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133 Cards in this Set
- Front
- Back
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The visceral pericardium is synonymous with which layer of the heart?
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Epicardium
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The parietal pericardium is synonymous with which layer of the heart?
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NONE! It is the parietal pericardium only!
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How much thicker is the left ventricular wall than the right?
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Approx. 3x
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T or F:
The endocardium of the atria is thicker than the ventricles |
True!
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Which heart layer contains the purkinje fibers?
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subendocardium
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T or F:
Cardiac valves are highly vascular. |
False! They are avascular.
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What tissue is the progenitor of cardiac valve cusps?
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Endocardial cushions (mesenchymal tissue covered by endothelium)
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Approximately what % body weight does the heart comprise in a normal dog?
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0.75%
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Where are postmortem clots normally found in the heart?
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Atria, right ventricle, and large vessels at the base of the heart
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Why would an animal with prolonged heart disease present with postmortem clots in the left ventricle?
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May lack adequate glycogen reserves and ventricle may fail to contract during rigor mortis.
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What are the 4 or 5 main categories of cardiac response to injury?
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Cellular degeneration (vacuolar, fatty)
Cell loss (apoptosis, necrosis) Inflammation Repair (fibrosis, scarring) (sometimes regeneration) |
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T or F:
The mammalian heart has a high capacity for regeneration from injury. |
False! This describes fish and amphibians.
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What are the two populations of myocytes?
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Working myocytes
Conduction fibers |
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What types of inflammation may the heart experience?
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Granulomatous
Supurative Fibrinous Plasma cell Eosinophilic |
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Which major physical factors impact the stroke volume?
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Contractility
Preload Afterload |
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Which major physical factors affect cardiac output?
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Stroke volume
Heart rate |
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What are the morphologic compensatory mechanisms to maintain cardiac output?
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Cardiac dilation
Myocardial hypertrophy |
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What are the neurohormonal mechanisms that maintain cardiac output?
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Increase HR
Increase TPR Increase blood volume Redistribute blood flow |
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What are the two forms of cardiac hypertrophy?
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Eccentric and concentric
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What are the limitations to hypertrophy?
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Inadequate diffusion
Reduced mitochondria:microfibril ratio Decreased cardiac filling Synthetic deficiencies |
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What are some good differentials for animals presenting with prominent epicardial or endocardial hemorrhages?
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Electrocution
Septicemia Endotoxemia Anoxia (or could be just a horse) |
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What is the cause of mulberry heart disease? How does it present?
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Selenium-vitamin E deficiency in growing pigs.
hydropericardium and severe myocardial hemorrhage |
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What hormones regulate blood volume? What does each do and where does it originate?
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Renin/angiotensin - reduce Na/H20 excretion - kidney
Aldosterone - reduce Na/H20 excretion - adrenals ADH - increase thirst and water retention - pituitary |
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The following are mechanisms of cardiac adaptation except:
Ventricular hypertrophy Change in heart rate Vasoconstriction Ventricular hyperplasia Ventricular dilation |
Ventricular hyperplasia
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What are some common congenital anomalies of the cardiovascular system?
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PDA
VSD Tetralogy of fallot & etc... |
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Which factor is the most critical to the outcome of cardiac compression?
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Time
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Fibrinous pericarditis is NOT a common feature of (choose one):
Psittacosis Glasser's dz. FIP Mycobacteriosis Mycoplasmosis |
Mycobacteriosis (causes granulamotous inflammation)
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What are the five main groupings of heart pathology?
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Congenital anomalies
Epicardial dz. Endocardial dz. Myocarcial dz. Neoplasms |
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What are the main types of congenital anomalies?
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Failure to close fetal shunts
Failure to develop normal valves Malpositioning of great vessels Heterotopias |
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T or F:
In a PDA, blood always shunts from L to R. |
False!
This is normally true but, if the pulmonary resistance becomes too high, the left ventricle cannot overcome the pressure and blood will flow R to L! |
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What is involved in the Tetralogy of Fallot?
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High VSD
Dextroposition of the aorta Pulmonic stenosis R-sided hypertrophy and dilation (secondary) |
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What are the 3 general adaptations to stress that the heart can take?
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1) hypertrophy
2) dilation 3) neurohormonal |
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What are the two types of cardiac hypertrophy?
