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Systemic Pathology I > Pathology of the Cardiovascular System Pt 1 > Flashcards

Pathology of the Cardiovascular System Pt 1 Flashcards

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1
Q

What is the function of the cardiovascular system?

A
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2
Q

What are the compensatory mechanisms that are available to mantain cardiac function? 4

A

◦ Heart has ability to increase in size if there is increase in requirements.
◦ Whenever there is any type of problem affecting the cardiac system, there is compensatory mechanisms.

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3
Q

Label the parts of the heart indicated in this image:

A

A.) Pulmonary Valve
B.) Tricuspid Valve
C.) Aortic Valve
D.) Mitral Valve

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4
Q

Which side i the left in this image

A

Left Ventricle is 5x size of right since it does more work/ more powerful

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5
Q

What does the right side do to the blood?

A
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6
Q

What are characteristics of cardiac muscle?

A

Striations with central nuclei, Z bands

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7
Q

What issues can affect cardiomyocytes?

A
  • Fatty degeneration (can cause atrophy)
  • Lipofuscinosis (presence of lipofuscin granules that can be found close to nuclei) Sometimes you can see it in heart of animal that is cachectic. (Wear and tear pigment)
  • Vacuolar degeneration
  • Fatty infiltration
  • Myocytolysis (partial loss of contractile proteins, sarcomeres)
  • Neoplasia
  • Necrosis: Cell death
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8
Q

Which of the issues with cardiomyocytes are reversible?

A
  • Fatty degeneration (can cause atrophy) -> reversible
  • Vacuolar degeneration -> reversible
  • Fatty infiltration -> reversible
  • Myocytolysis (partial loss of contractile proteins, sarcomeres)-> Reversible
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9
Q

Which of the issues with cardiomyocytes are irreversible?

A
  • Lipofuscinosis (presence of lipofuscin granules that can be found close to nuclei)-> irreversible will happen to everyone. Sometimes you can see it in heart of animal that is cachectic. (Wear and tear pigment)
  • Neoplasia -irreversible
  • Necrosis: Cell death -> irreversible
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10
Q

What occurs if there is preservation of the basement membrane occurs with cardiomyocytes? How does it differ to skeletal muscle?

A

Preservation of basement membrane in skeletal muscle it can regenerate.
If this happens in cardiac tissue, fibroblasts deposition and colleges deposition/ scar will replace instead. There is some degree of regeneration, but for practical purposes, no cardiac Myocyte regeneration.
Heart damage = Loss of Cardiac myocytes -> Scar

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11
Q

TRUE or FALSE: An animal with history of a heart attack is less susceptible to heart failuure since they have a scar in cardiac tissue.

A

FALSE
* Someone who has had a heart attack is more susceptible for heart failure since they have scar in cardiac tissue from the heart attack (cardiac myocyte damage)

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12
Q

What is the ratio of thickness of Right ventricle to left ventricle?

A

L ventricle is larger than right ventricle.
Thickness is 1: 3-4 in regards to right and left ventricle.

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13
Q

In large animal medicine, what is the assumption if the ventricular wall ratio is 1:3 or 1:4 ( R : L)?

A

The assumption is that there was not a cardiac issue

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14
Q

What is the pathway of blood from the placenta to the umbilical arteries?

A

Oxygenated blood is carried to fetus from umbilical vein/ The deoxygenated blood returns through the 2 umbilical arteries.

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15
Q

What can happen if the bypasses that are open in fetal development remain open instead of closing?

A

If these bypasses that are specific to fetus remain open instead of closing, it is considered a congenital abnormality.
Fetal liver is small and is not being utilized for toxin filtration, so level of blood going to the liver is less than it is in adult animals.
If they still have a patent ductus arteriosis you can have encephalitis.
Lungs in fetus non functional, so there is communication between atria, so oxygenated blood coming from caudal vena cava goes right to the left side. Only a small amount of blood will be mixed with deoxygenated blood.
Foremen ovale

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16
Q

What is seen in this image? What is the cause?

