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Pathology II > Test 1- Cardio > Flashcards

Test 1- Cardio Flashcards

1
Q

Normal Cardiac Function

A

• Maintenance of adequate blood flow (cardiac output)

Delivery of Oxygen, nutrients and hormones to

peripheral tissues

Removal of Carbon Dioxide (CO2) and other metabolic waste products

Maintenance of normal thermoregulation and glomerular filtration rate (GFR)urine output

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2
Q

Compensatory mechanisms available to maintain cardiac function

A

Cardiac dilatation (stretching of cardiac muscle –> ↑contractile force –>↑stroke volume –> maintain normal cardiac output)

Myocardial hypertrophy

↑in heart rate

↑in peripheral resistance- helps because more blood goes into the peripery

Redistribution of blood flow

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3
Q
A

Different Types of Injuries:

Some are reversible and some are irreversible; These are all reversible- if we take out the way that these injuries are created, then we can repair them

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4
Q
A

These injuries are all illreversible- Remember, cardiomyocytes CAN NOT UNDERGO REGENERATION!

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5
Q
A

Follow the blood pathway from placenta (umbilical vein) to umbilical arteries.

Note the coloration of the different mixes of fetal blood, depending on where one looks at the system.

bypassing- oxygenated blood- umblicial vein

umblical arteries- non-oxgentated blood back

fetal life- connections between the ventricules and the atrium through the foramen ovale- this should disapear after birth

ductus arterious- bypassing the lungs and the blood will go straight into the aorta because the lungs are not functional- this should close and form the ligamentum arterious

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6
Q
A

Serous atrophy of heart -cow

Common in starving, emanciated animals

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7
Q
A

Epicardial hemorrhage (petechia, ecchymosis), endotoxemia – cow.

Animals that died from septis

This can also be an antomical change at slaughtering.

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8
Q

Cardiac Failure/Decompensation

A

Cardiac syncope – acute onset of cardiac failure causing collapse and unconsciouness(abnormal heart rhythm, defective heart valves etc)

Congestive heart failure (CHF)- Develops slowly from gradual loss of cardiac output due to pressure or volume overload or myocardial injury.

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9
Q
A

Brisket edema, bull, R- sided CHF

L- sided CHF- pulmonary edema will be the main manifestation- this can lead to R-sided CHF because this will lead to pulmonary hypertension

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10
Q
A

Heifer, idiopathic pulmonary hypertension leading to CHF

fluid in cutaneous tissue

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11
Q
A

Ascites (hydroperitoneum), dog

transudate

What other conditions in addition to CHF that can result in ascites?

  1. Hyperproteinemia- kidney disease, liver disease, protein loosing enteropathy
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12
Q

Post-mortem examination of the heart: what are we looking for?

A

Serous atrophy, coronary groove,

remember to look at the heart while it’s attached to the lungs- also it usually follows the flow of the blood

shape of the valves, aorta, ventricules

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13
Q
A

Tricuspid valve(right AV)

rupture of the chorade tendenae which can produce a prolapse of the valve

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14
Q
A

Left Mitral Valve

greyish discoloration is normal

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15
Q

Congenital anomalies

A
  • Can affect the heart or blood vessels
  • Animals may die in utero or may present clinical signs after birth

• Clinical signs may include exercise intolerance, cyanosis and stunted body growth.

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16
Q
A

Congenital valvular anomalies

Valvular hematocyst, mitral valve

Usually seen in ruminants; blood filled cysts in the valves; these are NOT associated with clinical disease

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17
Q

Tetralogy of Fallot

A

Tetralogy of Fallot: VSD, Overriding aorta (dextroposition of the aorta), pulmonic stenosis,—>right ventricle hypertrophy.

One of the most common cardiac abnormalities in human beings: “blue babies”

Inherited in Keeshonds, also common in English bulldogs

4 things that happen:

  1. Ventricular spetial defiect
  2. Displacement of the aorta
  3. Thickening of wall of the right ventricle
  4. Narrowing of the pulmonary valves

Results in significant disease

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18
Q
A

Dog, right ventricular hypertrophy secondary to pulmonic stenosis

heart is enlarged and has a rounded appearance

Left ventricle on the right

Rounded appearance of the heart was secondary to pulmonic stenosis

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19
Q
A

Blue arrows: aortic valve;

Green arrows: fibrous band. “is among the most frequently encountered anomalies in dogs”. Results in compensatory concentric hypertrophy of the left ventricle and post-stenotic dilation of the aorta. Results in narrowing of the base of the aorta, which leads to L-sided CHF

Common in dogs

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20
Q
A

Tricuspid dysplasia, dorsal view from the atrium. Most common in cats, but it’s rare.

