Pathology Flashcards
What is cardiomyopathy?
Any disease of the cardiac muscle that result in some change in heart size
What are the three types?
Dilated , thickened, restrictive
What occurs in dilated?
Heart is 2,3x larger but weighs the same, with no histological differences
What can cause dilated cardiomyopathy?
50% is genetic but also toxins such as alcohol, or iatrogenic due to certain chemotherapy
Effects of dilated cardiomyopathy
Poor exercise tolerance, SOB, fainting, leg swelling, palpitations
What occurs in thickened cardiomyopathy
Big thickened walls , bulging interventricular septum, aortic outflow obstruction, diastolic dysfunction, but strong systolic, abnormal histology disorganised swirls in the myofibrils
Causes of thickened cardiomyopathy
Majority is genetic defects in myosin or tropomyosin, some environmental, sporty athletes etc
Effects of thickened cardiomyopathy
Sudden death
What occurs in restricted cardiomyopathy
Lack of compliance, diastolic dysfunction as doesn’t fill properly, can look normal
Causes of restrictive cardiomyopathy?
Deposition of something on walls of the heart, e.g. metabolic by product iron, cancer, radiation sarcoidosis amyloidosis
What is amyloidosis
deposition of the protein amyloid which can’t be broken down by the body, this is systemic so occurs in kidneys etc
How to identify amyloid deposition?
Stains congo red, or in polarised light apple green, waxy pink material in normal staining
Arrhythmogenic right ventricular dysplasia
The wall of the right ventricle is replaced with adipose tissue
Effects of ARVD?
Fainting arrhythmias sudden death raised jvp
Causes of ARVD?
Genetic autosomal dominant, but with very low penetrance so very few people with the gene have phenotypic expression
Myocarditis
Inflamation of the myocardium
Infectious Myocarditis causes
Most are viral Coxsackie A and B, Echo Virus
Bacterial limes disease
Infectious Myocarditis effect
Thickened beefy red myocardium, lots of lymphocytes in tissue
Non infectious Myocarditis
Hypersensitivity to infection
Rheumatic fever- myocytes are mistaken by the body for an infectio due to antigens
Drug eosinophilic myocarditis
Rheumatic fever effect
Mitral stenosis- thickening and fusion of the valves
Short thick chord tendinae
Myocardium patchy inflamed sections
Aschoff bodies- areas of granulomas scaring
Causes of pericarditis
Infection- usually viral Echo, pneumonia or TB can occur Idiopathic Uraemic- Kidney failure Post MI Connective tissue disorder
Effect
Uraemic etc sticks layers together restricting and slowly strangling the heart
Cardiac tamponade due to acute inflammation build up of fluid
Endocarditis
Heart lining and valve
Causes of infective endocarditis
If healthy valves has to be a very virulent organism, IV drug abuse septicaemia
If pre existing fault e.g surgery rheumatic fever, less virulent can cause infection