A

Common change that is visible.
* Gelatinous yellow appearance of coronary groove.
* Fat of coronary groove is abnormal looking
* This indicates an animal in poor nutritional state, due to dental, illness, GI issues, starvation.
* Indicates very little fat deposition.
◦ Areas of fat mobilization

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17
Q

What is seen in this image? What is the cause? When is a typical time this is seen?

A

Petechia, ecchymosis
Terminal hypoxia can result in petechia,
* Petechia noted on coronary groove.
* This is indicates that animal was anoxic, hypoxic, or sepsis
* This can be seen in cows after slaughter, and normally did not have this before going into slaughterhouse.
◦ Animals are stunned, and then they are hanged to bleed them after cutting spinal cord, they take some time to die so there is terminal hypoxia.

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18
Q

What is cardiac syncope?

A
  • Cardiac syncope – acute onset of cardiac failure causing collapse and unconsciousness (abnormal heart rhythm, defective heart valves etc.).
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19
Q

What is Congestive heart failure?

A
  • Congestive heart failure (CHF): Develops slowly from gradual loss of cardiac output due to pressure or volume overload or myocardial injury.
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20
Q

Which is slower to develop: Congestive heart failure or cardiac syncope?

A

Congestive heart failure

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21
Q

What is wrong with this bull? What is this a manifestation of? What is the pathogenesis?

A

Brisket edema -> manifestation of chronic cardiac failure.
* Swelling in area of brisket, presence in cattle with high altitude disease/ high mountain disease.
* Pathogenesis: High altitude air is very light/ very little o2, to compensate, heart has to work harder and pump more blood into lungs to be oxygenated and causes pulmonary hypertension, which leads to congestion/ heart failure ( from increased vascular resistance)

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22
Q

What animals may have pulmonary hypertension ? What extracardiac lesion can be seen with these patients with chronic congestion?

A
  • Pulmonary hypertension: animals that have recovered from severe bouts of pneumonia. Areas of the lung necroses and was replaced by connective tissue. This places pressure on the vasculature and causes congestion/ hypertension. Increased hydrostatic pressure, right side will compensate, but when myocardium increases to a certain size their is ischemic injury. Liver is right there, if there is stagnation of blood in caudal vena cava, this blood will cause chronic hepatic congestion, and this will cause** nutmeg liver. **
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23
Q

What is seen in this image?

A

Heifer, idiopathic pulmonary hypertension leading to CHF

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24
Q

How can pulmonary fibrosis lead to right sided heart failure? What can be seen in these animals?