Either born dead or die very quickly.

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21
Q
A

Ventricular septal defect

Dog, VSD, TAMU,
Dr. J. Edwards

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22
Q
A

VSD, calf, UCVM, OI, 2010, view from the right ventricle

valvular hemtaocyst on the left

hole= communication between the left and right ventricle

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23
Q
A

VSD, calf, UCVM, OI, 2010, view from the right ventricle

Jet lesion= the white stripes; trauma to the endocardium; these are individual areas of endocardosis

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24
Q
A

VSD, calf, UCVM, OI, 2010. “Jet lesions” (endocardial fibrosis) within the right ventricular free wall- this tells us that there is abnormal blood flow in that area

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25
Q
A

VSD, calf, UCVM, OI, 2010. “Jet lesions” (endocardial fibrosis) within the right ventricular free wall

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26
Q

Patent Ductus Arteriosus

A

One of the more common defects – recorded in all species

ductus arteriosus- should close and turn into the ligamentum arterious after birth

remember the left side of the heart of the heart is more powerful- blood comes from the aorta into the artery- over time, these animals develop pulmonary hypertension

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27
Q
A

Normal

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28
Q
A

Persistent right aortic arch (PRAA). Results in dysphagia(trouble eating) and megaesophagus(constricts the esphagus) . Affected animals often die of aspiration pneumonia.

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29
Q
A

Calf, persistent right aortic arch (PRAA). Most common in dogs. German Shepherds, Irish Setters and Great Danes are predisposed. Complications of this vascular anomaly?

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30
Q

Hemopericardium

A

ruptured atrial hemangiosarcoma, dog- This can be a cause of death; this results in cardiac tympany

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31
Q
A

Pericardial diseases

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32
Q
A

Pericardial effusion – “mulberry heart disease” Vit. E/Selium def.- pig- presence of transudate

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33
Q
A

Pig: Myocardial hemorrhagic necrosis, pleural effusion, pulmonary edema. Vitamin E/ Selenium deficiency.

fibrin

heart looks red and pale in certain areas

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34
Q
A

MDx: Fibrinous pericarditis,

Calf, “black leg”- Clostriudium chaveoi

fibrin around the heart

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35
Q
A

Fibrinous pericarditis, “black leg”, steer

dots= little bubbles with gas

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36
Q
A

Hardware disease, cow, TAMU

ingestion of hardware

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37
Q
A

Cow, Hardware disease, Dr. King’s Cornell files

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38
Q
A

Foreign bodies, hardware disease, cow, Cornell files

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39
Q
A

A piece of wire had perforated the cranial wall of the reticulum, OI, UCVM.

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40
Q
A

The piece of wire penetrated both, the reticulum and the adjacent diaphragm resulting in leakage of ingesta into the peritoneum. Fibrin admixed with suppurative exudate was present in the affected area (fibrino-suppurative peritonitis). N08-B9, UCVM

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41
Q
A

Chronic (constricted) pericarditis

-Chronic cardiac tamponade, cow

thickened; percardial sack- chronic fibrinos pericarditis that lead to cardiac typany and death

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42
Q

Endocardial Diseases Degeneration

A

Endocardial mineralization

Occurs secondary to excessive intake of vitamin D or calcinogenic plants (Cestrum, Trisetum, Solanum spp.) that contain Vitamin D analogs. It may also occur in debilitated cattle with Johne’s disease (fibrosis & mineralization of the endocardium of the left atrium).

Valvular endocardiosis (myxomatous or mucoid valvular degeneration)

Age-related disease in middle-age to old dogs (most common in males) characterized by degeneration of valvular collagen. The cause is not known, but a genetically influenced degeneration of connective tissue is suspected.

Cavalier King Charles Spaniels are particularly susceptible.

