Cardiovascular Pathology 3

Front 1

What does the endocardium line?

Back 1

Cardiac chambers and valve cusps

Front 2

What is the most common manifestation of endocarditis in domestic species?

Back 2

Valvular endocarditis rather than mural

Front 3

What species is endocarditis most common?

Back 3

Ox, Sheep and pig

Front 4

Pathogenesis of endocarditis?

Back 4

Septicaemia -->septic embolism -->deposit --> thrombus

Front 5

Which valves are most commonly effected by endocarditis?

Back 5

The atrioventricular valves.

Front 6

Which side of the heart is most commonly effected by endocarditis?

Back 6

The left hand side of the heart exception being cattle who are mainly right.

Front 7

What is shown here?

Back 7

Valvular endocarditis

Front 8

What is the consequences of valvular endocarditis?

Back 8

Increased afterload so concentric hypertrophy

Insufficiency

Front 9

What is a vegetative thrombi?

Back 9

Raised thrombi

Front 10

Components of the vegetative thrombi?

Back 10

Fibrin matrix, friable necrotic debris, neutrophils and bacteria

Front 11

Possible outcomes of a valvular endocarditis?

Back 11

1) Septic emboli travelling to other areas of body

2) Valvular stenosis/incompetence.

Front 12

Incompetence refers?

Back 12

The valve is unable to form a seal against the backflow of blood leading to regurgitation and leakage.

Front 13

Stenosis means?

Back 13

Narrowing of the valvular orifice.

Front 14

A right sided endocarditis tends to have an emboli that goes where?

Back 14

To the pulmonary areas

Front 15

A left sided embolism tends to go where?

Back 15

Myocardial and peripheral infarction and infection. Random arrangement of them highlights it is haemotogenous spread.

Front 16

Name a valvular degenerative disease common in small breed dogs and cavaliers?

Back 16

Myxomatous valvular disease or

Front 17

What valve is most commonly affect with myxomatous valvular disease?

Back 17

AV valves especially on the left(Mitral)

Front 18

What system do we grade myxomatous valvular disease?

Back 18

Whitney 1-4

Smooth white to discrete nodules through to coalescing to plaque like thickenings with cuspal distortio and chordal involvement and rupture.

Front 19

Microscopically what can be seen with myxomatous valvular disease?

Back 19

Accumulation of mucopolysaccharide

Front 20

What occurs with myxomatous valvular disease on the heart?

Back 20

Valve cusp distortion with consequent incompetence and leakage of blood into the atrium during systole. (Eccentric hypertrophy)

Front 21

What grade would this be on the Whitney scale for Myxomatous valvular disease?

Back 21

Grade 2. Smooth white discrete nodules

Front 22

Features of valvulopathy in horses?

Back 22

Chronic, Fibrous material mainly on the mitral valve and aortic valve cusp

Front 23

Sequence of events that lead to the formation of fibrous lesions on the cusps of the horse valves?

Back 23

1) Spare cellular infiltrations in the superficial outflow layer of the cusp

2) Various villous or papillary eruptions of the outflow endothelium

3)Deeper levels irregular whorls or meshes of collage fibres which may be more organised resulting in nodules or distortion.

Front 24

What is necrotising endocarditis?

Back 24

Isolated foci of necrosis on the LA endocardium just above the LAV valve ring in old dogs and uraemia.

Front 25

When would endocardial calcification occur ?

Back 25

Due to a mineral imbalance high Ca and P, hypervitaminosis D, High soil K which is low in Mg and P

Front 26

When does uraemia occur?

Back 26

Renal failure --> Ammonia can't be broken down into urea and be excreted so it accumulates. It is toxic to endothelium and can lead to thrombus.

Bleachy smell

Front 27

Other incidental findings in the endocardium?

Back 27

Haematocysts and lymph cysts

Melanosis

Front 28

What has occured here

Back 28

Metastatic calcification of the endocardium

Front 29

Back 29

A small haematocyst can be seen here

Front 30

This is characteristic of?

Back 30

Necrotising endocarditis with calcified foci

Front 31

What is a jet lesion?

Back 31

Areas of fibrosis adjacent to an incompetent heart valve.

Can occur in vessels too.