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Pathology II > Test 1- Cardio > Flashcards

Test 1- Cardio Flashcards

1
Q

Normal Cardiac Function

A

• Maintenance of adequate blood flow (cardiac output)

Delivery of Oxygen, nutrients and hormones to

peripheral tissues

Removal of Carbon Dioxide (CO2) and other metabolic waste products

Maintenance of normal thermoregulation and glomerular filtration rate (GFR)urine output

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2
Q

Compensatory mechanisms available to maintain cardiac function

A

Cardiac dilatation (stretching of cardiac muscle –> ↑contractile force –>↑stroke volume –> maintain normal cardiac output)

Myocardial hypertrophy

↑in heart rate

↑in peripheral resistance- helps because more blood goes into the peripery

Redistribution of blood flow

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3
Q
A

Different Types of Injuries:

Some are reversible and some are irreversible; These are all reversible- if we take out the way that these injuries are created, then we can repair them

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4
Q
A

These injuries are all illreversible- Remember, cardiomyocytes CAN NOT UNDERGO REGENERATION!

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5
Q
A

Follow the blood pathway from placenta (umbilical vein) to umbilical arteries.

Note the coloration of the different mixes of fetal blood, depending on where one looks at the system.

bypassing- oxygenated blood- umblicial vein

umblical arteries- non-oxgentated blood back

fetal life- connections between the ventricules and the atrium through the foramen ovale- this should disapear after birth

ductus arterious- bypassing the lungs and the blood will go straight into the aorta because the lungs are not functional- this should close and form the ligamentum arterious

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6
Q
A

Serous atrophy of heart -cow

Common in starving, emanciated animals

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7
Q
A

Epicardial hemorrhage (petechia, ecchymosis), endotoxemia – cow.

Animals that died from septis

This can also be an antomical change at slaughtering.

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8
Q

Cardiac Failure/Decompensation

A

Cardiac syncope – acute onset of cardiac failure causing collapse and unconsciouness(abnormal heart rhythm, defective heart valves etc)

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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9
Q
A

Brisket edema, bull, R- sided CHF

L- sided CHF- pulmonary edema will be the main manifestation- this can lead to R-sided CHF because this will lead to pulmonary hypertension

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10
Q
A

Heifer, idiopathic pulmonary hypertension leading to CHF

fluid in cutaneous tissue

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11
Q
A

Ascites (hydroperitoneum), dog

transudate

What other conditions in addition to CHF that can result in ascites?

  1. Hyperproteinemia- kidney disease, liver disease, protein loosing enteropathy
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12
Q

Post-mortem examination of the heart: what are we looking for?

A

Serous atrophy, coronary groove,

remember to look at the heart while it’s attached to the lungs- also it usually follows the flow of the blood

shape of the valves, aorta, ventricules

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13
Q
A

Tricuspid valve(right AV)

rupture of the chorade tendenae which can produce a prolapse of the valve

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14
Q
A

Left Mitral Valve

greyish discoloration is normal

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15
Q

Congenital anomalies

A
  • Can affect the heart or blood vessels
  • Animals may die in utero or may present clinical signs after birth

• Clinical signs may include exercise intolerance, cyanosis and stunted body growth.

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16
Q
A

Congenital valvular anomalies

Valvular hematocyst, mitral valve

Usually seen in ruminants; blood filled cysts in the valves; these are NOT associated with clinical disease

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17
Q

Tetralogy of Fallot

A

Tetralogy of Fallot: VSD, Overriding aorta (dextroposition of the aorta), pulmonic stenosis,—>right ventricle hypertrophy.

