrosis appear histologically when it is weeks old?

A

Persistent stromal tissue - fibroblasts, collagen and capillaries

33
Q

Myocardial necrosis is seen in which disease of pigs?

A

Mulberry heart disease

34
Q

What are the causes of myocardial necrosis in mulberry heart disease?

A
  • Vitamin E deficiency

Nutritional, due to diet with high content of unsaturated fatty acids leading to peroxidation of the cell membranes.

35
Q

What are the 3 main pathological components of mulberry heart disease?

A
  • Necrosis
  • Hydropericardium
  • Haemorrhages
36
Q

What is the cause of equine myocardial degeneration?

A

Monensin intoxication

37
Q

What are the pathogenic signs of equine myocardial degeneration caused by Monensin intoxication?

A
  • Arrhythmic heart beat and ventricular fibrillation
  • Petechial pericoronal haemorrhages
  • Necrosis of myocytes
38
Q

Which species is the least susceptible to monensin?

A

Poultry

can use it to treat parasites in chickens

39
Q

What is the effect of chemotherapeutic agents (e.g. Doxorubicin) on the heart?

A

Cause necrosis of cardiac myocytes

40
Q

How does the appearance of necrosis due to chemotherapeutic agents (e.g. Doxorubicin) appear?

A

Dose-related chronic cardiotoxicity characterized pale myocardium, hyaline necrosis, hydropic degeneration of the myocytes

41
Q

Inflammation of the myocardium is termed?

A

Myocarditis

42
Q

What are the portals of entry for inflammation of the myocardium

A
  • Haematogenous dissemination

- Embolic dissemination from vegetative endocarditis into the coronary arterial tree

43
Q

What are the 6 different types of myocarditis?

A
  1. Purulent – neutrophil dominated
  2. Necrotising
  3. Haemorrhagic
  4. Lymphocytic
  5. Eosinophilic
  6. Granulomatous
44
Q

What is a vegetation?

A

Abnormal growths that contain collections of bacteria may form in your heart at the site of the infection and damage the heart valves, which can cause them to leak

45
Q

Myocarditis is seen which with canine viral infection?

A

Canine parvovirus

  • Usually affects pups <10 weeks of age
  • Cells that are rapidly dividing are the target cells for parvovirus
  • Viral agents may produce acute necrosis with little or moderate lymphocytic inflammatory response
46
Q

Give some other examples of viruses causing myocarditis

A
  • West Nile virus
  • Foot and mouth disease virus
  • Canine distemper
  • Bluetongue in sheep
47
Q

What is the cause of purulent myocarditis?

A

Bacteria

- Direct extension of pericarditis and/or endocarditis

48
Q

Give examples of bacterial causes of purulent myocarditis

A
  • Burrelia burgdorferi: lyme disease
  • Histophilus somni
  • Black leg
  • Listeria monocytogenes
  • Streptococcus equi
  • Staphylococcus aureus
49
Q

Equine disseminated granulomatous myocarditis is caused by which bacteria?

A

Mycosis

Aspergillosis

50
Q

Give 3 examples of protozoan parasites that infect the heart

A
  • Sarcocystis spp
  • Toxoplasma spp
  • Neospora spp
51
Q

Give 2 examples of cestodes that infect the heart

A

cysticercus spp

hydatid cyst

52
Q

Give 2 examples of nematodes which infect the heart

A
  • Dirofilaria immitis

- Angiostrongylus vasorum

53
Q

Describe the cycle of Sarcocystis spp

A

Normally develop in 2-host cycles consisting of an intermediate host (prey) and the final host (predator)

e. g. Cattle-dog, Cattle-cat, cattle-human, sheep-dog, sheep-cat, etc
- Incidental finding

54
Q

Canine myocarditis is caused by which infectious agents?

A

Toxoplasmosis - Toxoplasma gondii

Neosporosis - Neospora caninum

55
Q

Describe the pathology of Toxoplasma gondii

A
  • Affects immunosuppressed and young animals
  • Tachyzoites spread systemically and caused interstitial pneumonia, myocarditis, hepatic necrosis, meningoencephalomyelitis. chorioretinitis, lymphadenopathy and myositis
  • T gondii is also an important cause of abortion and stillbirth in sheep and goats and pigs
  • Heart => necrosis and chronic pyogranulomatous myocarditis
56
Q

Describe the pathogenesis of Neospora caninum

A

Puppies: CNS /neuronal symptom dermatitis, hepatitis, pneumonia, and myocarditis can occur Adult dogs: sporadically develop neosporosis

57
Q

The name of the dog heart worm is?

A

Dirofilaria immitis

58
Q

Which other canine worm damages the heart?

A

Lungworm

Angiostrongylus vasorum

59
Q

Describe the pathology of Angiostrongylus vasorum

A
  • Adults live in pulmonary artery and RV; larvae are found in lung parenchyma
  • Enlarged RV, cardiac silhouette rounded
  • Right sided heart failure
  • Eosinophilic vasculitis
  • Multifocal granulomatous and eosinophilic pneumonia
  • Bleeding disorder
60
Q

Give an example of a benign endothelial cell neoplasia

A

Haemangioma - tumour arising from endothelial cells in vessels

61
Q

Describe the gross and histological appearance of a haemangioma

A

Gross - Red-black blood containing masses that protrude into the lumen or epicardial surface
Histo - well differentiated vascular spaces lined by endothelial cells

62
Q

Give an example of a malignant endothelial cell neoplasia

A

Haemangiosarcoma

63
Q

Describe the gross and histological appearance of a haemangiosarcoma

A

Gross – similar to haemangioma (Red-black blood containing masses that protrude into the lumen or epicardial surface)
Histologically - scattered, elongated plumb neoplastic endothelial cells.
- Often highly metastatic

64
Q

A tumour of striated muscle (myocardium) is termed?

A

Rhabdomyoma

Rhabdomyosarcoma

65
Q

A tumour of the epi- / pericardium is termed?

A

Mesothelioma

66
Q

Give 3 examples of heart base tumours

A
  • Aortic body tumours
  • Ectopic thyroid adenoma / carcinoma
  • Metastases: sarcoma / carcinoma
67
Q

What are the consequences of aortic body tumours?

A
  • Surround and compress great vessels

- Arise at the base of the heart and can cause vascular obstruction and cardiac failure

68
Q

Describe the appearance of aortic body tumours

A

Large white, firm masses that surround and compress the great vessels and atria

69
Q

Describe the histological appearance of aortic body tumours

A

Microscopically the neoplastic cells are polyhedral with vacuolated cytoplasm and abundant fibrous connective tissue.

70
Q

What is a chemodectoma?

A

Chemodectoma is a rare tumour of the neuroendocrine tissue of the carotid body

Y3 Cardiovascular pathology (4 decks)

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