Path- Cardio 1

untimely's version from 2015-04-12 19:08

HEART: Intro+post mortem changes

Question Answer
what should the ratio of thickness of the walls be in the heart? what can this thickness be contributed to?should be 3":1" of the LV wall:RV wall (thickness is proportional to the pressure of that chamber)
look at slide 5 for a picture of the wall of the heartfrom in to out: trabeculae-->endocardium-->myocardium-->fatty connective tissue and coronary artery and vein--> serous pericarium (visceral layer, epicardium) --> pericardial space--> serous pericardium (parietal layer) --> fibrous pericardium
Long-term compensation to increased work load---> this is through hyper___ (plasia or trophy?)TROPHY (cells get bigger, there are not new cells created)
Normal heart has a 3-to 5-fold reserve capacity, by increasing the heart rate and stroke volume. LONG TERM compensation to inc work load can lead to...dilation and hypertrophy
if there is a sig. change in weight or shape of the heart, what pathological mechanisms should you suspect?dilation and hypertrophy
Pathophysiologic Mechanisms of Cardiovascular Dysfunction--> PUMP FAILURE can be charaterized by what two situations?weak contractility and emptying of chambers, impaired filling of chambers
Pathophysiologic Mechanisms of Cardiovascular Dysfunction--> obstruction to forward blood flow can happen from what 4 problems?valvular stenosis, vascular narrowing, systemic or pulmonary hypertension
Pathophysiologic Mechanisms of Cardiovascular Dysfunction--> Regurgitant blood flow happens when?volume overload of chamber behind failing affected valve
Pathophysiologic Mechanisms of Cardiovascular Dysfunction--> Shunted blood flows from congenital defects...what are two examples of defects which can cause this?septal defects in heart, shunts between blood vessels
Pathophysiologic Mechanisms of Cardiovascular Dysfunction--> Rupture of the heart or a major vessel can lead to what two problems?cardiac tamponade, massive internal hemorrhage
Pathophysiologic Mechanisms of Cardiovascular Dysfunction--> Cardiac conduction disorders (arrhythmias) are a failure of what?failure of synchronized cardiac contraction
Congestive heart failure (CHF) develops slowly from gradual loss of cardiac pumping efficiency associated with---- what two things?(1) pressure or volume overload (2) myocardial damage
where does blood accumulate in congestive heart failure?BEHIND the failing chamber
left congestive heart failure results in congestion where?pulmonary congestion and edema
right congestive heart failure results in congestion where?hepatic congestion
what are the three most common causes for LEFT congestive heart failure?(1) loss of myocardial contractility (myocarditis, myocardial necrosis, cardiomyopathy) (2) dysfunction of the mitral or aortic valves (3) several congenital heart diseases
dysfunction of the mitral or aortic valve will lead to which sided congestive heart failure?LEFT
nutmeg liver is a result of?R sided congestive heart failure
which causes MORE severe sodium and water retention-- L or R sided congestive heart failure?Right sided
clinical sign of R sided CHF in HORSES/RUMINANTS?ventral subcutaneous edema
clinical sign of R sided CHF in DOGS?ascites
clinical sign of R sided CHF in CATS?hydrothorax
what are three common causes of R CHF?(1) pulmonary hypertension (2) cardiomyopathy (3) disease of the tricuspid and pulmonary valves
disease of the tricuspid and pulmonary valves will lead to which sided congestive heart failure?RIGHT
how long does it take for rigor rmortis to occur? why does it happen?fast- about 15-30 min because of lack of ATP to maintain relaxation of myofibrils, leading to rigid ventricular walls
if there is clotted blood in the left ventricle when you do a post-mortem, what do you know?you know that myocardial dz was present BEFORE death, because usually rigor mortis causes the LVs to become rigid and that empties them before the clotting of blood begins
where will you see blood clots in the heart post mortem, and what will it look like?looks like a "red currant jelly" mass in the atria, RV and large vessels (NOT IN THE L VENTRICLE, UNLESS THERE WAS MYOCARDIAL disease)
if there is a clot in the heart that looks like chicken fat, what does it indicate?indicates anemia or prolonged agonal period (yellow bc mostly clotted serum/plasma)
if you see Red staining of endocardium and epicardium, what is this? what should it not be confused with?this is blood imbibition, don't confuse it with hemorrhage

congenital anomalies (also by species but not sure if he cares about that)