One of the most common cardiac abnormalities in human beings: “blue babies”

Inherited in Keeshonds, also common in English bulldogs

4 things that happen:

  1. Ventricular spetial defiect
  2. Displacement of the aorta
  3. Thickening of wall of the right ventricle
  4. Narrowing of the pulmonary valves

Results in significant disease

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18
Q
A

Dog, right ventricular hypertrophy secondary to pulmonic stenosis

heart is enlarged and has a rounded appearance

Left ventricle on the right

Rounded appearance of the heart was secondary to pulmonic stenosis

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19
Q
A

Blue arrows: aortic valve;

Green arrows: fibrous band. “is among the most frequently encountered anomalies in dogs”. Results in compensatory concentric hypertrophy of the left ventricle and post-stenotic dilation of the aorta. Results in narrowing of the base of the aorta, which leads to L-sided CHF

Common in dogs

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20
Q
A

Tricuspid dysplasia, dorsal view from the atrium. Most common in cats, but it’s rare.

Either born dead or die very quickly.

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21
Q
A

Ventricular septal defect

Dog, VSD, TAMU,
Dr. J. Edwards

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22
Q
A

VSD, calf, UCVM, OI, 2010, view from the right ventricle

valvular hemtaocyst on the left

hole= communication between the left and right ventricle

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23
Q
A

VSD, calf, UCVM, OI, 2010, view from the right ventricle

Jet lesion= the white stripes; trauma to the endocardium; these are individual areas of endocardosis

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24
Q
A

VSD, calf, UCVM, OI, 2010. “Jet lesions” (endocardial fibrosis) within the right ventricular free wall- this tells us that there is abnormal blood flow in that area

