SM 146 Myocardial Pathology

Question 1

What parasite cause myocarditis in immunocompromised patients?

Answer 1

Toxoplasmosis

Question 2

What are the subtypes of Restrictive Cardiomyopathy?

Answer 2

Myocardial and Endomyocardial

Question 3

What does acute pericarditis result in?

Answer 3

Depends on the underlying cause, but can result in constrictive heart failure due to impairment of diastolic filling

Question 4

Which cardiomyopathy is a “final common pathway”?

Answer 4

Dilated cardiomyopathy, with causes stemming from excess alcohol, viral illness, pregnancy, and heredity

Question 5

What are causes of acute pericarditis?

Answer 5

Viral infection, immune diseases, acute MI (Dressler’s syndrome)
Drugs/immune related
Physical agents
Granulomatous

Question 6

What is the end result of myocarditis?

Answer 6

Congestive heart failure, and occasionally cardiac death

Question 7

What are cardiomyopathies?

Answer 7

A heterogenous group of diseases with intrinsic myocardial dysfunction as their common feature, may be primary or secondary

Question 8

What is the most common tumor in the heart?

Answer 8

Primary heart tumors are rare, but the most common is Cardiac Myxoma, involving the LA or Mitral Valve

Question 9

How does RCM present?

Answer 9

Right sided heart failure and secondary to systemic disease

Question 10

What parasite can cause myocarditis?

Answer 10

T. cruzi, via Chagas disease, which dilates the heart

Question 11

What causes Myocardial Restrictive Cardiomyopathy?

Answer 11

Infiltrative processes and generalized illness

Question 12

What are the 3 types of primary cardiomyopathies?

Answer 12

Dilated, Hypertrophic, and Restrictive

Question 13

How are the atria and ventricles separated?

Answer 13

Dense fibrous tissue insulates both compartments and forms separate electrically linked syncytia

Question 14

How does HOCM present?

Answer 14

Dyspnea, angina, cardiomegaly, and a crescendo decrescendo systolic murmur

Question 15

Why is hypertrophy of cardiomyocytes potentially bad?

Answer 15

Although it initially increases function, eventually it leads to failure

Question 16

What can cause an immune-related myocarditis?

Answer 16

Cardiac transplantation

Question 17

How does dilated cardiomyopathy present?

Answer 17

Congestive heart failure, fatigue, and embolitic events

Question 18

How do the parietal pericardium and visceral pericardium differ?

Answer 18

Parietal pericardium is an outer fibrous sac made of collagen, and cannot stretch

Visceral pericardium aka epicardium is a serous sac that adheres to the surface of the heart, and contains the arteries, nerves and lymphatics that supply the heart

Cardiac tamponade will rapidly result in the heart being unable to fill since the parietal pericardium does not stretch

Question 19

What can cause myocarditis?

Answer 19

Any microorganism, commonly viral, but also bacterial, fungal, and parasitic

Question 20

What are infiltrative processes?

Answer 20

Amyloidosis, sarcoidosis, hemochromatosis

Question 21

What can an autopsy of dilated cardiomyopathy show?

Answer 21

4 chamber dilation, especially of the ventricles

Question 22

What is a secondary cardiomyopathy?

Answer 22

A cardiomyopathy extrinsic to the myocardium (drug toxicity) or part of a systemic process (amyloidosis)

Question 23

How does Myxoma effect the heart?

Answer 23

Myxomas impair ventricular filling, and cause a diastolic murmur that varies with the patient’s position

Question 24

What causes hypertrophic cardiomyopathy?

Answer 24

Hypertrophy of the ventricular muscle in the absence of hemodynamic load

Question 25

What causes Endomyocardial Restrictive Cardiomyopathy?

Answer 25

Diseases that are limited to the subendocardial myocardium, such as Lofflers eosinophilic endocarditis

Question 26

Mutations in which proteins lead to HOCM?

Answer 26

Mutations in contractile proteins lead to HOCM

Question 27

Which side of the heart does Restrictive Cardiomyopathy effect and why?

Answer 27

Restrictive cardiomyopathy prevents diastolic filling and effects the right side of the heart, leading to right sided heart failure

Question 28

What are the types of secondary cardiomyopathies?

Answer 28

Toxic, metabolic, storage, infiltrative, and neuromuscular

Question 29

Which portion of the heart is most enlarged in HOCM?

Answer 29

The IV Septum, which obstructs left ventricular outflow

Question 30

What is a primary cardiomyopathy?

Answer 30

A cardiomyopathy that is intrinsic to the myocardium and may be of unknown cause