Question Answer
what are the three classifications of congenital anomalies?(1) Anomalies from failure of closure of fetal cardiovascular shunts (2) Anomalies from failure of normal valvular development (3) Anomalies from malpositioning of great vessels
what are the 4 Anomalies from failure of closure of fetal C/V shunts?(1) Patent ductus arteriosus (PDA) –dogs (2) Atrial septal defect (ASD) (3) Ventricular septal defect (VSD) (4) Tetralogy of Fallot (conotruncal septal defects in Keeshonds)
which failure of closure of fetal C/V shunts happens in DOGS specifically?patent ductus arteriosus
which failure of closure of fetal C/V shunts happens in KEESHOND DOGS specifically?Tetralogy of Fallot
what are the 4 Anomalies from failure of normal valvular development?(1) Pulmonic stenosis –dogs (2) Subaortic stenosis -pigs, dogs (3) Valvular hematomas (hematocysts) -young ruminants (4) Others (endocardial cushion defects in pigs and cats, mitral malformation in cats, tricuspid dysplasia in cats)
pulmonic stenosis happens in who?dogs
subaortic stenosis happens in who?pigs and dogs
valvular hematomas happens in who?young rumis
endocardial cushion defects happens in who?pigs and cats
tricuspid dysplasia happens in who?cats
mitral malformation happens in who?cats
what are the 2 Anomalies from malpositioning of great vessels?(1) Persistent right aortic arch (PRAA) –dogs (2) Transposition of the aorta and pulmonary artery
who does Persistent right aortic arch (PRAA) occur in?dogs
what are three cardiac abnormalities which don't fit into any of the three categories of congenital anomalies?Ectopiacordis, Endocardial fibroelastosism, Heterotopic epithelial rests
what are the three possible sequelae to a congenital anomaly of the heart?neonatal death, Gradual cardiac decompensation(stunted, cyanosis, poor exercise tolerance, murmurs)-->congestive failure, no clinical dz
what should you know about a patent ductus arteriosis in calves?have delayed morphologic closure but have functional closure
what is happening in a patent ductus arteriosis?duct between the pulmonary artery and the aorta fails to close. So dexoygenated blood is getting shunted into the aorta to go to the body
where do Ventricular septal defects (VSDs) usually occur? who does it usually occur in?(hole in the wall (septum) between the R and L side of the heat). They are usually subaortic in location, and are most common in dogs
what are Atrial septal defects (ASD) caused by? who do they occur in most often?failure of the foramen ovale to close. Common in dogs
what are the 4 lesions of the Tetralogy of Fallot? who is this inherited in?Ventricular septal defect, Pulmonic stenosis, Dextroposed aorta, secondary RV hypertrophy. ...inherited in keeshond dogs
what are the three types of pulmonic stenosis, and what is a resulting pathology?May be supravalvular, valvular, or subvalvular. Pulmonic stenosis leads to secondary compensatory RV hypertrophy
Aortic stenosis(AS) occurs in who? what is a result of this stenosis?dogs, there will be secondary compensatory LV hypertrophy
what is the most common cardiac anomaly in cats?Malformation of the mitral valve
Malformation of the mitral valve happens in who, and what does it look like?CATS (most common cardic anomaly in cats), it is charaterized by Short thick leaflets and chordae tendineae and an enlarged oriface
Persistent right aortic arch (PRAA)--> happens in who? explain what is happening to cause this problemcommon in dogs, the ligamentum arteriosum forms a vascular ring over the esophagus--> may produce obstruction.
what is Ectopia cordis, and where is it usually?a congenital malformation in which the heart is abnormally located either partially or totally outside of the thorax. Can be in the NECK
Valvular hematomas (hematocysts) occur in who, and what is happening? sequale?common in young ruminants. They will Undergo spontaneous regression (within a few months of birth) and have no functional significance
5 Most Common Cardiovascular Anomalies in the dog?(1) Patent ductus arteriosus (2) Pulmonic stenosis (3) Subaorticstenosis (4) Persistent right aortic arch (5) Ventricular septaldefect
what is a Endocardial cushion defect?AKA AV SEPTAL DEFECTS. The walls separating all four chambers of the heart are poorly formed or absent. It is a congenital heart disease, which means it is present from birth.
5 Most Common Cardiovascular Anomalies in the cat?(1) Endocardial cushion defects (aka AV septal defects) (2) Mitral malformation (3) Ventricular septal defect (4) Endocardial fibroelastosis (5) Patent ductusarteriosus
3 most common cardiovascular anomalies in the horse?(1) Ventricular septal defect (2) Patent ductus arteriosus (3) Persistent truncus arteriosus
4 most common CV anomalies in the cow?(1) valvular hematomas (2) atrial septal defect (3) ventricular septal defect (4) Transposition of aorta and pulmonary artery
what is happening in the Transposition of aorta and pulmonary artery?the aorta is coming from the RV and the pulmonary artery is coming from the LV
2 most common CV anomalies in the pig?(1) subaortic stenosis (2) Endocardial cushion defect

