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334692
Cardiopathology
Beschreibung
Doctorate Pathology (Systems Pathology) Mindmap am Cardiopathology, erstellt von melian.yates am 06/11/2013.
Keine Merkmale angegeben
pathology
systems pathology
pathology
systems pathology
doctorate
Mindmap von
melian.yates
, aktualisiert more than 1 year ago
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Erstellt von
melian.yates
vor etwa 11 Jahre
263
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Zusammenfassung der Ressource
Cardiopathology
Congenital Diseases
1) Septal Defects (Chamber development/partitioning)
Atrial Septal Defect
Persistent foramen ovale
1) LA -> RA -> RV
RA dilation
Increased RV Preload => Eccentric RV Hypertrophy
2) Pulmonary overperfusion
Increased pulmonary return => LA dilation
Ventricular Septal Defect (VSD)
1) LV -> RV
Increased RV Preload & Afterload => Eccentric RV Hypertrophy
2) Pulmonary overperfusion
Increased pulmonary return => Dilation & Increased LV Preload => LV Eccentric Hypertrophy
Development of ventricular septum: Ventral -> Dorsal (Opening Dorsal near Pulmonary valve or Mitral Valve)
2) Great Vessel Vascular Anomaly (Great vessels & Valve origins)
Pulmonic Stenosis
1) Increased RV Afterload
=> RV Concentric Hypertrophy
2) Pulmonary Artery Poststenotic Dilation
Dilation of base of pulmonary artery
Aortic Stenosis
1) Increased LV Afterload
=> LV Concentric Hypertrophy
2) Aortic Poststenotic Dilation
Tetralogy of Fallot
Uncommon
Calves, Pigs, Dogs
Multiple congenital abnormalities simultaneously
1) Pulmonic Stenosis
Increased RV Afterload
=> 3) RV HYpertrophy
2) VSD: RV -> LV
Systemic Hypoxia
4) Dextro-rotated aorta
Patent Ductus Arteriosus
Calves (Major vessels - Don't close until 2 weeks after birth (Normal))
3-5cm distal to Aortic & Pulmonary valves
1) Aorta -> Pulmonary artery (Blood flow)
=> Increased RV Afterload => RV Concentric Hypertrophy
2) Pulmonary Overperfusion
=> Increased Pulmonary return -> LA Dilation & LV Preload -> LV Eccentric Hypertrophy
Shunting Sequelae
Blood shunts from Left -> Right => Pulmonary Hyperperfusion
=> Sustained Pulmonary Hypertension
=> Vascular changes in lung & arteriosclerosis
=> Increased resistance (Increased pressure in RT) => SHUNT REVERSAL (Right -> Left => Cyanosis)
Aortic Arch Syndrome
Abnormal development of the Aorta from the foetal brachial arches
Aortic Arch (LT side = Normal)
Mechanical disruption
Persistent Aortic Arch
Most Common
Aorta arises from anomalous right side (RT 4th brachial arch) + Persistent Ductus Arteriosus (ligamentum arteriosum)
Consequence: Vascular ring formation => Stricture of the oesophagus => Megaoesophagus => Regurgitation (undigested)
Double Aortic Arch
Vascular ring formed by persistence of both 4th brachial arches around the oesophagus
Very rare
Anomalous Subclavian Arteries
Aberrant origin of one or both subclavian arteries causes oesophageal stricture
3) Valvular Dysplasias
Usually atrioventricular valves affected
Leaflets of endocardium
1) Valve leaflets replaced by web-like structure
2) Short chordae with small papillary muscles
Combination of 2 forms possible
Result of impaired development during embryogenesis
Genetics, Mother (issues during pregnancy), Chemicals, Infectious agent
Others: Coarctation of the aorta, Ectopia cordia, Endocardial fibroelastosis (Endocardium increases thickness), Pericardial abnormalities (absent or malformed)
Pathophysiological Mechanisms
Pump failure
Heart not contracting as hard as it should
Obstruction to forward blood flow
Systemic - Valves, Lungs (Increased PVR), Hypertension
Regurgitant Blood Flow
Malformed valves not closing adequately - Esp. AV valves - Reflux back into Atria
Shunted Blood Flow
