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31 Cards in this Set

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define cardiomyopathy.
a disease of the cardiac muscle that is not ischemic heart disease, hypertensive heart disease, or valvular heart disease
what is gold standard for diagnosing cardiomyopathy?
endomyocardial biopsy
what is dilated (congestive) cardiomyopathy?
a progressive cardiac dilation followed by cardiac hypertrophy
what are the causes of dilated cardiomyopathy?
- genetic (autosomal dominant inheritance of cytoskeletal proteins)
- myocarditis
- Toxins: EtOH, drugs, excessive Fe
what is Peripartum cardiomyopathy?
a dilated cardiomyopathy caused by pregnancy
what is the most common cardiomyopathy?
dilated cardiomyopathy
what are the gross changes associated with dilated cardiomyopathy?
- large, flabby heart (heart can weigh up to 900 g)
- thickened walls
- mural thrombi
what is the most common reason for a cardiac transplant in adults?
dilated cardiomyopathy
what causes hypertrophic cardiomyopathy?
mutations in one of the genes that encodes sarcomere proteins
what changes do you see grossly in a patient with hypertrophic cardiomyopathy?
- massive heart (up to 1000 g)
- disproportionate thickening of the interventricular septum
you are about to begin an autopsy on a 17 year old male. you are told that he was previously healthy and collapsed during a basketball game. paramedics arrived to find him without a pulse and he was pronounced dead on the scene. what do you suspect caused his death? what do you expect to find upon examination?
- hypertrophic cardiomyopathy
- thick interventricular septum
- massive heart
- myocyte hypertrophy
- myofiber disarray
- interstitial fibrosis
what are some causes of restrictive cardiomyopathy?
- amyloidosis
- radiation fibrosis
- sarcoidosis
- metaplastic neoplasm
- errors in metabolism
what is the prognosis of a patient with a restrictive cardiomyopathy?
poor, less than 10% 10 year survival
what is the gross appearance of a heart with myocarditis?
enlarged, flabby heart with mttled hemorrhagic areas
what age group is most often affected by Giant cell myocarditis?
10 - 40 years old
what will you see microscopically in a patient with giant cell myocarditis?
- inflammatory cell infiltrate
- multinucleated giant cells
- necrosis
what age group is myocarditis most common in?
1 - 10 years old
what is the prognosis of a patient with giant cell myocarditis?
fatal without a transplant and even with a transplant 25% will recurr
what are the most common reasons for a cardiac transplant?
- dilated cardiomyopathy
- ischemic heart disease
what is currently the major limitation to long-term success of cardiac transplants?
Diffuse Stenosing Intimal Proliferation
what is diffuse stenosing intimal proliferation?
low level chronic rejection leads to growth factor secretion which leads neointima formation
name the four types of pericardial effusions are the cause of each.
- serous = due to systemic edema
- chylous = due to lymphatic obstruction
- serosanguineous = due to chest trauma
- hemopericardium = blood in the peridcardium for any reason
how much fluid can be tolerated if it is a slow gradual increase? how much can be tolerated if it is a rapid increase?
- up to 500 mL
- up to 150 mL
what is the most common form of pericarditis?
fibrinous
what is the classic cause of fibrinous pericarditis?
uremia in renal failure
your attending in the pathology lab shows you a heart that has a "bread and butter" appearance. he also tells you the patient died from renal failure. what is your most likely diagnosis?
fibrinous pericarditis
what is the most common cause of purulent pericarditis?
bacterial infection
what is the most common cause of caseous pericarditis?
TB until proven otherwise
what is a soldier's plaque?
a fibrous pericarditis that is most often located on the anterior surface of the heart due to chronic pericarditis
what are the 2 types of chronic pericarditis? which is worse?
- adhesive and constrictive
- constrictive
what is the classic cause of constrictive pericarditis? what is the most common cause now?
- TB
- idiopathic in developed countries, TB in undeveloped countries