Abnormal Pericardial Cavity Content

Question Answer
what is it called if there is blood in the pericardium?hemopericardium
4 big causes of hemopericardium?(1) iatrogenic puncture (2) FB (nail, wire, bullet) (3) ruptured vessel (aorta in horse) or chamber (post-infarction aneurysm, spontaneous atrial rupture in dogs) (4) rupture of neoplasm (hemangiosarcoma, heart base tumor)
what are the lesions associated with hemopericardium? The sequale?There is blood in the pericardial sac which causes compression of the heart --> CARDIAC TAMPONADE. The sequale is CARDIAC FAILURE (cardiogenic shock) from compression of atria and an inability to fill the chambers
what is it called when there is edema fluid in the pericardium?hydropericardium
what are three possible causes of hydropericardium?(1) serous pericarditis (uremia, NaCl poisoning in chickens) (These inc permeability of vessels) (2) right heart failure (backs up into coronary aa which then push fluid into pericardium) (3) obstruction at base of heart
explain the pathogenesis of hydropericardium (remind me of basic causes) (serous pericarditis, heart base obstruction, RHF) These problems cause INCREASED vascular permeability, INCREASED hydrostatic pressure and Hypervolemia of congestive failure
what are the lesions and sequelae to hydropericardium?LESION: clear to yellow watery fluid distending pericardial sac. SEQUELAE: Death from primary disease, OR recovery accompanied by removal of fluid
Hemorrhagic pericardial effusions-- who does this happen in? what two things might cause this?usually happens in large breed dogs, two possible causes are IATROGENIC, or SECONDARY TO HEMANGIOSARCOMA (sac is also quite thickened)
what's the difference between a hemopericardium and Hemorrhagic pericardial effusions?in a hemorrhagic pericardial effusion, the blood wont clot bc it is mixed with other fluids as well-- in a hemopericardium, the blood will clot
when/in who would you see urates in the pericardium?gout in reptiles and birds
Abnormal pigmentation-->If you see melanosis (hyperpigmentation associated with increased melanin) what are you thinking?melanosis is actually Normal in aortic intima (innermost tunic of aa/vv) of dark-skinned animals
if you see dark pigmentation in the inner layer of the aorta of a a dark skinned animal, what is this?melanosis
brown atrophy is aka? When do you see this, and how does it look histologically?aka lipofuscinosis. This may be present in cachectic animals, or inherited in Ayrshire cattle. Histologically, you will see yellowish-brown granules adjacent to nuclei in cardiac muscle cells