A
  • Pulmonary Fibrosis -> Pulmonary hypertension -> Chronic hepatic Congestion -> Right Sided Heart Failure.
  • Seen: Pulmonary edema, ascites
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25
True or False: Left sided heart failure is characterized by acites
FALSE: Right sided heart failure is characterized by ascites.
26
How does congestion cause ascites? What is another differential for ascites?
Congestion backs up to the veins -> causing congestion, and ascites DDX: Hypoprotienemia is another example)
27
What are we looking for in a post mortem exam of the heart?
* Comparison of Left and right cardiac wall to make sure ratio is correct. * Look at valves, make sure they are normal * Make sure that there is no communications between the atria or ventricles * Size of aorta/ pulmonary artery -> make sure there is no narrowing * Looking for gross lesions like petechiae, ect.
28
Is this valve normal or abnormal?
Normal ( thin)
29
Is this valve normal or abnormal?
Normal (thin)
30
What must you look for when opening the heart and use caution not to damage when opening?
Cordae tendinae
31
What are you looking for with the cordae tendinae? When may this issue occur?
Need to look for cordae tendonare rupture. Can happen to people who have car accidents and they hit steering wheel and impact can cause rupture. You can see it in animals with trauma, endocarditis, ect.
32
What are the congenital abnormalities associated with the heart?
33
Will congenital abnormalities present at birth? What may indicate them to us?
May take time for these to present. We need to be looking at this when looking at small animals. * cyanosis, poor condition, poor growth, ect are all examples of things to look for congenital abnormalities
34
What is seen in this image? What is important to note about it?
Valvular hematocyst -> usually don't cause symptoms. Regress with age.
35
How does cardiomyocytes receive nutrients after birth? What about with fetal life? What can be found at these locations where valves were?
No blood vessels within valves after birth. They get nutrients/ oxygen from adjacent osmosis. In fetal life, their are vessels that send nutrients to the heart. This is where these hemacysts grow
36
What is the tetrology of fallot?
Tetralogy of Fallot: VSD, Overriding aorta (dextroposition of the aorta), pulmonic stenosis, -> right ventricle hypertrophy.
37
What breeds are predisposed to having tetrology of fallot?
Inherited in Keeshonds, also common in English bulldogs
38
What is the most common cardiac abnormalities in human babies?
tetrology of fallot Known as "blue babies"
39
What is occuring in this picture (circled in green) what is this likely a consequence of?
40
What is seen in this image? What is indicated by the blue arrows? What is indicated by the green arrows? What is the resulting compensatory mechanism?
41
What is occuring in this image? What is the outcome of animals with this issue?
This is tricuspid dysplasia (Valvular insufficiency). This is not compatible with life, most animals are born dead.
42
What is the outcome usually of tricuspid dysplasia? What animals are usually affected? Is this common?
Tricuspid dysplasia usually not compatible with life -> born dead -> more in cats, but can see in all other animals. Rare overall
43
What is a ventricular septal defect?
Opening between ventricles. Depending on size of defect will cause the severity of signs.
44
What is the issue with a ventricular septal defect?
-> left ventricle is more powerful, blood moves from left to right through the defect, but then you scan see it with exercise that they have intolerance. They also will have ventricular overload on the right side since their is increased blood volume/ pressure. This will cause right ventricular hypertrophy and then congestive heart failure. You can see cyanosis in the animals when the blood moves from right to left due ton the hypertrophy.
45
What is seen in this image?
Ventricular Septal Defect
46
You have a calf who has stunted growth, a heart murmur on ascultation, and a valvular hematocyst. The calf developed clinical signs of heart failure and exercise intolerance, and decided to pursue humane euthanasia. Durring the necropsy you find the following: (see image) What was this calves problem
Ventricular septal defect
47
What is seen in this image encircled in blue?
* You can see whitish connective tissue of the endocardium . This is endocardial fibrosis, causing “jet lesions” from turbulences
48
What is seen in this image encircled in blue?
“Jet lesions” (endocardial fibrosis) within the right ventricular free wall
49
What is a PDA? What is the issue/ where is the defect located?
* PDA -> Patent Ductus Arterosis. Communication of Pulmonary artery with the aorta.
50
What is the issue in these images?
51
TRUE or FALSE: Patent ductus arteriosis is one of the most common defects recorded in all species.
TRUE
52
What are the clinical signs and pathogenesis of PDA?