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43
Q
A

Dog, valvular endocardiosis, UCVM, OI

present in Cavalier King Charles Spaniel

mostly left- AV(mitral) valve is the main one affected

Develop Left sided CHF; males are more suceptible

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44
Q
A

Normal mitral valve

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45
Q
A

Valvular endocardiosis: cusp (leaflet) of right atrioventricular (tricuspid) valve, dog

nodular type of apperance

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46
Q
A

Dog, TAMU,
Valvular endocardiosis, note endocardial fibro- elastosis within the atrium (“jet lesions”).

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47
Q

Endocardial Diseases Inflammation

Endocarditis (valvular and mural)

A

Endocarditis (valvular and mural)

Often the result of bacterial infections

The pathogenesis of endocarditis is complicated but endothelial injury, blood turbulence and hypercoagulability are often involved.

Death is the result of heart failure secondary to valve dysfunction or the effects of bacteremia

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48
Q
A

Dog. Valvular endocarditis and endocardial fibro-elastosis

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49
Q
A

Dog, TAMU, Endocarditis, aortic valve

50
Q
A

Dog, TAMU, Endocarditis, aortic valve

51
Q
A

Valvular bacterial endocarditis, cow, right AV valve, H&E

lesions= septic thrombi

52
Q
A

Pig,

Etx:Erysipelas,

valvular endocarditis,

53
Q
A

(Verrucous) Valvular endocarditis, aortic valve, pig Etiology: Erysipelothrix rhusiopathiae

54
Q
A

Dog, ulcerative mural endocarditis, left atrium – uremia, acute renal failure.

Uremic Endocarditis- lesion that we will see in dogs with renal failure

55
Q
A

Uremic (ulcerative) endocarditis, dog

56
Q
A

Dirofilariasis, dog (Dirofilaria immitis). The parasites are usually found in the pulmonary arteries and right ventricle. Also in the R atrium and venae cavae in heavy infestation. May lead to CHF.

Can damage the pulmonary artery

57
Q

Myocardial necrosis and mineralization

A

May be the result of nutritional deficiencies, chemical and plant toxicities, ischemia, metabolic disorders, inherited diseases and physical trauma.

In veterinary medicine is more commonly seen in cases of vitamin E-selenium deficiency (cattle, sheep, pigs) or ionophore toxicity (horses & ruminants: monensin, lasalocid etc.—-> antibiotics given to promote feed efficiency and prevent coccidiosis in cattle, sheep & poultry), gossypol toxicity (gossypol meal is used as a protein source in pigs), uremia (dogs, cats).

58
Q
A

Calf, “white muscle disease”, ;Lesions are “chalky” and have a “gritty” consistency.

fat in the coronary groove- normal; areas of white discoloration on the epicardical surface, but there shouldn’t be fat there- mineralization

COWS- LEFT SIDE OF THE HEART

59
Q
A

Lamb, Nutritional myopathy – “white paint brush strokes”,

will mostly be found in the right ventricle

60
Q
A

Calf, 2 days-old, heart, nutritional myopathy – Von Kossa stain. Extensive mineralization of degenerated/ necrotic muscle fibres.

whitish discoloration on the left ventricle- white muscle disease

very fatal

61
Q
A

Pig, “mulberry heart disease”- results in myocardial degeneration and necrosis

Vit E/ selium deficency

mulberry heart- muddled, dark red discoloration mixed with areas of myocardial degeneration, which is pale

62
Q
A

Cow, monensin(antiboditics used as growth promotors) toxicity

small areas of darkish discoloration with some indentation; acute myocardial degeneration and necrosis

myocardial injury

63
Q

Cardiomyopathies

A

Cardiomyopathies (Structural or functional abnormalities of the myocardium).

• May be primary or secondary

Primary (idiopathic):
• Dilated – cat, dog, hamster, turkey, pig, cow

  • Hypertrophic –cat, dog, rat, pig
  • Restrictive -cat

Secondary (specific heart muscle disease):- Most are secondary
• Congenital
• Nutritional deficiencies (taurine deficiency in cats)
• Toxic (e.g. Doxorubicin)
• Ischemic
• Inflammatory
• Endocrine disorders: hyperthyroidism, hypothyroidism, diabetes mellitus

  • Neoplastic infiltration
  • Systemic hypertension in cats
64
Q

Primary Cardiomyopathies

A

Present in a wide range of domestic, laboratory and wild animal species

In veterinary practice are more commonly seen in dogs and cats

Hypertrophic cardiomyopathy is most common in cats

Dilated cardiomyopathy is seen in both, dogs and cats - specially males.