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eccentric
concentric |
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Name some neurohormonal adaptations that can help the heart to adapt to stress.
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neurohomonal adaptation
ADH Renin/Angiotensin vascular tonus |
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Why do horses often have large pale clots?
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rouleaux (rapid erythrocyte sedimentation)
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Which conditions may result in chicken fat clots?
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severe anemia
systemic inflammation dz leukemia prolonged agonal periods |
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HR x SV = ???
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CO
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What are three main mechanisms that increase blood volume?
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Renin/angiotensin (kidneys)
ADH release (pituitary) Increased water uptake (increased thirst via hypothalamus) |
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What are some factors that would increase afterload?
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lung dz
congenital malformation hypertension valvular dz hypermetabolism |
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What are three factors that directly impact stroke volume?
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End systolic volume (contractility affects this)
End diastolic volume afterload |
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What factor directly influences preload?
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venous/arterial pressure
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Let's play eccentric or concentric hypertrophy...
...addition of cardiac sarcomeres in parallel. |
concentric
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Let's play eccentric or concentric hypertrophy...
...addition of cardiac sarcomeres in series. |
eccentric
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Let's play eccentric or concentric hypertrophy...
...result of increased pressure. |
concentric
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Let's play eccentric or concentric hypertrophy...
...result of increased volume. |
eccentric
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What are factors that can negatively influence ventricular complance?
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myocardial ischemia
cardiac dz aging muscle |
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What is the most common type of pericardial inflammation?
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fibrinous pericarditis
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What are the major divisions of myocarditis (ie: where can it occur)?
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atrial, ventricular, papillary, septal
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What are the major divisions of pericarditis (ie: where can it occur)?
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Visceral (epicarditis)
Parietal |
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What are the major divisions of endocarditis (ie: where can it occur)?
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Valvular
Parietal |
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T or F:
Pulmonary stenosis is the most common failure of valvular development? |
False!
Pulmonary and subaortic have approximately the same prevalence |
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Let's play eccentric or concentric hypertrophy...
...pulmonary stenosis. |
Concentric hypertrophy
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Let's play eccentric or concentric hypertrophy...
...increase in afterload. |
concentric
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T or F:
Aortic stenosis is always subvalvular. |
True!
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What animal commonly presents with valvular cysts? What are common sequelae to these?
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Calves; regress after several months; no functional abnormalities
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What are the TOP 3 most common congenital heart defects in dawgs?
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Subvalvular aortic stenosis
PDA Pulmonic stenosis |
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What are the TOP 3 most common congenital heart defects in cats?
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Mitral valve dysplasia
VSD Endocardial cushion defect |
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What are the most important clinically encountered equine congenital heart defects?
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VSD
Tetralogy of fallatio PDA |
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What are the most important clinically encountered bovine congenital heart defects?
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VSD
Ectopia cordia R/L ventricular hypoplasia PDA |
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What are the main causes of hydropericardium?
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(generalized edema)
increased hydrostatic pressure reduced oncotic pressure (hypoproteinemia) decreased lymph drainage increased vascular permeability |
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What are some processes associated with hydropericardium?
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renal dz
congestive heart failure (dialated cardiomyopathy of cats and pigs) pulmonary hypertension (brisked dz) |
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What are some causes of hemopericardium?
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rupture of vessel
perforation of vessel idiopathic! tumor (hemangiosarcoma) |
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What are some causes of pneumopericardium?
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interstitial pulmonary emphysema
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If a pericardial exudate contains cells, what is the process called?
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pericarditis
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There three routes of infection leading to pericarditis. What are they?
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Spread from adjacent tissue
Penetration Hematogenous |
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Let's play NAME THAT EXUDATE!!!...
...low cellularity. |
serous OR fibrinous (not synonymous necessarily though)
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Let's play NAME THAT EXUDATE!!!...
...neutrophils present. |
Suppurative or purulent
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Let's play NAME THAT EXUDATE!!!...
...organized and scar tissue formation. |
Fibrous
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What type of conditions are usually associated with fibrinous pericarditis?
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pneumonia or septicemia
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What is a good example of fibrinous pericarditis in pigs and what is the pathogen?