* PDA -> Communication of Pulmonary artery with the aorta. * Supposed to close and become ligamentous arteriosus within the 1st 2 weeks of life. * Sometimes doesnt happen -> Can be subclinical anomaly, especially if it is very small. If it is big like in this image -> this can produce clinical problems * L side of heart more powerful. Blood goes from aorta -> pulmonary artery * Over time it can cause pressure overload on the right side of the heart, and into the lungs. This causes pulmonary hypertension. ◦ Eventually can lead to right sided congestive heart failure.
53
Is this heart in a normal position?
Yes
54
What is the condition represented in this image?
Persistent right aortic arch (PRAA).
55
What are the complications associated with PRAA?
PRAA- > the esophagus is constricted but the aorta, pulmonary artery, and the ligament arteriosum. This causes esophageal constriction. Manifestation is megaesophagus. May not present this right away since they are drinking milk. Once they start eating regular food that’s when you start to see dilation of the esophagus. Many die from regurgitation caused aspiration pneumonia. Also weight loss and failure to thrive due to poor nutritional status -> dysphagia and Megaesophagus
56
Waht is seen in this image?
PRAA
57
What is seen in this image?
Hemopericardium
58
What is seen in this image?
Ruptured hemopericardium
59
What is a hemopericardium?
Blood in the pericardial sac
60
Is this common? What is a common consequence of a hemopericardium? What is a common cause?
Common Cause: Hemangiosacoma -> cysts within the aorta/ atrium. Consequence: Cardiac tamponade and acute heart failure since heart cannot contract/ fill appropriately. This is relatively common.
61
What is a ususal note made by owners about patient history that leads you to beleive they died of pericardial effusion?
Dog was doing fine and then all of a sudden collapsed and died.
62
Why does an animal with hypoproteinemia with pericardial effusion not die when an animal with hemopericardium will?
This is becasue the pericardial sac has time to adjust to the filling pericardial sac in cases of hypoprotienemia. With hemopericardiums this is an acute issue and happens so quickly the pericardial sac does not have time to adapt
63
What is seen in this image? What is a likely cause in a pig?
64
What are other lesions associated with the cause of mulberry heart disease in pigs? What is the cause? What is the normal history for these patients? What is seen when post mortem occurs? What does the heart look like? What animals does this mostly happen to?
65
What is seen in this image? What indicates degeneration/ necrosis of myocardocytes?
Fibrin strands in fluid are indicitive of myocardial degeneration and necrosis.
66
What is seen in this image? Who are these lesions seen in mostly? How would you describe it? What is the causative agent?
* Fibrinous pericarditis -> black leg -> Clostridium Chevoui * Lesions can also be present in heart, may be only site of lesion. * Young cattle typically. * Roughened/ granular heart. * Air bubbles can be seen on surface of heart.
67
What is seen in this image? What is the cause of these lesions? What leads you to believe that?
68
What is hardware disease? What could occur with this condition? What are clincial signs?
* Hardware disease -> cattle cannot discriminate between food and foreign material. They can swallow foreign material ( nails, ect) and end up reticulum (can perforate the pericardium, even the heart and cause myocarditis. Usually very painful, hard breathing, lordosis, ect. Puncturing pericardium will lead to pericardial effusion)
69
What is occuring in this image?
This is from hardwear disease, you can see the fiberous adhesion in the lower right of the image.
70
What should you do first when doing a post mortem on a cow?
* First thing you do when you do a post mortem in a cattle, you feel around near the reticulum to try to find a fibrous adhesion between reticulum and pericardium. This would indicate a foreign body.
71
What is the likely cause of the pathology in this image?
72
What is seen in this image? What is the condition this will cause?
Hardware disease
73
What is the outcome of chronic (constricted) pericarditis in cattle? What can be seen grossly ?
* These animals die of chronic heart failure. * Difficulties with heart contraction * Areas of fibrosis. Areas of attachment between visceral and parietal pericardium.
74
What is likely the cause of the pathology in this image?
75
What are the causes of endocardial mineralization?
* Mineralization in the endocardium, aorta ect * Can be cause by ◦ Excessive intake of vitamin D? ◦ Occurs when their are plants with vitamin D analogs. ◦ You can also see it in animals with Johnnes disease.
76
What is valvular endocardiosis? what animals is this common in? Is there a breed predilection?
* You can also see valvular endocardiosis -> seen in midddle age to old dog. Degeneration of valvular collagen. Any breed can be affected. * King Charles spaniels, daschunds, are particularly susceptible.
77
