Cardiopathology Lecture 2 Flashcards by Jen McGann

List the layers of the heart from outer to inner

Fibrous pericardium
Parietal pericardium
Parietal cavity
Visceral layer of pericardium (epicardium)
Myocardium
Endocardium

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What is pericardial effusion

Build of up fluid in pericardial sac

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What is cardiac tamponade? What is happening to heart

Result from pericardial effusion—> increase presssure on the heart, reduced ventricular filling, backflow of blood—> right and left heart failure and ultimately cardiogenic shock

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What kind of shock is cardiac tamponade

Cardiogeneic shock

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What are the two types of pericardial effusion

Hydropericardium
Hemopericardium

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What is hydropericardium and what causes it

Fluid accumulation in pericardial sac
1. Increased hydrostatic pressure (CHF)
2. Decreased oncotic pressure (hypoproteinemia)
3. Lymphatic obstruction (heart base mass)
4. Increased vascular permeability (pericarditis)

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What is hemopericardium and what can cause it

Bleeding into pericardial sac
1. Cardiac hemangiosarcoma
2. Trauma: rupture of atria, aorta, or pulmonary artery

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What are some causes pericarditis

Bacterial infection, traumatic reticulopericarditis (hardware dz), idiopathic

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What are some causes of epicardial hemorrhage

Anoxia, sepsis, endotoxemia, DIC, coagulopathy, trauma, electrocution

Can be agonal change (at death increase BP-hemorrhage)

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What does serous atrophied fat on the heart look like

Fat is gelatinous and clear to serous, lymphatics may be prominent

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What are some causes of serous atrophy of fat on the heart

Chronic prolonged negative energy balance- emactiation

Ex: cancer patients

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what is wrong with heart

Serous atrophy of fat

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What is traumatic reticulopericarditis/ hardware disease

Migration of metal object from reticulum directly puncturing pericardial sac

Direct introduction of bacteria from gut

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What does the heart look like in acute traumatic reticulopericarditis/ hardware diseae

Fibrinosuppurative pericarditis
“Bread and butter” appearance

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What cell type is most common with bacterial infections

Neutrophils

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What is wrong with heart

fibrinosuppurative pericarditis

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What does chronic reticulopericarditis/ hardware disease look like

Constrictive pericarditis, fibrosis of epicardium to pericardium, reduced contraction of ventricles

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Selenium and Vitamin E are key components in protecting cells from ___

Oxidative damage

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Activity and high oxygen demand leave myocardial cells sensitivity to ___

Oxidative damage

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Selenium and vitamin E deficiencies lead to _____

Myocardial degeneration and necrosis

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What age group are nutritional deficiencies associated with myocardial disease seen in

Young animals

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Patient has selenium and vitamin E deficiencies- what did it do to heart/what disease? What species is it common in

White muscle disease- necrosis and mineralization
Species: sheep’s and cows

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What is wrong with this heart? What caused it? What species is it common in

Mulberry heart disease due to selenium and vitamin
E deficiencies

Species: pig

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What important role does copper serve with the heart

Promotes cross linking of collagen in vessels

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What can copper deficiency lead to

Weakened vascular integrity, predisposing to vascular aneurysmal dilations or tears

What are some ways in which toxins damage the heart

Depress myocardial function, directly injury cardiac cells- degeneration and necrosis, hypersensitivity reactions

What species do ionospheres, coccidiostats, monesin and lasalocid cause toxicity in and what is the result

Causes myocardial degeneration and necrosis in horses

What toxicities are associated with anthracycline (doxorubicin, adriamycin)? And what are the drugs used for

Uses: chemo drug to tx lymphosarcoma in dogs Causes acute myocardial necrosis through oxidative damage, cytokine release, and inhibition of protein synthesis

What toxicities is gossypol associated with and in what species

Swine>goats>ruminants and horses fed cottonseed products Causes myocardial necrosis and degeneration

What toxicities can occur due to plants with excess vitamin D and calcinogenic plants

Epidcardial deposits of minerals- necrosis and mineralization due to shoving Ca2+ into heart

How can uremia be toxic to the heart

Deposit of urate crystals following acute or repeated episodes of uremia from chronic renal disease that cause ulcerative lesions that are resolved with fibrosis and mineralization

What are some downstream effects of infectious and inflammatory cardiovascular disease

Infarcts, ischemia, hypertension, cor pulmonale (pulmonary vascular disease that leads to right heart enlargement)

What are some gross lesions associated with infectious and inflammatory cardiovascular disease

1. Hemorrhage- petechiae and ecchymosis on epidcardium and endocardium of LV 2. Areas of tan discoloration (necrosis, inflammation, or fibrosis) 3. Roughened or irregular areas (fibrosis, inflammation) 4. Irregularly thickened “vegetative” valves

What are 3 important inflammatory routes to heart

1. Hematogenous or embolic dissemination/septicemia (most common) 2. Direct extension from pleural or mediastinal infections 3. Foreign body penetration or trauma

what is wrong here

Endocardial hemorrhage secondary to acute bacterial septicemia

What are some outcomes of infection, inflammation, +/- necrosis of myocardium

1. Complete resolution 2. Poor myocardial regeneration capacity 3. Granulation tissue—> scarring (fibrosis) +/-mineralization 4. Progressive myocardial damage- DCM