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Glasser's Dz; caused by Haemophilus suis
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What are some acute sequelae to pericarditis?
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fibrinous or suppurative exudate
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What are some chronic sequelae to pericarditis?
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fibrous CT develops; compresses heart (constrictive pericarditis) leading to compensatory hypertrophy and congestive heart failure
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What are some metabolic epicardial alterations that can be found? What are common causes?
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Serous atrophy of fat (malnutrition or cachexia)
Uric acid deposits (gout) |
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What are three OVERARCHING problems that can occur in the endocardium (think BIG PICTURE)?
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Endocardial degeneration
Valvular dysfunction Endocarditis |
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What are three types of endocardial degeneration?
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mineralization
fibrosis endocardiosis |
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Endocardial degeneration through mineralization typically involves what substance?
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Calcium (specifically due to excessive amounts of vitamin D or Vit D analogs)
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What are some examples of endocardial fibrosis?
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chronic debilitating dz (Johne's)
Jet lesions chronically dilated hearts |
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T or F:
Endocardiosis is an inflammatory process. |
False!
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What is the most common cause of congestive heart failure in OLD dogs?
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endocardiosis
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Nodular thickening of the valves at the free edge with smooth and shiny beige nodules within the leaflets describes...
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...endocardiosis
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Where is endocardiosis most commonly found?
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mitral valve > tricuspid > aortic/pulmonary valves
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Which breeds are susceptible to endocardiosis?
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small/toy breeds
male cavalier king charles spaniel |
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What is the underlying process to endocardiosis?
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fibrosis and mucoid degeneration (associated w/valvular collagen degeneration)
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What are some sequelae to endocardiosis?
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valvular insufficiency
jet lesions splitting/rupture of atria or chordae tendonae |
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What are the main types of valvular dysfunction?
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insufficiency
stenosis |
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Which valves are most commonly affected in valvular insufficiency?
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mitral valve > tricuspid >>> aortic/pulmonary valves
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What are sequelae to AV insufficiency?
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atrial dilation and atrial endocardial fibrosis (jet lesions)
hypertension of preceding vessels rupture (atrial wall, chordae tendonae) |
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Pulmonary stenosis is an important finding in which species?
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dogs (beagle, english bulldog, and chicuahua)
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Subaortic stenosis is an important finding in which species?
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pigs
dogs (newfoundland, boxer, german shepherd) |
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What are sequelae to pulmonary stenosis?
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concentric hypertrophy or R ventricle
normal shit (systemic backup of blood and all that) |
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What are some sequelae to subaortic stenosis?
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ventricular concentric hypertrophy
myocardial nerosis fibrosis in inner L ventricular wall thickening of intramyocardial arterial walls |
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T or F:
mural endocarditis is more common than valvular |
False!
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Which is the most common type of valvular endocarditis?
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Mitral > aortic > tricuspid > pulmonary
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What is the most common cause of endocarditis?
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bacterial infxn (can be parasitic or mycotic)
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This type of endocardial lesion is characterized by large vegetations occluding the valvular surface.
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endocarditis
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Which species commonly presents with mural (parietal) endocarditis?
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camelids
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What are the three forms of endocarditis? Which is acute and which is chronic?
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vegetative (acute)
verucae (chronic) ulcerations (acute or chronic) |
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What are common causes of endocarditis in the dog? in the horse?
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Dog (E. coli and Strept)
Horse (S. vulgaris) |
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What are some common sequelae to endocarditis?
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Bland infarcts
Septic infarcts Valvular insuficiency/stenosis --> congestive heart failure |
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What is a specific cause of myocardial concentric hypertrophy in cats?
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Hyperthyroidism - increased TH increases myocyte contractile protein production
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How does altitude cause myocardial hypertrophy in cattle?
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high altitude = low O2
causes pulmonary hypertension --> R sided heart failure |
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What are common underlying causes of R ventricular myocardial hypertrophy in the dog? cow? horse?
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dirofilariasis (dog)
congenital pulmonic stenosis (dog) high altitude dz (cow) chronic alveolar emphysema (horse) |
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What are common underlying causes of L ventricular myocardial hypertrophy in the dog? cat?
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congenital subaortic stenosis (dog)
hyperadrenocorticism and chronic renal failure (dog) hyperthyroidism and chronic renal failure (cat) |
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What is a common underlying problem for myocardial dilation in cats?
