Caridac Pathology: Cardiac Myopathies And Myocarditis

Front 1

Definition of Cardiomyopathy?

Back 1

PRIMARY myocardial disease attributable to chronic INTRINSIC myocardial (ventricular) dysfunction

Front 2

Classifications of Cardiomyopathies?

Back 2

Dilated (90%)
Hypertrophic
Restrictive

Front 3

Secondary Cardiomyopathies?

Back 3

Ischemic
Valvular
Inflammatory
General System Disease (CT, sarcoidosis)
Toxic Rxn (booze, chemo)

Front 4

Chambers affected in Dilated Cardiomyopathy?

Back 4

All 4, but greater in ventricles

Front 5

Mean Age of Dilated Cardiomyopathy presentation?
Age Range?

Back 5

4th decade
20-50 years

Front 6

Gender and Dilated Cardiomyopathy?

Back 6

2-3 times greater in men

Front 7

Wall thickness in Dilated Cardiomyopathy?

Back 7

Normal to slightly thinned

Front 8

coronary arteries in Dilated Cardiomyopathy?

Back 8

normall good (<75% stenosis)

Front 9

Common complication w/ Dilated Cardiomyopathy?

Back 9

Mural Thrombi (50%)

Front 10

Histo of Dilated Cardiomyopathy?

Back 10

Myofiber Hypertrophy or Atrophy (so big and small)
FIBROSIS (interstitial and endocardial)

Front 11

Different possible pathogeneses for Dilated Cardiomyopathy?

Back 11

Viral (coxsackievirus B)
Booze or Chemo
Genetic/Familial (25-35%)
Pregnancy

Front 12

Is Dilated Cardiomyopathy a diastolic or systolic disorder?

Back 12

SYSTOLIC b/c there is poor contractility

Front 13

What about Hypertrophic Cardiomyopathy?

Back 13

Its DIASTOLIC b/c of restriction of ventricular filling

Front 14

Mean age of presentation of Hypertrophic Cardiomyopathy?

Back 14

30's

Front 15

Gender and Hypertrophic Cardiomyopathy?

Back 15

66% Men

Front 16

Gross appearance of Hypertrophic Cardiomyopathy?

Back 16

Asymmetrical
Most Often involves IVS

subendocardial scars
LV outflow tract plaque
thickened anterior MV leaflet

Front 17

Histo of Hypertrophic Cardiomyopathy?

Back 17

Severe Myofiber Hypertrophy
Myocardial Fiber DISARRAY
Intramural coronary artery thickening
Interstitial fibrosis

Front 18

Pathogenesis of Hypertrophic Cardiomyopathy?

Back 18

Point Mutations in genes coding for sarcomeric proteins forming contractile apparatus

Auto Dom

Front 19

Genetic/Familial prevalence in Hypertrophic Cardiomyopathy?

Back 19

50-60%

Front 20

Sudden death in Hypertrophic Cardiomyopathy vs Dilated?

Back 20

Dilated: 20%
Hypertrophic: 40$

Front 21

CHF in Dilated vs Hypertrophic Cardiomyopathy?

Back 21

Dilated: >95%
Hypertrophic: 10%

Front 22

Restrictive Cardiomyopathy issue?

Back 22

Decreased ventricular compliance => Impaired filling (diastole)
Contractile fxn usually unaffected

Front 23

Etiology of Restrictive Cardiomyopathy?

Back 23

Idiopathic
Associated w/ systemic diseases (amyloidosis, sarcoidosis, etc)

Front 24

Morphology of Restrictive Cardiomyopathy?

Back 24

Ventricles: normal size, not dilated
Firm Myocardium

Front 25

Histo of Restrictive Cardiomyopathy

Back 25

Interstitial fibrosis
Hemochromatosis
Amyloidosis

Front 26

Define Myocarditis?

Back 26

Inflammation of myocardium which is the CAUSE of myocardial injury, not a response to it

Front 27

Gross morphology of Myocarditis?

Back 27

Normal or dilated ventricles

Front 28

Histo of Myocarditis?

Back 28

interstitial inflammation w/ focal necrosis of myocytes adjacent to inflammatory cells

Front 29

Etiologies of Myocarditis?

Back 29

Infections
Immune
Unknown

Front 30

Types of Infections --> Myocarditis

Back 30

VIRAL (most common)
coxsackie A and B
HIV related
BACTERIAL
PROTOZOA:
trypanosoma (chagas)
toxoplasmosis

Front 31

Types of Immune related etiologies of Myocarditis?

Back 31

SLE
Drug hypersensitivity

Front 32

Type of Unknown (?) Etiology of Myocarditis?

Back 32

sarcoidosis
giant cell

Front 33

Histo of Viral related Myocarditis?

Back 33

LYMPHOCYTES

Front 34

Histo of Bacterial related Myocarditis?

Back 34

Neutrophils
Bacteria

Front 35

histo of Toxoplasmosis Myocarditis?

Back 35

Lymphocytes
Plasma Cells
Organisms

Front 36

another cause of myocarditis not mentioned earlier?

Back 36

Rheumatic

Front 37

histo of acute rheumatic myocarditis?

Back 37

aschoff bodies
anitschkow cells (catepillar cells)