By age 10, what percent of king charles calvaliers have valvular endocardiosis?
100%
78
What is seen in this image?
79
What is seen in this histological image of this leafelet of tricuspid valve?
80
What is the most common cause of CHF in older dogs?
Valvular endocardiosis
81
What is seen in this lesion of valvular endocardiosis?
Jet lesions
82
What is mural endocarditis?
endocarditis associated with the wall of the heart
83
what is valvular endocarditis?
endocarditis associated with the valves of the heart
84
What is endocarditis usually caused by? What is the pathogenesis ? What is cause of death in these animals?
Complications: valvular insufficiency/ stenosis -> CHF -> death
85
What is seen in this image?
Thrombi -> causes valvular insufficiency since the valves cannot completely close. endocardium is more what from endocardial fibrosis. * dogs always ask of you will see valvular endocardiosis or valvular endocarditis
86
What is seen in this image ( circled in blue)?
Endocarditis in aortic valve
87
What valves are more commonly affected by valvular endocarditis?
* Valves more commonly affected -> right atrioventricular valve and aortic valve.
88
What are the chronic lesions of endocarditis reffered to as?
89
What is seen in this image?
Valvular endocarditis ( vegetative/ verrucous lesions)
90
What is the pathology seen in this image?What does each arrow represent in this histological slide?
Endocardits usually caused by bacteria Yellow arrow -> fibrin Blue arrow -> many inflammatory cells (neutrophils more common. Platelys also found) Black arrow -> bacterial colones
91
What is a cause of sudden death in pigs?
92
What is the likely cause of the pathology on this pig heart?
93
What is seen in this image? It is of a pig, what is the likely causative agent?
94
If you find valvular endocarditis in a pig, as well as septic emboli, where else must you look on post mortem exam?
Kidneys
95
What is seen in this image? What is the ususal cause of this? What are they characterized by?
96
In what animals can you see chronic ulcerative mural endocarditis?
Seen in dogs, rarely in cats, sometimes in other animals. This is valvular endocarditis due to renal failure.
97
Where in the heart would you see chronic ulcerative mural endocarditis? What is it associated with? What other lesions may you see here?
* Seen in left atrium * Associated with Uremia. * Dystrophic calcification * Seen with acute renal failure
98
What is seen in this image? What are 3 examples of where these lesions can be seen?
99
What is seen in these images?
Dirofilariasis, dog (Dirofilaria immitis)
100
Where are heartworm usually found in the heart? What may be the result of infestation?
101
What is the causes of myocardial necrosis and mineralization?
- May be the result of nutritional deficiencies, chemical and plant toxicities, ischemia, metabolic disorders, inherited diseases and physical trauma. - In veterinary medicine is more commonly seen in cases of vitamin E-selenium deficiency (cattle, sheep, pigs) or ionophore toxicity (horses & ruminants: monensin, lasalocid etc. -> antibiotics given to promote feed efficiency and prevent coccidiosis in cattle, sheep & poultry), gossypol toxicity (pigs), uremia (dogs, cats).
102
What animals are affected by gossypol toxicity? What is the resulting damage to these animals?
* Gossypol toxicity (pigs) is from cotton seed meal. Potency can cause cardiomyocyte degeneration and necrosis.
103
What is seen in this image?
White muscle disease( Selenium/ Vit E deficiency)
104
In cows what side of the heart will you see white muscle disease?
Left
105
In sheep what side of the heart will you see white muscle disease?
Right
106
What is the consistency of the heart of a cow with white muscle disease?
Gritty/ Chalky
107
What is seen in this image?
White paint brush strokes
108
What is seen in these images? What kind of stain is this? What is staining dark red? What is the likely cause of this ?
109
What is seen in this image? What is the cause?
Pig, “mulberry heart disease” This is caused by vasculitis.
110
What is seen in this histological slide?
Necrotising vasculitis with eosinophilic areas around the vascularture.
111
What is seen in this image?
Monesin Toxicity, it is very subtle. You can see areas of degeneration/ necrosis.
112
Farmer was using a chemical as a growth promoter and antiparasitic. There was some issues with feed mixing and within 1-2 months all cattle fed the feed had developed congestive heart failure and died/ had to be euthanized. What is the likely chemical that caused this?
monensin toxicity
113
What is a cardiomyopathy?
Structural or functional abnormalities of the myocardium
114
What kind of cardiomyopathies are there?
Primary or Secondary
115
What are the primary cardiomyopathies? What is another term used to indicate them?
116
What are the secondary cardiomyopathies? What is is the classfication based on for these cardiomyopathies?

Systemic Pathology I (23 decks)

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