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Taurine deficiency
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What are the most susceptible regions of myocardial necrosis?
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L ventricular papillary muscle
Subendocardial myocardium |
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What are come general causes of myocardial necrosis?
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nutritional deficiencies (vit E and Se)
toxicities |
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What are the four mechanisms of toxicity in myocardial necrosis?
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(1) Exagerated pharmacological action of drugs on cardiovascular tissues
(2) exposure to substances that depress myocardial fxn (3) direct injury to myocytes by chemicals (4) hypersensitivity rxn |
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What are the three general causes of myocarditis?
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viral
bacterial parasitic |
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What is an important viral factor in myocarditis of ruminants? How does the heart present in these animals?
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FMD (aphtovirus, picornaviridae)
necrotizing myocarditis ("tiger heart") |
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What is an important viral factor in myocarditis of young animals?
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Parvovirus
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What are some of the presentations of myocarditis? What is a pathogen or disease associated with each? (hint - suppurative is the answer to one)
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Suppurative (pyogenic bacteria)
Lympho-plasmacytic (viral) Histiocytic/granulomatous Eosinophilic (parasites) Necrotizing (toxoplasmosis) Hemorrhagic (eg: cattle w/blackleg) |
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What are some possible sequelae to myocarditis?
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healing (resolution)
scattered myocardial scars progressive myocardial damage (acute) or chronic myocardial failure |
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What are some causes of primary cardiomyopathies?
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IDIOPATHIC, always IDIOPATHIC
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What are some causes of secondary cardiomyopathy?
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genetic
micronutrients toxic metabolic/endocrine disorders physical injury/shock infection |
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T or F:
Hypertrophic primary cardiomyopathy is non-reversible. |
true
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How does hypertrophic cardiomyopathy present grossly?
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enlarged hearts with prominent hypertrophy of the L ventricle. L ventricular cavity is small and L atrium is thickened
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How can primary cardiomyopathy be distinguished from secondary?
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Microscopy - secondary retains normal structure and primary has swollen fibers and vacuolar appearance
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What are the "5 P's" of a saddle thrombus?
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Poikilothermia
Pulselessness Pale pallor) Pain Paresis |
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What is a common sequel to cardiomyopathy in cats?
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thromboembolism (saddle thrombus)
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How does hypertrophic cardiomyopathy lead to thromboembolism?
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Increased L ventricular diastolic pressure --> L atrial pressure increase --> L atrial dilation = thrombus formation in L atrium
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What dog breeds are susceptible to dilative cardiomyopathy?
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Large breeds (Dobermans, Portuguese water dogs, Dobies, Great Danes)
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Dilative cardiomyopathy is also called...
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"round heart disease"
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What are some common primary tumors of the heart?
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Hemangioma
Fibroma Myxoma Fibrooma Rhabdomyoma mesothelioma (and all the sarcoma versions) |
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What is the most common primary tumor of the heart? Where is this usually found?
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Hemangiosarcoma of the R auricle
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What is a common cause of a metastatic heart tumor in the cow?
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Lymphosarcoma
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What are the top 4 cardiac diseases of the dog?
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1. Valvular endocardiosis
2. COngenital heart dz 3. dilated cardiomyopathy 4. hemorrhagic pericardial effusion |
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What are the 4 most common cardiac diseases of the cat?
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1. hypertrophic cardiomyopathy
2. dilated cardiomyopathy 3. hyperthyroidism-associated hypertrophy 4. congenital heart dz |
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What are the subdivisions of the vascular system?
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arterial
venous lymphatic capillary |
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What are some reactions to injury of the endothelium?
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necrosis
plasma proteins can permeate endothelium exposed collagen promotes thrombus formation |
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What are some reactions to injury of vascular smooth muscle cells?
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formation of free radicals and PGs
hypertrophy degeneration necrosis |
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What are predisposing factors to thrombosis?
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endothelial damage
clotting disease turbulence or stasis |
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How do organs affected by DIC present microscopically?
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numerous fibrin thrombi present in arterioles and capillaries
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What are some causes of DIC?
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bacterial endotoxins
hemolysis shock extensive tissue necrosis infections neoplasia |
