Cardiovascular Pathology

Question 1

How does systemic disease cause CHF?

Answer 1

Whatever the dz, it increases cardiac workload of an otherwise normal heart –> congestion and edema

Question 2

Describe starling forces and lymphatic system changes relative to edema

Answer 2

• increased capillary hydrostatic pressure
• increased vascular permability
• decreased interstitial oncotic pressure
• decreased lymphatic drainage

Question 3

Two sequela of left heart failure vs right heart failure

Answer 3

LEFT
1. Pumonary congestion
2. Pulmonary edema

RIGHT
1. Hepatic congestion
2. Ascites

Question 4

Nutmeg Liver

Answer 4

chronic, passive congestion of the liver due to RIGHT-sided heart failure

Question 5

How can you tell which sided heart failure this is?

Answer 5

LEFTsided heart failure: diffuse pulmonary edema and congestion:
- The lung is NOT collapsed
- Thickened interlobular septa

pulmonary edema causes thickened interlobular septa b/c of increased pulmonary interstitial edema

Question 6

What are the 3 most common cardiac anomalies of dogs?

Answer 6

• PDA
• PS
• SAS

Question 7

What are the 2 most common cardiac anomalies of cats?

Answer 7

• VSD
• Mitral valve dysplasia (malformation)

Question 8

Congenital Heart Diseases

What are the 5 non-closure anomalies?

Answer 8

1. PDA
2. ASD
3. VSD
4. Patent foramen ovale
5. Tetralogy of fallot

Question 9

ID + sequela

Answer 9

VSD
- left-sided heart failure (LV to RV/directly into pulmonary trunk –> pulmonary edema)

Question 10

ID + sequela

Answer 10

ASD
- LA -> RA -> vena cava -> right-sided heart failure (ascites)

Question 11

Tetraology of Fallot: 4 components and the sequela

Answer 11

1. VSD
2. Overriding Aorta (blood exits into aorta from both RV and LV due to right displacement)
3. Pulmonic stenosis
4. Right ventricular hypertrophy

Sequela = Cyanosis

overriding aorta

Question 12

What caused RV hypertrophy

Answer 12

Pulmonic stenosis

Question 13

What 2 species are most likely to get SAS

Answer 13

Dogs and swine

Question 14

Name/cause of this lesion

Answer 14

Jet lesions of SAS (caused by turbulent flow hitting the aortic wall)

Question 15

What species get congenital valvular hematoma/hematocyst?

Answer 15

Calves; no functional consequences

Question 16

ID + pathogenesis

Answer 16

NORMAL development of 4th aortic arch: Right branch becomes Rsubclavian a., Left branch becomes aortic arch

Vascular Ring Anomaly: Persistent Right 4th Aortic Arch
- German Shepherds
- Right branch fails to regress into Rsubclav.a.
–> entraps esophagus/trachea –> megaesophagus

Question 17

What do white lesions in the myocardium indicate?

Answer 17

necrosis/mineralization; inflammation, neoplasia

Question 18

A primary cause of myocardial hypertropy is __?__ cardiomyopathy and is irreversible.

A secondary cause of myocardial hypertrophy is a(n) __?__ response to a(n) __?__ in workload and is reversible.

Answer 18

A primary cause of myocardial hypertropy is hypertrophic cardiomyopathy and is irreversible.

A secondary cause of myocardial hypertrophy is a(n) compensatory response to a(n) increase in workload and is reversible.

Question 19

Concentric hypertrophy: __?__ walls, normal or smaller lumen

Eccentric hypertrophy: __?__ walls, enlarged lumen

Answer 19

Concentric hypertrophy: Thick walls, normal or smaller lumen

Eccentric hypertrophy: Normal walls, enlarged lumen

Question 20

ID + pathogenesis

Answer 20

Hypertrophic Cardiomyopathy – cats
- thickened LV walls (fails to relax) –> decr. diastole into LV (less volume capacity) –> incr. backflow into LA –> 2º LA dilation –> left-sided congestion

Question 21

ID + pathogenesis

Answer 21

Restrictive Cardiomyopathy – cats

• impaired diastole b/c of diffuse myocardial fibrosis or excessive moderator bands –> stiff myocardium but NORMAL ventricular wall thickness –> can lead to 2º, atrial enlargement (bilateral)

Question 22

ID + pathogenesis

Answer 22

Dilated Cardiomyopathy – dogs
- 1º systolic dysfunction that leads to 2º dilation

Question 23

Dystrophic myocardial mineralization

Answer 23

damage to tissue that causes mineralization, 2º to myocardial necrosis

vs. metastatic which = is multi-focal and 2º to incr. Ca and P levels

Question 24

What species are prone to VitE/selenium deficiency and what is the sequela

Answer 24

Herbivores – myocardial mineralization (VitE deficiency = lack of free-radical scavengers –> necrosis)

Question 25

Brain-heart syndrome

Answer 25

a type of myocardial necrosis in dogs with **brain or SC injury**: injury causes **catecholamine release** increases BP too high, --> overworked heart --> myocardial necrosis

Question 26

What vales are most commonly affect in SA vs LA in **vegetative valvular endocarditis**?

