Endocarditis, Myocarditis / Cardiac Patho / Test 2/2 Flashcards Preview

CVPR 312 Cardiac Pathophysiology > Endocarditis, Myocarditis / Cardiac Patho / Test 2/2 > Flashcards

Flashcards in Endocarditis, Myocarditis / Cardiac Patho / Test 2/2 Deck (39):
1

Infective endocarditis is caused by ?

Microbial infection of the lining of the heart.

2

Characteristic lesions of Infective endocarditis?

Vegetation (valves)

3

Carditis that Evolves over weeks or months ?

(SBE) Sub acute Bacterial Endocaditis

4

Carditis that has a rapid onset of days to weeks ?

(ABE) Acute Bacterial Endocarditis

5

Susceptible hosts for Infective Endocarditis ?

Elderly
Children with CHD repairs
Mitral Prolapse
IV drug abuse
Patients undergoing CPB
Nosocomial

6

Nosocomial

(Hospital Aquired Infection)

7

Infective Endocarditis Etiologic organisms ?

Streptococci
Staphylococci

8

With Non-Infective Endocarditis what can occur following some form of endothelial damage?

Platelet deposition on valves

9

What can develop on valve in a variety of clinical conditions, specifically non-infective endocarditis.

Sterile thrombotic lesions

10

Myocarditis is an inflammatory disease of cardiac muscle

It can be:

&
May be:

Acute
Sub-acute
Chronic


Focal or diffuse

11

Myocarditis may be caused by infectious organisms, such as viruses, bacteria, fungi, protozoa, or helminths, or by a toxin, such as cocaine
Myocarditis can also be associated with systemic illnesses such as?

- collagen-vascular,
- autoimmune diseases, &
- granulomatous,

12

Non-Infectious causes for Myocarditis ?

Cardiotoxins
Hypersensitivity Reactions
Systemic Disorders

13

The true incidence of myocarditis is unknown because the majority of cases are asymptomatic.
Involvement of the myocardium has been reported in
__ to __ percent of patients with acute viral infections
Autopsy studies have revealed varying estimates of the incidence of myocarditis. A five percent prevalence of active myocarditis was reported in a high-risk group of 186 sudden, unexpected medical deaths in children

1 to 5%

14

Certain groups appear to be at increased risk of virus-induced myocarditis, and the course may be hyperacute. Name 4 groups at risk?

Young Males
Pregnant women
Children (particularly neonates)
Immunocompromised patients

15

What contributes to myocyte damage and necrosis?

-Direct viral-induced myocyte damage and
-Post-viral immune inflammatory reactions

16

Inflammatory lesions and the necrotic process may persist for months, although the viruses only replicate in the heart for at most ?

2 -3 weeks after infection

17

Evidence from experimental models has incriminated what contibuting factors to Myocarditis ?

cytokines such as:
- interleukin-1 and TNF,
- oxygen free radicals and
- microvascular changes

18

The clinical presentation of myocarditis is variable
Most cases are ?

Sub-clinical

(disease that is not severe enough to present definite or readily observable symptoms.)

19

Myocarditis may be the cause of unexpected sudden death, presumably due to what?

Ventricular tachycardia or Ventricular fibrillation

20

Most common infectious etiologic agents "VIRAL" causes of Myocarditis in the USA?

- Influenza A & B
-Enteroviruses (most common)
-CMV
-HIV

21

Most common infectious etiologic agents "PARASITIC" causes of Myocarditis?

- Chagas’ disease
- toxoplasmosis
- trichinosis

22

Chagas’ disease AKA

(Trypanosoma cruzi) (most common cause of myocardits in/from S. America)

23

Most common infectious etiologic agents "BACTERIAL" causes of Myocarditis?

- Lyme disease
- Diphtheria

24

How do you get Diphteria?

(injury from toxins of Corynebacterium diphtheriae)

25

Describe the morphology of Myocarditis ?

-Cardiac Dilation
-Flabby myocardium
-Pale
-Focal Petechial Hemorrhages on the visceral pericardium.

26

How would you identify
"ACUTE VIRAL" Myocarditis under the microscope ?

-Edema
-Inflammatory infiltrate of lymphocytes.
-Myocyte degeneration and/or necrosis

27

How would you identify "CHRONIC VIRAL" Myocarditis under the microscope ?

-Inflammation is less
conspicuous
-Myocardial fibrosis

28

How would you identify "PARACITIC" Myocarditis under the microscope ?

Identify the organisms

29

How would you identify "BACTERIAL" Myocarditis under the microscope ?

neutrophilic inflammatory infiltrate

30

toxoplasmosis

Parasitic disease

31

How would you identify Cardiac Transplant Rejection under the microscope ?

-interstitial lymphocytes
-myocyte degeneration
-may resemble viral type

32

How would you identify "GIANT CELL Myocarditis" under the microscope ?

-multinucleated giant cells present
-lymphocytes, macrophages, eosinophils
-foci of necrosis

33

3 Myocarditis Clinical Features
?

-Asymptomatic
-Congestive Failure
-Arrhythmias

34

6 Cardiotoxins to blame for myocarditis?

- Catecholamines
- Anthracyclines
- Cocaine
- Alcohol
- Carbon monoxide poisoning
- Chemo Drugs (Doxorubicin)

35

Most popular Virus to blame for myocarditis?

Coxsackie Virus

36

Lyme disease can cause myocarditsis, what is the name of the organism responsible ?

Borrelia Burgdorferi

37

Chagas' Disease is a Protozoal infection that originated from South America. What is the name of the organism responsible fo this disease?

American trypanosomiasis

38

6 Systemic disorders that can cause myocarditis?

- Collagen-Vascular diseases
- Sarcoidosis: Granulation tissue
- Kawasaki Disease
- Hypereasinophelia
- LUPUS
- Scleroderma: Excess collagen

39

Name the layers of the heart in order, starting from inside the heart?

EM VP PC PP FP

Endocardium
Myocardium
Visceral Pericardium
Pericardial Cavity
Parietal Pericardium