Larger dog breeds like Doberman pinschers, Portuguese water dogs, Dalmatians, Saint Bernards etc., have an increased susceptibility (familial pattern).

65
Q
A

Dog, Dilated cardiomyopathy usually in large breed dogs: rounded and enlarged heart

heart will be large, mis-shapened, very rounded

66
Q
A

Dilated cardiomyopathy, dog.

67
Q
A

Dilated cardiomyopathy, dog.

both the left and right ventricles will be enlarged

68
Q
A

Cat, HCM, TAMU

Hyper-trophic cardiomyopathy

younger -middle aged cats

hypertrophy of the left ventricule, so the left ventricular chamber will decrease in size/volume, because these animals develop left-sided HF,

69
Q
A

Cat, HCM, Noah’s Arkives

cardiomegaely

hypertrophy of the left ventricular, w

70
Q
A

Cat, HCM, Noah’s Arkives

hypertrophy of the left ventricular, which you can see as it is on the right

71
Q
A

Cat HCM. Cardiomocytes exhibit variable degrees of hypertrophy and are often arranged in an interweaving rather than parallel pattern.

72
Q
A

Marked cardiomegaly. The lungs were congested and edematous.

73
Q
A

Heart weight: 38.9 g. Normally it should be no more than 16 g. Note marked enlargement of the left atrium due to congestive left-sided heart failure,

74
Q
A

Thrombus at the bifurcation of the abdominal aorta into
the external iliac arteries (“Saddle thrombus” –> Aorto-iliac thrombosis),

classical example

75
Q

Myocarditis

A

Often the result of an hematogenous infection:

  • Viral- Parvo, FMD(“tiger heart”)
  • Bacterial
  • Parasitic (Protozoan: Toxoplasmosis, sarcocystosis, neosporosis, encephalitozoonosis, trypanosoma cruzi…; Metazoan: Cysticercosis, trichinosis
76
Q
A

Cattle, “black leg”,- can cause lesions in the heart

Etiology: Clostridium chauvoei

77
Q
A

Acute necrotizing and suppurative myocarditis –feedlot heifer,

Histophilus somni- produces a vasculitis that results in thrombosis

78
Q
A

Acute necrotizing and suppurative myocarditis – feedlot heifer, UCVM, OI

Etiology: Histophilus somni- necrotizing myocarditis in cattle

rim of fibrosis around the necrosis

79
Q
A

Heifer, chronic suppurative myocarditis, CHF (H. somni),

80
Q

Parasitic myositis

A

cysticercus is the larval stage of a taenia (Platyhelminth

parasite )tapeworm.

The adult stage is in the intestine of the definite host (humans, dogs, wild carnivores). The larval stage (cysticercus) is in the muscle of the intermediate host (pigs, cattle, moose, reindeer etc.,).

Cysticercosis in humans (including neurocysticercosis) is the result of ingestion of taenia eggs, not from ingestion of cysticerci. Ingestion of cysticerci by consumption of raw or incompletely cooked pork completes the cycle: formation of the tapeworm in the intestine.

81
Q
A

Pig –Heart & Skeletal muscle,

Cysticercus cellulosae (Taenia solium of humans) Dr. King`s Show & Tell

82
Q
A

Pig –Heart & Skeletal muscle,

Cysticercus cellulosae (Taenia solium of humans) Dr. King`s Show & Tell

83
Q

Cardiac Neoplasia

A

• Primary

Rhabdomyoma

Rhabdomyosarcoma

Schwanomma

Hemangiosarcoma

Heart base tumors (usually aortic body tumors [chemodectoma] – less often tumors arising from ectopic thyroid or parathyroid tissue)

  • Secondary
  • Metastatic tumors, including LSA –specially cattle.
84
Q
A

Atrial HAS, dog.

85
Q
A

HSA, dog, TAMU

86
Q
A

Atrial HSA, Dog

87
Q
A

Chemodectoma (heart base tumor), dog

88
Q
A

7y-old Holstein cow, enzootic leukosis

89
Q
A

7y-old Holstein cow, enzootic leukosis

90
Q
A

7y-old Holstein cow, enzootic leukosis

91
Q
A

2 y-old Sheltie

92
Q
A

Major Arterial Diseases

93
Q
A

Multiple cutaneous infarcts, Pig –”diamond skin disease”

Etiology: Erysipelothrix rhusiopathiae

94
Q
A

Idiopathic necrotizing polyarteritis, “beagle pain syndrome”

95
Q

What gives arthritis?

