Flashcards in Myocardial Pathology Deck (18)
What are the three forms of infectious Myocarditis?
What usually causes fungal myocarditis?
chemotherapy and steroids which weaken the immune system.
T or F Rheumatic fever is usually associated with organ-specific autoimmune diseases?
It is usually associated with systemic autoimmune diseases.
What is the most common primary tumor of the heart in teens and adults? What about in infancy and childhood?
adults- Cardiac Myxoma (benign)
Infants/children- Rhabdomyoma (benign- also its made of skeletal muscle cells)
What is the most common location of a cardiac myxoma?
What are complications of a cardiac myxoma?
can get stuck in the mitral valve.
also can embolize into systemic circulation and lodge into brain, kidneys, or other organs.
What parts of the heart are usually affected with Rheumatic Fever?
variable involvement of pericardium, myocardium, endocardium
Also can have cardiac vessel predominant inflammation; and vasculitis which can lead to infarcts.
What are the important substances to remember that can cause toxic cardiomyopathy?
-Adriamycin-chemotherapeutic drug (has cumulative dose-dependent toxicity meaning that you have to keep track of how much someone takes of this their whole life)
-Exogenous substances- EtOH (or any metabolite acetaldehyde) or Cobalt which people get from artificial joint protheses. Alot of times EtOH causes nutritional deficiencies also if people drink so much that they don't eat much anymore.
What is the disease where proteins deposit around blood vessels and in organ parenchyma? What is a buzz-word for this disease?
"beta-pleated sheets"- this disease often deposits proteins with this structure.
"granny-apple green" is another one she mentioned. amyloid proteins turn this color under a special Polarized Congo Red Stain (not important).
What is an important disease that is often associated with amyloidoses?
Plasma Cell Neoplasm: Multiple Myeloma
Most cases are sporadic and related to mulitple myeloma.
How do you differentiate between primary and secondary cardiomyopathy?
Primary cardiomyopathy is defined as a heart disease resulting from a primary abnormality in myocardium.
This excludes HYPERTENSION, VALVULAR DISEASE, and MYOCARDIAL INFARCT (also ischemic cardiomyopathy). These are examples of secondary cardiomyopathy (she mentioned that like three times so know that). They all cause hypertrophy and/or dilation.
inflammation of the heart
What are causes of primary restrictive cardiomyopathy? What are causes of secondary restrictive cardiomyopathy?
primary (true cardiomyopathy)- idiopathic, amyloidoses, radiation induced-fibrosis
secondary (not cardiomyopathy)- pericardial constriction.
what are the mechanisms of impairment in dilated, hypertrophic, and restrictive cardiomyopathy?
dilated- impairment of contractility (systolic function)
hypertrophic and restrictive- impairment of compliance (diastolic function)
What is the genetic component of dilated, hypertrophic, and restrictive cardiomyopathy?
dilated- 30-40% genetic
hypertrophic- about 100% genetic
restrictive- 0% pretty much always acquired.
What are microscopic changes associated with dilated and hypertrophic cardiomyopathy?
hypertrophic- myocyte disarray
Where do the three major mutations occur in hypertrophic cardiomyopathy?
-myosin-binding protein C
-beta-myosin heavy chain
-Cardiac Troponin T