What cell type is dominant in pyogenic bacteria myocarditis lesions

Suppurative- neutrophils

What cell type is dominant in viral infections (WNV) and immune mediated

Lymphocytic

What histo changes are associated with canine parvovirus, foot and mouth disease

Necrotizing

What cell type is associated with idiopathic or parasitic myocarditis lesions

Eosinophilic

What disease are know to manifest as dilation and cause DCM

1. Taurine deficiency in cats 2. Cobalt toxicity 3. Myocarditis 4. Doxorubicin

DCM is an important cause of ___ in dogs

CHF

What species/breeds and age tend to be affected in DCM

Young to middle aged giant and large breed dogs

What is the boxer specific DCM

Arrhythmogenic right ventricular cardiomyopathy

What cell type/ myocarditis lesion is this and what diseases would it be affiliated with

Eosinophilic myocarditis- idiopathic or parasitic

What cell type/ myocarditis lesion is this and what diseases are associated with it

Lymphocytic myocarditis- viral infections (WNV) and immune mediated

Based on gross image what is wrong

DCM

What does the gross heart of DCM patients look like

Rounded, can have double apex, all chambers of heart may be dilated, ventricles are flabby and thin

What is wrong

DCM

What is wrong

DCM Left: loss of cardiomyocytes, fat, fibrosis Right: thin and wavy with fibrosis

What are the histological changes seen in DCM

Fibrosis, fat

What species is HCM common in and what age

Young adult-middle aged cats

What are some causes of HCM

Idiopathic or autosomal inheritance in several breeds- especially Maine coons

What species and age is thyrotoxic cardiomyopathy common in

Older cats

What causes thyrotoxic cardiomyopathy

Functional adenomatous hyperplasia or adenoma of thyroid (hyperthyroid)

What is the weight of the heart if hypertrophic and thyrotoxic cardiomyopathy

>20 grams

What is the gross appearance of heart in HCM or thyrotoxic cardiomyopathy

Thickening of left ventricle and interventricular septum LA may be dilated

What does the histology look like in HCM

Myocyte disarray, hypertrophy of myocytes, and fibrosis

___ develops over time with HCM and TCM

CHF

What is a major sequelae of HCM or TCM

Left atrial thrombosis and caudal abdominal aorta thromboembolism in 10-20% (saddle thrombi)

What is wrong

HCM or TCM

what is wrong

HCM or TCM- giant cardiomyocytes and not all going same direction

What is wrong here and what caused it

saddle thrombi caused by HCM or TCM

What is the primary cause of endocarditis

Bacterial

What is the main bacterial agent causing endocarditis in pigs

Erysipelothrix rhusiopathiae

What is the main bacterial agent causing endocarditis in cattle

Trueperella pyogenes

What are the main bacterial agents that can cause endocarditis in many species

Streptococcus, E. Coli, staphylococcus

What is the pathogens is of endocarditis

1. Infection 2. Multiple bouts of bacteremia/sepsis + factors affected virchow ‘s triad 3. Fibrin and bacteria adhere to disrupted valve surface 4. Mass of fibrin, bacteria, inflammatory cells, and granulation tissue grow +/- portions of mass dislodge 5. Septic emboli in distant sites causing infarcts and new abscess formation 6. Valve dysfunction and or septic shock 7. Death

What is wrong

Endocarditis

What is wrong

endocarditis

Grossly what does endocarditis look like

Friable grey/black/tan masses adhered to the surface of valves (vegetative), margins of valves are rough and irregular (eroded and necrotic)

Where is the most common site of endocarditis

Mitral valve then aortic valve (left side)

In cattle where is the most common site for endocarditis

Tricuspid valve

What is endocardiosis

Myxomatous valvular degeneration, valvular insufficiency

What age and breeds tend to get endocardiosis

Middle to old age toy to medium sized dogs

What is the most common cause of CHF in old dogs

Endocardiosis

What is the most common cause of new murmur in older dogs

Endocardiosis

What is wrong

Endocardiosis

What is wrong

endocardiosis

What valve is endocardiosis most common in

Mitral valve

What are some associated lesions/sequelae of endocardiosis

1. Atrial dilation and rupture 2. Jet lesions- endocardial fibrosis caused by turbulence- white tissue above valves 3.rupture of chordae tendineae

What is wrong here

endocardiosis

What are group is feline endomyocarditis/ endocardial fibrosis most common in

Young cats <4yrs

When does feline endomyocarditis/ endocardial fibrosis most commonly occur

After stressful events

What happens in feline endomyocarditis/ endocardial fibrosis

Inflammation of left ventricular outflow tract

What do cats with feline endomyocarditis/ endocardial fibrosis typically present with

Interstitial pneumonia

What does the gross heart look like in cats with feline endomyocarditis/ endocardial fibrosis

Nothing or enlarged heart with white to grey discoloration of left ventricular endocardium and aortic outflow tract

What does histology look like in cat with feline endomyocarditis/ endocardial fibrosis. Acute and chronic

Acute: mixed inflammation in endocardium and adjacent myocardium Chronic: marked fibroplasia and/or granulation tissue

What is wrong here

feline endomyocarditis/ endocardial fibrosis

Cardiopathology Lecture 2 Flashcards

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