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25
VSD, calf, UCVM, OI, 2010. “Jet lesions” (endocardial fibrosis) within the right ventricular free wall
26
Patent Ductus Arteriosus
One of the more common defects – recorded in all species ductus arteriosus- should close and turn into the ligamentum arterious after birth remember the left side of the heart of the heart is more powerful- blood comes from the aorta into the artery- over time, these animals develop pulmonary hypertension
27
Normal
28
Persistent right aortic arch (PRAA). Results in dysphagia(trouble eating) and megaesophagus(constricts the esphagus) . Affected animals often die of aspiration pneumonia.
29
Calf, **_persistent right aortic arch (PRAA)_**. Most common in dogs. German Shepherds, Irish Setters and Great Danes are predisposed. Complications of this vascular anomaly?
30
Hemopericardium
ruptured atrial hemangiosarcoma, dog- This can be a cause of death; this results in cardiac tympany
31
Pericardial diseases
32
Pericardial effusion – “mulberry heart disease” Vit. E/Selium def.- pig- presence of transudate
33
Pig: Myocardial hemorrhagic necrosis, pleural effusion, pulmonary edema. Vitamin E/ Selenium deficiency. fibrin heart looks red and pale in certain areas
34
MDx: Fibrinous pericarditis, Calf, “black leg”- Clostriudium chaveoi fibrin around the heart
35
Fibrinous pericarditis, “black leg”, steer dots= little bubbles with gas
36
Hardware disease, cow, TAMU ingestion of hardware
37
Cow, Hardware disease, Dr. King’s Cornell files
38
Foreign bodies, hardware disease, cow, Cornell files
39
A piece of wire had perforated the cranial wall of the reticulum, OI, UCVM.
40
The piece of wire penetrated both, the reticulum and the adjacent diaphragm resulting in leakage of ingesta into the peritoneum. Fibrin admixed with suppurative exudate was present in the affected area (fibrino-suppurative peritonitis). N08-B9, UCVM
41
Chronic (constricted) pericarditis -Chronic cardiac tamponade, cow thickened; percardial sack- chronic fibrinos pericarditis that lead to cardiac typany and death
42
Endocardial Diseases Degeneration
**_Endocardial mineralization_** Occurs secondary to excessive intake of vitamin D or calcinogenic plants (Cestrum, Trisetum, Solanum spp.) that contain Vitamin D analogs. It may also occur in debilitated cattle with Johne’s disease (fibrosis & mineralization of the endocardium of the left atrium). **_Valvular endocardiosis (myxomatous or mucoid valvular degeneration)_** Age-related disease in middle-age to old dogs (most common in males) characterized by degeneration of valvular collagen. The cause is not known, but a genetically influenced degeneration of connective tissue is suspected. Cavalier King Charles Spaniels are particularly susceptible.
43
Dog, valvular endocardiosis, UCVM, OI present in Cavalier King Charles Spaniel mostly left- AV(mitral) valve is the main one affected Develop Left sided CHF; males are more suceptible
44
Normal mitral valve
45
Valvular endocardiosis: cusp (leaflet) of right atrioventricular (tricuspid) valve, dog nodular type of apperance
46
Dog, TAMU, Valvular endocardiosis, note endocardial fibro- elastosis within the atrium (“jet lesions”).
47
Endocardial Diseases Inflammation Endocarditis (valvular and mural)
**_Endocarditis (valvular and mural)_** _Often the result of bacterial infections_ The pathogenesis of endocarditis is complicated but endothelial injury, blood turbulence and hypercoagulability are often involved. Death is the result of heart failure secondary to valve dysfunction or the effects of bacteremia
48
Dog. Valvular endocarditis and endocardial fibro-elastosis
49
Dog, TAMU, Endocarditis, aortic valve
50
Dog, TAMU, Endocarditis, aortic valve
51
Valvular bacterial endocarditis, cow, right AV valve, H&E lesions= septic thrombi
52
Pig, Etx:Erysipelas, valvular endocarditis,
53
(Verrucous) Valvular endocarditis, aortic valve, pig Etiology: Erysipelothrix rhusiopathiae
54
Dog, ulcerative mural endocarditis, left atrium – uremia, acute renal failure. Uremic Endocarditis- lesion that we will see in dogs with renal failure
55
Uremic (ulcerative) endocarditis, dog
56
Dirofilariasis, dog (Dirofilaria immitis). The parasites are usually found in the pulmonary arteries and right ventricle. Also in the R atrium and venae cavae in heavy infestation. May lead to CHF. Can damage the pulmonary artery
57
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** (gossypol meal is used as a protein source in pigs), **uremia** (dogs, cats).
