Pathology - Primary Myocardial And Pericardial Diseases

Front 1

Types of myocardial diseases:

Back 1

DCM, HCM, RCM

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most common cardiomyopathy

Back 2

dilated cardiomyopathy

Front 3

Dysfunctionality in dilated cardiomyopathy:

Back 3

Systolic dysfunction of ALL 4 CHAMBERS due to cardiac dilation

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most common acquired DCM

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due to alcohol, either due to direct toxic effect or secondary to nutritional deficiency

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Histology of DCM:

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myocyte hypertrophy and interstitial and endocardial FIBROSIS

HF: hypertrophy and fibrosis

Front 6

Types of myocardial diseases:

Back 6

DCM, HCM, RCM

Front 7

most common cardiomyopathy

Back 7

dilated cardiomyopathy

Front 8

Dysfunctionality in dilated cardiomyopathy:

Back 8

Systolic dysfunction of ALL 4 CHAMBERS due to cardiac dilation

Front 9

most common acquired DCM

Back 9

due to alcohol, either due to direct toxic effect or secondary to nutritional deficiency

Front 10

Histology of DCM:

Back 10

myocyte hypertrophy and interstitial and endocardial FIBROSIS

HF: hypertrophy and fibrosis

Front 11

Most common CV disease cuased by a sincle gene mutation:

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hypertrophic cardiomyopathy

Front 12

functional defect in HCM

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diastolic dysfunction

Front 13

functional mutral/tricuspid valve insufficiency with 2x heart weight

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most liekely dilated cardiomyopathy

Front 14

banana shaped LV chamber:

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massive myocardial hypertrophy in HCM

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endocardial plaque in HCM casued be:

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mitral valve banging up against wall

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flabby heart with 4 chamber dilation

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DCM

Front 17

DCM affects:

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20-50yr old

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prognosis of DCM:

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50% die within 2 yrs

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treatment of DCM:

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transplantation

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complication of DCM:

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progressive CHF puts pt at risk for thromboembolic complication and arrhythmia

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Ventricular outflow obstruction on HCM due to:

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septal hypertrophy

Front 22

massive myocardial hypertrophy without ventricular dilation:

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HCM

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treatment of DCM

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surgical removal of myocardium; ventricular relaxing drugs

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genetic defect implicated in DCM:

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contractile genes encoding sarcomeric proteins: beta myosin heavy chain

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young athlete dies after complaints of exertional dyspnea:

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HCM

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Children/ YA in tropical areas such as africa with restrictive cardiomyopathy:

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Endomyocardial fibrosis

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Loeffler endomyocarditis:

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endomyocardial fibrosis with elevated eosinophilia blood levels

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damage in loeffler's due to:

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eosinophilial byproducts: primarily a myeloproliferative disorder.

Front 29

EFE occurs in:

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children in first two yrs of life, associated with other CMs:

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EFE:

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endocardial fibroelastosis - thickening of ?@#$?? look at ppt

Front 31

Viral causes of Myocarditis:

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Coxackie A and B, enteroviruses, CMB, HIV

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Protozoa causes of myocarditis:

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T. cruzi, toxoplasma

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Bacterial causes of myocarditis:

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borrelia burgorferi, Diptheria toxin

Front 34

non-infectious causes of myocarditis:

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drug reactions and immune diseases

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decreased ventricular compliance resulting in impaired ventricular filling during diastole

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restrictive cardiomyopathy

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Transthyretin deposition in heart:

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Senile cardiac amyloidosis causing restrictive CM

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Ventricular morphology in RCM:

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normal in size but biatrial dilation exists

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myocarditis diagnosed by:

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endomyocardial biopsy via catheter

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Morphology of heart in myocarditis:

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flabby, mottled, floppy heart

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prognosis of myocarditis:

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slow progression to DCM, also arrhythmias or suddent death

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DCM pt with iron deposition seen with Prussion Blue stain. Primary dysfunction:

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systolic dysfunction due to infereference with metal dependent enzymes or oxidative damage due to hemosiderosis

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protein in primary amyloidosis? secondary?

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primary: AL, secondary AA

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dose dependent myocardial toxicity pathogenesis?

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lipid peroxidation of myofiber membrane causing myofiber swelling and vacuolization, fatty change, and MYOCYTOLYSIS

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cardiac tamponade seen in:

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pericardial effusions causing restricted filling

Front 45

causes of hemopericardium:

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rupture, trauma

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Friction rub on auscultation. diagnosis? what else on physical exam?

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pericarditis with ECG changes and distant heart sounds

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Pericarditis can resolve in:

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scarring or chronic constrictive pericarditis

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most common pericarditis:

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fibrinous and serofibrinous pericarditis

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Primary paricarditis usually caused by what?

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viral infection

Front 50

Malignncy and tuberculosis causes what kind of acute pericarditis?

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hemorrhagic

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acute MI and uremia cause what kind of pericarditis?

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fibrinous/serofibrinous

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bacteria causes what pericarditis and how is this organized:

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purulent pericarditis usually causing fibrosis

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Caseous pericarditis:

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complication of tuberculosis

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Healed pericarditis usuall resolve in:

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fibrous thickening of membranes or mild adhesions

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adhesive mediastinopericarditis

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looks like DCM where adhesions to mediastinum acutally shows as a chest compression per cardiac cycle

Front 56

Constrictive pericarditis:

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pericardial sac scars so much that it limits filling, RCM-like

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most common primary tumor of heart in adults:

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myxoma, most common in LA, ball might obstruct valve

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Most common heart tumor in children:

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rhabdomyoma

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Carney syndrome:

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myxoma + skin lesions + endocrine tumors + peripheral nerve tumor

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spider cells:

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seen in rhabdomyomas

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Indications of transplant:

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V-DEC:
Valvular heart disease
DCM
End-stage ischemic heart disease
Congenital heart disease

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most common complication in heart transplant:

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rejection, including graft rejection in coronary arteries