Answer 26

SA: AV valves LA: semi-lunar valves ## Footnote Blackleg, parvo, etc.

Question 27

Most common neoplasia in dogs vs cattle vs brachycephalic dogs

Answer 27

All dogs: hemangiosarcoma (cancer of blood vessels) Cattle: lymphoma Brachycephalic dogs: Chemodectoma (aortic body tumor)

Question 28

Common sites of hemangiosarcoma

Answer 28

Right auricle, spleen, skin

Question 29

Common sites of lymphoma in cattle (BLV)

Answer 29

Heart, LNs, Abomasum Spine, Uterus

Question 30

What virus causes **lymphoma** in cattle and cats?

Answer 30

**Leukemia** Cattle: Bovine Leukemia Virus Cats: Feline Leukemia Virus

Question 31

Where do **chemodectomas** form?

Answer 31

On or around the **base** of the heart (never in the heart muscle itself) - typicaly near aortic arch or carotid aa.

Question 32

4 types of disease of the pericardium

Answer 32

1. Hydropericardium 2. Hemopericardium 3. Fibrinous pericarditis 4. Suppurative pericarditis (hardware dz)

Question 33

Hydropericardium

Answer 33

accumulation of transudate in pericardium by edematous diseases (right-sided HF) --> can lead to cardiac tamponade

Question 34

Cardiac tamponade

Answer 34

When fluid in pericardial sac leads to a pressure **greater** than in the ventricle and therefore **compressess** the heart --> fatal decr. in CO

Question 35

What causes hemopericadium in dogs vs. horses? Consequence?

Answer 35

Dogs: ruptured RA (hemangiosarcoma) Horses: ruptured aorta Consequence = cardiac tamponade

Question 36

What causes an **increase** in epicardial fat?

Answer 36

cachexia, anorexia, starvation --- *chronic negative energy balance*

Question 37

3 main causes of **fibrinous pericarditis** in **pigs**? ## Footnote **Fibrinous = insoluble mesh network (acute inflammation)** Fibrous = collagenous * sturdy (chronic inflammation

Answer 37

*hematogenous spread to the heart --> sepsis* 1. Haemophilus parasuis (Glasser's disease) 2. Streptococcus suis 3. Mycoplasma hyorhinus

Question 38

ID

Answer 38

Traumatic Reticuloperitonitis // **suppurative pericarditis** (hardware dz)

Question 39

Differences in valvular appearance b/w endocardiosis//MMVD and endocarditis

Answer 39

**Endocardiosis**//MMVD = nodular, smooth, glistening **Endocarditis** = fibrin! rough, dull granular

Question 40

Two factors needed for **endocarditis**

Answer 40

- bacteremia - turbulent blood flow

Question 41

Endocardial fibrosis - type of lesion/name

Answer 41

Diffuse lesion of congenital fibroelastosis: fibrin + elaston --> "stretchy" | Recall: fibrosis = collagen / connective tissue

Question 42

Metastatic mineralization

Answer 42

multi-focal and is 2º to increased calcium and phosphorus levels | VitD toxicosis, renal failure, Johne's disease

Question 43

3 factors of thrombosis (Virchow's Triad)

Answer 43

## Footnote hypercoag: glomerular dz (loss of antithrombin III), cushing's abnormal BF: cardiomyopathy endothelial injury: arteritis/vasculitis

Question 44

How do Dirofilaria immitis cause arteritis and pulmonary hypertension?

Answer 44

migration thru pulmonary artery, RA and RV --> endothelial damage to arteries

Question 45

Strongylus vulgaris causes arteritis where in horses? Sequela?

Answer 45

cranial mesenteric artery --> leads to ischemic necrosis and colic

Question 46

Arteriosclerosis | often interchanged with Atherosclerosis

Answer 46

"hardening of the arteries"

Question 47

What causes atherosclerosis

Answer 47

Accumulation of lipid, mø, and fibrous tissue in artery wall

Question 48

ID

Answer 48

Aneurysm: local dilaition of a weakened artery caused by copper deficiency or parasites

Question 49

Portosystemic shunt

Answer 49

when blood bypasses the liver and goes straight into caudal vena cava (aka does not get detoxified!) ## Footnote Example of consequence: Due to bypassing the liver, ammonia from GIT does not get transformed into urea (which gets excreted via kidneys) causing--> *hyperammonemia**

Question 50

Lymphangiectasis: definition + causes

Answer 50

dilation of lymp vessels - congenital anomaly - obstruction of lymph drainage

Question 51

ID + pathogenesis + sequela

Answer 51

**Chylothorax** = accumulation of lymphatic liquid in thorax due to a *leakage* or *rupture* of the thoracic duct. Sequela = pulmonary atelectasis (no more negative pressure in thx --> lungs collapse)