Path- Cardio 2

untimely's version from 2015-04-12 22:20

Degeneration, infiltration, necrosis/apoptosis and mineralization

Question Answer
what are the 4 reactions to injury that the heart can have?growth disturbance, sublethal injury, lethal injury, neoplasia
What are two growth disturbances the heart can experience, and are these permanent or reversible?atrophy and hypertrophy- they are REVERSIBLE (remember this is just size of cells changing, not amount)
what are 5 reactions heart tissue can make to a sublethal (REVERSIBLE) injury?fatty degeneration, Lipofuscinosis, Vacuolar degeneration, fatty infiltration, myocytolysis
degeneration is ___cellular, infiltration is ___cellular (such as fatty degeneration vs fatty infiltration)degeneration=INTRAcellular. Infiltration=EXTRAcellular
if there is myocardial necrosis, what histological things occur?leukocytic infiltration, phagocytosis, Persistence of sarcolemmal “tubes” of basal lamina, and with SEVERE damage, fibroblasts will produce collagen leading to scarring
how often is there regeneration of the myocardiocytes?usually NOT observed. You might see a limited amount in very young animals (esp. avian).
When is there hyperplasia of the heart?ONLY in the first several months of life... after that, all growth of the heart is due to hyperTROPHY until normal cell size reached
Explain what happens to a normal myocardial cell as it undergoes necrosisnormal cell --> hyaline necrosis--> macrophagic invasion--> healing with fibrosis (see slide 71)
hyaline necrosis is aka?zenker's necrosis
what would cause serous atrophy of fat? What does this lesion look like? anorexia, starvation, cachexia---> this leads to mobilization of fat depots. This results in epicardial fat being replaced by gray wet gelatinous tissue
what causes fatty infiltration of the heart? how does the lesion appear?Caused by obesity, you will see an INCREASED number of lipocytes within the myocardium
what are three causes of fatty degeneration?anemia, toxemia, nutritional deficiency (Cu!)
what are the gross and histological lesions of fatty degeneration?GROSS: You will see a mottled, pale, flabby ("thrush-breast heart"). HISTO: you will see spherical vacuoles IN the myocytes which will positive stain for fat with fat stains like oil red o
example of a histological stain for fat?oil red o
Myofibrillar degeneration (myocytolysis) can happen in what two situations in what two animals?(1) furazolidone toxicosis in birds!! (abx used in poultry industry) (2) K+ deficiency in rats
Cardiotoxicity Examples on slides 79-81will be ascites in celom, heart will kinda look like a deflated ball, the mm cells are all wavy and messed up and no clear boundaries
what are three causes of vaculor degeneration?(1) doxorubicin (adriamycin) cardiotoxicity (this is an anti-cancer drug) (2) antiviral drugs (3) mitochondrial swelling and disruption
how does vaculor degeneration appear histologically?sarcoplasmic vacuolation due to distention of sarcoplasmic reticulum, myofibrillar lysis, myocyte atrophy, fibrosis
Hyaline or Zenker'snecrosis/apoptosis--> what is this? (not in notes but i needed for clarity)a severe glassy or waxy hyaline (proteinaceous material) degeneration or necrosis
which nutritional deficiency can lead to hyaline/zinkers necrosis of heart mm?vitamin E/selenium (THIS IS WHITE MM DZ! THE HEART IS A MM!)
there are 6 things that can cause hyaline/zinkers necrosis. what are they?(1) ischemia (2) nutritional deficiency (Se-vit E) (this leads to lipid perioxidation--> cell damage) (3) toxins---> chemical: (monensin, cobalt, gossypol), plant: (Cassiasp., Karwinskiasp., fluoroacetate-containing plants), bacterial (4) metabolic disease (azoturia) (5) physical injury (defibrillator shock) (6) secondary to neural injury –“heart-brain syndrome” (--->excess catecholamine release)
which metabolic dz can cause hyaline/zenker's necrosis?azoturia--> aka Equine exertional rhabdomyolysis, aka monday morning dz, happens when forced exercise after a period of rest during which feed has not been restricted
(powerpoint) what are three chemicals which cause hyaline/zenkers necrosis?(1) gossypol (Gossypium spp. - cottonseed oil meal) (2) colbalt (2) monensin
(powerpoint) what are 3 types of plants which cause hyaline/zenker's necrosis?(1) Cassia sp. (coffee senna) (2) Karwinskia sp. (coyotillo) (3) fluoroacetate-containing plants
(long notes) what are the plant TOXINS which can cause zenkers necrosis?Fluoroacetate and fluoroacetate-containing plants!!, also cardiac glycoside plants, and Adromedotoxin (grayanotoxin) - containing plants
(long notes) what are the plant/plant derivatives which can cause zenker's necrosis?yew, ground hemlock (Taxus spp.)., coffee senna (Cassia occidentalis)., coyotillo (Karwinskia humboldtiana)., white snakeroot (Eupatorium rugosum)., gossypol (Gossypium spp. - cottonseed oil meal).