A
  1. Etiology: Erysipelothrix rhusiopathiae
  2. Idiopathic necrotizing polyarteritis, “beagle pain syndrome”
96
Q

What gives fibrinoid necrosis?

A
  1. Fibrinoid necrotizing arteritis
  2. Edema disease (enterotoxemic colibacillosis) in pigs.
97
Q
A

Fibrinoid necrotizing arteritis – swine.
Left: “Mulberry heart disease” Bottom: Gastric submucosal blood vesselsedema disease

98
Q
A

Edema disease (enterotoxemic colibacillosis) in pigs.

Bacterial enterotoxin (verotoxin) that causes endothelial cell injury in arterioles resulting in fluid loss and edema. Affected animals may exhibit focal bilaterally symmetric encephalomalacia (Cerebrospinal angiopathy of swine).

99
Q

Arteriosclerosis

A

Arteriosclerosis (“hardening of the arteries”) is a generic term applied to the thickening and loss of elasticity of arterial walls. Atherosclerosis is the most important pattern of arteriosclerosis and is characterized by the presence of atheromas (or atheromatous (fibrofatty) plaques) within the intima and media. These plaques contain cholesterol and other lipids.

100
Q

Arteriosclerosis diseases

A
  1. Coronary atherosclerosis

2.

101
Q
A

Coronary atherosclerosis, dog, Texas A&M Cause: Hypothyroidism

102
Q
A

Dog, coronary atherosclerosis

103
Q
A

Dog, coronary atherosclerosis,

104
Q
A

Dog, coronary atherosclerosis

105
Q
A

Coronary atherosclerosis,

106
Q
A
107
Q
A

Arterial mineralization (arteriosclerosis), cow – Johne’s disease

108
Q

Arterial rupture

A

Commonly the result of physical trauma.

Spontaneous ruptures are rare.

Fatal rupture of the uterine artery during parturition occurs occasionally in aged mares with low serum copper levels.

Mycotic vasculitis can lead to rupture of the internal carotid artery in horses with guttural pouch mycosis

Rupture of the aorta in horses is well-known but rare and may occur in periods of excitement and physical activity, such as racing, or in stallions during breeding (thought to be secondary to ↑ intra-aortic pressure).

109
Q
A

Dissecting aneurysms are also reported in the coronary and renal arteries of young male racing greyhounds – can lead to fatal arterial rupture

Dissecting aneurysm, pig with Copper deficiency

110
Q

If you are looking at a cross section of the heart, about how big should the right ventricular wall be compared to the left?

A

Right venticular free wall should be 1/3 of the thickness of the left

111
Q
A

Dissecting aneurysm, pig with Copper deficiency

112
Q

Virchow triad

A

Damage to the epithelium, can cause a thrombosis

113
Q
A

Coagulation cascade

fibrin- helps to tie the platelets there- secondary platelet plug

normal to seal a blood vessel that is injured

114
Q
A
115
Q
A

Seen in dogs with severe renal glomerular disease —>protein loosing nephropathy—>Significant loss of Antithrombin III, a major inhibitor of thrombin

Pulmonary thrombosis, dog

Other causes of pulmonary thrombosis- heartworms, DIC

116
Q
A

Strongylosis – colon, horse, Cornell files

can cause thrombosis in the cranial mesenteric artery

small black dots= small stronguli

117
Q
A

Colonic edema – small strongyles (cyathostomes) encysted in the mucosa,
Horse, UCVM-OI.

118
Q
A

Strongylus vulgaris, adults within the colonic lumen, horse, Cornell files

119
Q
A

typical lesion of verminous arthritis

right picture- cranial mesenteric artery

Inflammatory response- eosinophilic, maybe granulatamus

chronic response

120
Q
A

Histo: Verminous arteritis, (Strongylus vulgaris) cranial mesenteric artery,

121
Q
A

Saddle thrombosis, cat with HCM

Associated with hypertrophic cardio myopathy

Pathology II (20 decks)

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