58
Calf, “white muscle disease”, ;Lesions are “chalky” and have a “gritty” consistency. fat in the coronary groove- normal; areas of white discoloration on the epicardical surface, but there shouldn't be fat there- mineralization **COWS- LEFT SIDE OF THE HEART**
59
Lamb, Nutritional myopathy – “white paint brush strokes”, will mostly be found in the **right** ventricle
60
Calf, 2 days-old, heart, nutritional myopathy – Von Kossa stain. Extensive mineralization of degenerated/ necrotic muscle fibres. whitish discoloration on the left ventricle- white muscle disease very fatal
61
Pig, “mulberry heart disease”- results in myocardial degeneration and necrosis Vit E/ selium deficency mulberry heart- muddled, dark red discoloration mixed with areas of myocardial degeneration, which is pale
62
Cow, monensin(antiboditics used as growth promotors) toxicity small areas of darkish discoloration with some indentation; acute myocardial degeneration and necrosis myocardial injury
63
Cardiomyopathies
Cardiomyopathies (Structural or functional abnormalities of the myocardium). • May be primary or secondary **_Primary (idiopathic):_** • Dilated – cat, dog, hamster, turkey, pig, cow * Hypertrophic –cat, dog, rat, pig * Restrictive -cat **_Secondary (specific heart muscle disease):- Most are secondary_** • Congenital • Nutritional deficiencies (taurine deficiency in cats) • Toxic (e.g. Doxorubicin) • Ischemic • Inflammatory • Endocrine disorders: hyperthyroidism, hypothyroidism, diabetes mellitus * Neoplastic infiltration * Systemic hypertension in cats
64
Primary Cardiomyopathies
Present in a wide range of domestic, laboratory and wild animal species **In veterinary practice are more commonly seen in dogs and cats** _Hypertrophic cardiomyopathy is most common in cats_ Dilated cardiomyopathy is seen in both, dogs and cats - specially males. Larger dog breeds like Doberman pinschers, Portuguese water dogs, Dalmatians, Saint Bernards etc., have an increased susceptibility (familial pattern).
65
Dog, _Dilated cardiomyopathy_ usually in large breed dogs: rounded and enlarged heart heart will be large, mis-shapened, very rounded
66
Dilated cardiomyopathy, dog.
67
Dilated cardiomyopathy, dog. both the left and right ventricles will be enlarged
68
Cat, HCM, TAMU Hyper-trophic cardiomyopathy younger -middle aged cats hypertrophy of the left ventricule, so the left ventricular chamber will decrease in size/volume, because these animals develop left-sided HF,
69
Cat, HCM, Noah’s Arkives cardiomegaely hypertrophy of the left ventricular, w
70
Cat, HCM, Noah’s Arkives hypertrophy of the left ventricular, which you can see as it is on the right
71
Cat HCM. Cardiomocytes exhibit variable degrees of hypertrophy and are often arranged in an _interweaving_ rather than parallel pattern.
72
_Marked cardiomegaly._ The lungs were congested and edematous.
73
Heart weight: 38.9 g. Normally it should be no more than 16 g. Note marked enlargement of the left atrium due to congestive left-sided heart failure,
74
Thrombus at the bifurcation of the abdominal aorta into the external iliac arteries _(“Saddle thrombus_” --\> Aorto-iliac thrombosis), classical example
75
Myocarditis
Often the result of an hematogenous infection: * Viral- Parvo, FMD("tiger heart") * Bacterial * Parasitic (Protozoan: Toxoplasmosis, sarcocystosis, neosporosis, encephalitozoonosis, trypanosoma cruzi...; Metazoan: Cysticercosis, trichinosis
76
Cattle, “black leg”,- can cause lesions in the heart Etiology: Clostridium chauvoei
77
Acute necrotizing and suppurative myocarditis –_feedlot heifer,_ Histophilus somni- produces a vasculitis that results in thrombosis
78
Acute necrotizing and suppurative myocarditis – feedlot heifer, UCVM, OI Etiology: Histophilus somni- necrotizing myocarditis in cattle rim of fibrosis around the necrosis
79
Heifer, chronic suppurative myocarditis, _CHF (H. somni),_
80
Parasitic myositis
cysticercus is the larval stage of a taenia (Platyhelminth parasite )tapeworm. The adult stage is in the intestine of the definite host (humans, dogs, wild carnivores). The larval stage (cysticercus) is in the muscle of the intermediate host (pigs, cattle, moose, reindeer etc.,). Cysticercosis in humans (including neurocysticercosis) is the result of ingestion of taenia eggs, not from ingestion of cysticerci. Ingestion of cysticerci by consumption of raw or incompletely cooked pork completes the cycle: formation of the tapeworm in the intestine.