explain heart-brain syndrome, and what happensthere is neuronal injury, the neurons release too much catecholamines, and this affects the heart negatively
What are the gross lesions for zenker's necrosis?pale patches or streaks (often subendocardial and in papillary muscles), may have yellow or white dry gritty areas of calcification, and if it is Chronic, pale collapsed areas of scarring
what are the 5 histopathological characteristics of zenker's necrosis of the heart?(1) swollen, hypereosinophilic fibers with loss of striations (2) basophilic granules if mineralized (3) pyknotic nuclei (condensation) (4) leukocytic infiltration (5) fibrosis if chronic
what is mulberry heart disease?Vit E deficiency... in PIGS
how does vit E/selenium deficiency affect calves and lambs differently? (i think this is a thing, he didn't explain it too well, but it's slide 92)LV is affected more in claves, RV in lambs (you'd think L=lamb but nooooo )
what is monensin? what does it do/who is suseptible?it's an abx used in cow feel, horses are super suseptible
what are the two possible sequale to zenker's necrosis?(1) death from heart failure (2) recovery from myocardial scarring
what should you know about Fluoroacetate and fluoroacetate-containing plants?they are toxicants which affect the heart
what are the 4 plant/plant derivatives he had in read that he totally wants us to know cause cardiotoxicities?(1) yew, ground hemlock (Taxusspp.). (2) coffee senna (Cassia occidentalis). (3) coyotillo (Karwinskia humboldtiana). (4) white snakeroot (Eupatorium rugosum).
what plant-derived toxin causes cardiotoxiticty? (in red)gossypol (Gossypiumspp. -cottonseed oil meal).
what are 4 chemical agents which cause cardiotoxicities (in red)(1) Ionophores- (monensin, lasalocid, salinomycin, narasin, maduramycin, others) (2) Antineoplastic agents- anthracyclines- (doxorubicin, daunorubicin) (3) Antiviral agents -nucleoside reverse transcriptase inhibitors (AZT) (4) Antimicrobials- furazolidone in birds
what are feed additives which are cardiotoxic? (Examples) (in red) Ionophores- (monensin, lasalocid, salinomycin, narasin, maduramycin, others)
what are the antineoplastic agents which are cardiotoxic? (in red)the anthracyclines (doxorubicin, daunorubicin),
what are the antiviral drugs which are carditotoxic? (in red)nucleoside reverse transcriptase inhibitors (AZT) (Zidovudine)
what is the antimicrobial agent that is cardiotoxic, and in who? (in red)furazolidone in birds
what should you know about catecholamines and the heart? (examples?) (in red)catecholamines can be CARDIOTOXIC. examples include isoproterenol, epinephrine, norepinephrine, others.
what minerals can be cardiotoxic, and in who? (in red)NaCl in birds
what vitamins can be cardiotoxic? (in red)Vitamin D
what homones can be cardiotoxic (in red)growth hormone, thyroxine, glucocorticosteroids
vitamin D poisoning can lead to what problem?endocardial fibrosis and/or mineralization
what is "manchester wasting dz" and what causes it/ what is the resulting problem? aka?AKA enzootic(endemic) calcinosis. This is caused by plants which cause extensive calcificiation. Some of the plants that can cause this are Cestrum diurnum (day blooming jasmine), Trisetum flavescens (golden oat grass), Solanum malacoxylon. This problem will lead to Endocardial fibrosis and/or mineralization
Endocardial fibrosis and/or mineralization---> what are 5 possible causes of this problem?(1) vitamin D poisoning (2) "Manchester wasting disease", enzootic calcinosis (Cestrum diurnum, Trisetum flavescens, Solanum malacoxylon) (3) chronic cardiac dilation (4) cachexia (Johne's disease) (5) chronic uremia
what specific lesion might you see with Endocardial fibrosis and/or mineralization?"jet lesions" associated with valvular lesions (jet bc there is a constant jet of blood coming from the defective valve and causing fibrosis on the affected area)
chronic cardiac dilation, chronic uremia, and cachexia (Johne's disease) can all lead to what?Endocardial fibrosis and/or mineralization
what are the lesions of Endocardial fibrosis and/or mineralization?thick, rough, white areas on endocardium
what are 4 VALVULAR degenerative diseases which fall under "valvular endocarditis" that the DOG is prone to getting? What causes these problems and what is the histological result?Valvular endocardiosis, valvular fibrosis, mucoid or myxomatous valvular degeneration, chronic valvular disease! This is usually due to AGE and there may be a genetic influence due to breed disposition. This results in the degradation of valve collagen
what are the gross lesions of valvular? -- 3 major gross lesions(Valvular endocardiosis, valvular fibrosis, mucoid or myxomatous valvular degeneration, chronic valvular disease) (1) smooth, firm, thick (diffuse or nodular) valve cusps (usually AV and especially mitral, prolly cause only 2 flaps) (2) thick chordae tendineae (occasional rupture) (3) left atrial "jet lesions“ (occasional rupture)
