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13 Cards in this Set
- Front
- Back
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What causes Dilated cardiomyopathy?
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toxic (EtOH abuse is the most common identified cause, pheochromocytoma from cats, anthracycline chemo drugs (doxorubicin, daunorubicin), cocaine), pregnancy (esp black, multiparous, >30yo), often idiopathic
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What does a DCM heart look like (gross and histo)?
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LV or biV dilatation and impaired contractility.
flabby myocardium, possibly a thickened endocardium, maybe mural thrombi. Histo: both atrophy and hypertrophy of myocytes with interstitial fibrosis |
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What is myocarditis and why are we talking about it here?
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inflammation of myocardium associated with necrosis and degeneration of myocytes. usually idiopathic, probably viral (coxsackie, bacteria, fungi). can also be due to hypersensitivity or giant cell myocarditis, which is idiopathic and progresses rapidly.
We're talking about it here because it leads to a flabby dilated heart with a lymphocytic infiltrate and fibrosis. |
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What does a heart with acute myocarditis look like histologically?
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flabby and dilated heart with intense lymphocytic infiltrate surrounding necrotic and degenerated myocytes. After a while, decr inflammatory infiltrate and damaged myocytes are replaced by fibrosis.
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What other types of myocarditis are there other than infectious?
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Hypersensitivity (mix of lympocytes, eosinophils and plasma cells with interstitial and perivascular distribution with mild actual necrosis.)
Giant cell myocarditis (granulomatous, unknown etiology, see multinucleated giant cells and myocyte necrosis. Rapidly progressive and often fatal). |
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What causes HCM?
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half of cases (1/1000) is autosomal dominant (genetic abn of genes coding for sarcomeric proteins).
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What does a heart with HCM look like (gross and histo)?
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enlarged out of proportion to hemodynamic stress, asymmetric with IV septum being largest and prominent papillary muscles. Both atria are often dilated.
histo: myofiber disarray with hypertrophic myocytes. |
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What causes RCM?
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amyloidosis, endomyocardial disease (infiltrate of eosinophilic material, eg due to helminth infections), storage disease (esp hemochromatosis, have features of DCM too), sarcoidosis, interstitial fibrosis
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How does RCM manifest?
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limited diastolic filling with only minimally compromised contractile function.
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What's a pericardial effusion?
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excess fluid-- serous, chylous (with chylomicrons) or serosanguineous. eg-- cardiac tamponade from LV rupture post MI
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What's pericarditis?
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inflammation of the visceral or parietal pericardium, usually viral.
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What kinds of pericarditis are there and what are they caused by?
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Fibrinous (assoc with uremia or viral inf), Purulent (usually from bacteria), Hemorrhagic (involving a malignant tumor, Constrictive (chronic fibrosing disorder, secondary to mediastinal radiation or cardiac surgery or TB, scarred and thickened pericardium).
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What are the most common cardiac tumors in adults and children?
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adults: myxoma (polyploid mass in LA, histo: scattered mesenchymal cells with a loose myxoid background).
kids: rhabdomyoma (hamartoma, often multiple, assoc w/ tuberous sclerosis) |