Congenital defects (Septal defects, Persistant ductus arteriosus)
Rupture of Heart or Major
Hypovolemia => Shock, fluid build-up in pericardium, Increase in P
Cardiac Conduction Disorders
Arrhythmias - Unsynchronized contractions, blood not being pumped in proper direction
Myocardial Compensation
Responses of the myocardium to heart failure
Cardiomyocytes do NOT divide, can only undergo HYPERTROPHY, NOT Hyperplasia
Types
Concentric Hypertrophy
Response to increased Afterload (Ventricular volume </= Normal)
HYPERTROPHY ONLY
Increase in Mass (Thicker/larger wall)
Eccentric Hypertrophy
Response to increased Preload (Ventricular volume > Normal)
HYPERTROPHY & DILATION
Increase in Mass & Volume of chambers
Progression
Chronic Hypertrophy => Myofibre degeneration + Interstitial fibrosis
1:1 Ratio of Cardiomyocytes to Blood not held => Cardiomyocytes not properly perfused => Degeneration
Dilation can compensate up to a limit
Frank Starling Mechanism
Increase in Preload => Increase in SV (Functional)
Congestion earlier for failing heart
Aquired Diseases
Pericardial Diseases
Non-inflammatory
Hydropericardium
Excessive fluid accumulates in the pericardial cavity
Cardiac tamponade
Haemopericardium
Blood accumulates in the pericardial sac
Cardiac tamponade
Idiopathic Effusions
Inflammatory
Pericarditis
Causes:
1) Haemotogenous
Result of septicemia (Most Common)
2) Extension from surrounding tissues
Lungs, pleura, mediastinum > myocardium
3) Traumatic
Ex. Traumatic Reticulopericarditis
Serofibrinous/haemorrhagic
Purulent
Staph, strep
Leakage of fibrin
Sequelae
Resolution
Adhesion
Constriction
Myocarditis
Myocardial Diseases
Functional
Ex. Concentric/ Eccentric Hypertrophy
Metabolic Disturbances (Degeneration)
Hydrophobic degeneration
Fatty change/degeneration
Fatty infiltration
Hylaine degeneration
Mineralization (Calcification - Metastatic vs. Dystrophic)
Urate deposition (visceral gout)
Dehydration/Infectious agent (Impairing renal function)
Uric acid accumulates in tissues (not as soluble as urea)
Diet (too much Vit. D)
Parathyroid problems
Infarction (rare in animals)
Impairs contractability of heart
Embolism
Hyperthyroidism, Diabetes mellitus (Dogs)
Acute
Red (haemorrhage, hyperaemia)
Grey
Inflammation (Myocarditis)
Acute & Suppurative
Acute & Non-suppurative
Chronic
Lymphocytes, macrophages (No Neutrophils)
Infectious lesion (elsewhere) => infectious embolis
Parasitic
Fibrous sacs
Nutritional (deficiencies)
Cardiomyopathies (Nutritional & Idiopathic)
Nutritional (Vit. E/Se deficiency)
Antioxidant function
Mulberry heart disease
White muscle disease
Oxidative damage of myocytes => Necrosis
Genetic
Malignant hyperthermia (Pigs) - Point mutation in Ca2+ channel => Necrosis
Endocrine
Feline hyperthyroidism
Sxs: Thin, tachycardia, hypertension, hyperactive, (possibly aggressive), Increased BMR, Increased appetite
Pathology:
LV Concentric Hypertrophy
Uni/bi-lateral thyroid involvement
Neoplasia (older)/ Hyperplasia (younger)
Idiopathic
Dilated cardiomyopathy (DCM)
Cats (Taurine deficiency)
Horses, Dogs (Toxicity)
Hypertrophic cardiomyopathy (HCM)
Cats
LV Concentric hypertrophy
Saddle thrombus (10-20% of cases)
Myofibre disarray/ loss + fibrosis
Point mutation in contractile proteins
Turbulence in Atrium
Thrombus of LA => Aortic arch
Restrictive cardiomyopathy
Fibrosis of endocardium
Arrythmogenic RT ventricular cardiomyopathy
Primarily Boxers (familial)
Affects RV & S
Myocardial replacement
adipose tissue + fibrosis
=> Disruption of conduction tissue
Epicardial Disease
Ex. Serous atrophy of Fat
Endocardial Disease
Valvular Disease
Consequences:
Stenosis
More common in AV or PV (Semi-lunar valves)
Help flow to be unidirectional
=> Increased afterload > Concentric hypertrophy
Insufficiency/ Incompetence
AV Valves