what are the histo lesions of the valvular endocarditis of dogs?-- 3 major gross lesions (Valvular endocardiosis, valvular fibrosis, mucoid or myxomatous valvular degeneration, chronic valvular disease) (1) thickening of valve cusps by proliferation of fibroblastic tissue and accumulation of acid mucopolysaccharides (2) focal myocardial necrosis and fibrosis (3) +/- arteriosclerosis of intramyocardial arteries
what is the MOST COMMON CAUSE of CHF in OLD DOGS?VALVULAR ENDOCARDITIS-- (Valvular endocardiosis, valvular fibrosis, mucoid or myxomatous valvular degeneration, chronic valvular disease)
what do lesions of Rupture of chordae tendineae look like?torn chordae and mobile valve cusp


Question Answer
what are three different types/locations of inflammation in the heart?pericarditis, endocarditis, myocarditis
what are the two kinds of pericarditis?(1) fibrinous (2) suppurative (also there is granulomatous but he doesnt care about that one)
what are two portals of entry for the pericardium?(1) hematogenous dissemination (2) foreign body penetration from reticulum (cattle)...aka hardware dz
what are the defense mechanisms for the pericardium? (1)(1) immunological responses- both humoral and innate
FIBRINOUS pericarditis--> what causes this type of pericarditis?caused by **hematogenous** infection in streptococcosis, pasteurellosis, salmonellosis, Histophilussp. infection, blackleg, psittacosis, sporadic bovine encephalomyelitis
what are the LESIONS of FIBRINOUS pericarditis?yellow sheets and strands of fibrinon pericardial surface ("bread and butter heart"). If chronic, there may also be fibrous adhesions
what is bread and butter heart?common name for fibrinous pericarditis-- It's called this because there are yellow sheets and strands of fibrin on pericardial surface
what are possible sequale of FIBriNOUS pericarditis?(1) death from SEPTICEMIA (2) recovery with adhesions or resolution of exudate
SUPPURATIVE pericarditis--> what causes this type of pericarditis?caused by **traumatic reticuloperitonitis** ( FB penetration in cattle ("hardware disease") )
what are the lesions of SUPPURATIVE pericarditis?distended pericardial sac containing yellow to white pus, thick fibrous pericardium, fetid odor, may find FB
what are the possible sequale of SUPPURATIVE pericarditis?(1) death from septicemia (2) chronic cardiac failure from constrictive pericarditis
what are 4 portals of entry into the ENDOcardium?(1) hematogenous dissemination (2) parasitic migration (3) intravenous and intracardiac catheters(long-term placement) (4) uremia-induced vascular damage and secondary endocardial ulceration (dog, left atrium)
uremia induced inducedvascular damage and secondary endocardial ulceration, leading to endocarditis, often occurs in WHO, and where specifically?dogs, in the left atrium
what are the defense mechanisms of the endcardium? (2)(1) constant blood flow through cardiac chambers (2) immunologic responses (humoral and innate)
4 main causes of endocarditis?(1) hematogenous infection--> streptococcosis, erysipelas, phycomycosis, Trueperella pyogenes infection (2) strongylosis (3) uremia (4) trauma
what are some hematogenous agents which cause FIBRINOUS PERICARDITIS? streptococcosis, pasteurellosis, salmonellosis, Histophilussp. infection, blackleg, psittacosis, sporadic bovine encephalomyelitis
what are some hematogenous agents which cause ENDOCARDITIS?streptococcosis, erysipelas, phycomycosis, Trueperella pyogenes infection
explain the pathogenesis of endocarditisbacteremia and mechanical stress (exertion, cardiac anomalies)--> valvular endothelial damage--> thrombosis and endocarditis--> valvular dysfunction and septicemia
what are the gross lesions of endocarditis? (acute, chronic, and if uremia)friable dry yellow "vegetations" on valve....if chronic, firm, irregular nodular masses on valves ("verrucae"), and if uremic, LA endocardial ulceration
uremia leading to endocarditis with ulceration would be where most likely?LA
what are verrucae and what do they indicate? firm, irregular nodular masses on valves which indicate chronic endocarditis
what does endocarditis look like histologically?masses of fibrin and bacteria adhered to base of granulation tissue
what are 4 possible sequale to endocarditis?(1) cardiac failure from valvular dysfunction (2) death from bacteremia (3) septic embolism (4) recovery
Valvular endocarditis Vs Valvular endocardiosis?Endocarditis= inflammation of the endocardium. could be due to infxn, parasites, uremia, or trauma. Endocardosis: chronic fibrosis and nodular thickening of the free edges of the atrioventicular valves, with no known/specific cause (dogs- polygenetic trait)