81
Pig –Heart & Skeletal muscle, Cysticercus cellulosae (Taenia solium of humans) Dr. King`s Show & Tell
82
Pig –Heart & Skeletal muscle, Cysticercus cellulosae (Taenia solium of humans) Dr. King`s Show & Tell
83
Cardiac Neoplasia
• Primary Rhabdomyoma Rhabdomyosarcoma Schwanomma Hemangiosarcoma Heart base tumors (usually aortic body tumors [chemodectoma] – less often tumors arising from ectopic thyroid or parathyroid tissue) * Secondary * Metastatic tumors, including LSA –specially cattle.
84
Atrial HAS, dog.
85
HSA, dog, TAMU
86
Atrial HSA, Dog
87
Chemodectoma (heart base tumor), dog
88
7y-old Holstein cow, enzootic leukosis
89
7y-old Holstein cow, enzootic leukosis
90
7y-old Holstein cow, enzootic leukosis
91
2 y-old Sheltie
92
Major Arterial Diseases
93
Multiple cutaneous infarcts, Pig –”diamond skin disease” Etiology: Erysipelothrix rhusiopathiae
94
Idiopathic necrotizing polyarteritis, “beagle pain syndrome”
95
What gives arthritis?
1. Etiology: Erysipelothrix rhusiopathiae 2. Idiopathic necrotizing polyarteritis, “beagle pain syndrome”
96
What gives fibrinoid necrosis?
1. Fibrinoid necrotizing arteritis 2. Edema disease (enterotoxemic colibacillosis) in pigs.
97
Fibrinoid necrotizing arteritis – swine. Left: “Mulberry heart disease” Bottom: Gastric submucosal blood vesselsedema disease
98
Edema disease (enterotoxemic colibacillosis) in pigs. Bacterial enterotoxin (verotoxin) that causes endothelial cell injury in arterioles resulting in fluid loss and edema. Affected animals may exhibit focal bilaterally symmetric encephalomalacia (``Cerebrospinal angiopathy of swine``).
99
Arteriosclerosis
Arteriosclerosis (“hardening of the arteries”) is a generic term applied to the thickening and loss of elasticity of arterial walls. Atherosclerosis is the most important pattern of arteriosclerosis and is characterized by the presence of atheromas (or atheromatous (fibrofatty) plaques) within the intima and media. These plaques contain cholesterol and other lipids.
100
Arteriosclerosis diseases
1. Coronary atherosclerosis 2.
101
Coronary atherosclerosis, dog, Texas A&M Cause: Hypothyroidism
102
Dog, coronary atherosclerosis
103
Dog, coronary atherosclerosis,
104
Dog, coronary atherosclerosis
105
Coronary atherosclerosis,
106
107
Arterial mineralization (arteriosclerosis), cow – Johne’s disease
108
Arterial rupture
Commonly the result of physical trauma. Spontaneous ruptures are rare. Fatal rupture of the uterine artery during parturition occurs occasionally in aged mares with low serum copper levels. Mycotic vasculitis can lead to rupture of the internal carotid artery in horses with guttural pouch mycosis Rupture of the aorta in horses is well-known but rare and may occur in periods of excitement and physical activity, such as racing, or in stallions during breeding (thought to be secondary to ↑ intra-aortic pressure).
109
Dissecting aneurysms are also reported in the coronary and renal arteries of young male racing greyhounds – can lead to fatal arterial rupture Dissecting aneurysm, pig with Copper deficiency
110
If you are looking at a cross section of the heart, about how big should the right ventricular wall be compared to the left?
Right venticular free wall should be 1/3 of the thickness of the left
111
Dissecting aneurysm, pig with Copper deficiency
112
Virchow triad
Damage to the epithelium, can cause a thrombosis
113
Coagulation cascade fibrin- helps to tie the platelets there- secondary platelet plug normal to seal a blood vessel that is injured
114
115
Seen in dogs with severe renal glomerular disease ---\>protein loosing nephropathy---\>Significant loss of Antithrombin III, a major inhibitor of thrombin Pulmonary thrombosis, dog Other causes of pulmonary thrombosis- heartworms, DIC
116
Strongylosis – colon, horse, Cornell files can cause thrombosis in the cranial mesenteric artery small black dots= small stronguli
117
Colonic edema – small strongyles (cyathostomes) encysted in the mucosa, Horse, UCVM-OI.
118
Strongylus vulgaris, adults within the colonic lumen, horse, Cornell files
119
typical lesion of verminous arthritis right picture- cranial mesenteric artery Inflammatory response- eosinophilic, maybe granulatamus chronic response
120
Histo: Verminous arteritis, (Strongylus vulgaris) cranial mesenteric artery,
121
Saddle thrombosis, cat with HCM Associated with hypertrophic cardio myopathy

Pathology II (20 decks)

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