Large surface area
=> Regurgitation > upstream congestion > Increased preload > Eccentric Hypertrophy
Valvular Endocardiosis
Mostly Canine
> 6 yrs old
Small breeds (Ex. Cavalier King Charles Spaniel)
Mostly arterioventricular: Mitral valve
=> Valvular Insufficiency (NOT Stenosis)
Equine Valvulopathy
Valvular lesions subtle in Horses
Fibrosis
AV valves => Insufficiency
Aortic valve => Stenosis/Insuffiiciency
Endocarditis
Common: Cow, Sheep, Pig
Rare: Horse, Dog, Cat
Septicaemia/pyaemia from septic/purulent foci
Colonize/infect endothelium
Septic embolism -> deposit -> Thrombus
Septic Thrombi (from leaflets of valves)
Usually valvular (can extend to mural)
RT side: Cow
LT side: Other species
Both sides: Pig
Sequelae:
Post endocarditis valvular obliteration
Septic embolism
Thromboembolic infarction (post LAV endocarditis -> Kidney)
Pulmonary thromboembolism (post RAV endocarditis)
Necrotising Mural Endocarditis
Endocardial Calcification
Valve " Cysts"
Congenital
Haematomas/lymphatic (AV)
Jet lesions
Valvular insufficiency
Melanosis
Non-significant
Cardiac Neoplasia
Primary
Arises in Heart itself
Haemangiosarcoma
Endothelum (Mesenchymal)
RT Atrium
Chemodectoma (Heart base tumor)
Epithelial
Secondary
Lymphoma
Metastasis
Secondary Cardiac Disease
Cor pulmonale
=> Pulmonary disease -> Cardiac disease
Primary pulmonary disease
Pulmonary Thromboembolism
Mechanical vascular obstruction
Resp. Impairment
Altitude Disease (> 2000m)
Pulmonary hypertension
Increased Pulmonary resistance => Increased RT ventricle afterload
Systemic Disease
LT side of Heart affected
Ex. Cats: Renal failure => Hypertension
Vascular Disease
Arterial Disease
Hypertension
Intimal hypertrophy/ arteriosclerosis
Obliterates lumen in artery
Thickened tunica media
Proliferation of tunica intima
Decrease in size of lumen
Intramural Substance Deposit
Arteriosclerosis
Plaque lesions, poorly demarcated
Atherosclerosis
Amyloidosis
Spleen or Kidney
Result of chronic inflammation
Alpha sheet (soluble), Beta sheet (animals -> INSOLUBLE => Deposits in tissues)
Acute phase proteins (SAA) -> Normally alpha helix + inflammation => Beta pleated sheet
Systemic Reactive Amyloidosis (Most common), Heritary amyloidosis (sharpei, asian cats), AL amyloidosis (Increase in plasma cells (Tumor))
Calcification
Ca2+ deposits on walls of tissue
Metastatic or Dystrophic
Poor intestinal function
Base of Aorta -> Not hypercalceamic (mimicing metastatic)
Fibrinoid necrosis
Looks like Fibrin, but is NOT fibrin (degeneration of cells)
Wall has become necrotic & died
Inflammation (Arteritis)
Infectious (Generalized/local)
Bacterial
Thrombosis of vessels in skin (Infarcts)
Viral
Virus targeting endothelium -> infarction -> ulcers
Mycotic
Lush pasture/ High concentrates -> Dec. pH -> Inc. Lactic acid bacteria -> Mucosal erosion (Rumen/abomasum) -> FUNGAL INVASION (mucosa & vasculature) -> Thrombosis (obliteration of lumen) -> Necrosis
Parasitic
Upstream: Venacava -> obliteration
Downstream: Arteriosclerosis
Non-infectious
Type III Hypersensitivity
Ag-Ab complex (deposit in vasculature & glomeruli)
Immune complex mediated inflammation & tissue injury
Ex. Purpura haemorrhagica (Horses)
Sequella of infection
Idiopathic
Ex. Polyarteritis nodosa, Beagle pain syndrome
Mural/luminal changes
Aneurysms
Aortic rupture
Thrombosis
Venous Disease
Thrombosis/phlebitis
Jugulars, Venacava, Portal vein
Rupture
Exercise induced (Horses)
Mural/Luminal Structural Chamges
Aneurysm
Rupture
Thrombosis
1) Damage to Endothelium
2) Changes in BF
3) Changes in coagubility
Idiopathic (Ex. Hypertrophic cardiomyopathy)
Medienanhänge
Frank_starling_mechanism (image/png)
Bilateral_eccentric_hypertrophy (image/png)
Concentric_hypertrophy (image/png)
Eccentric_hypertrophy (image/png)
persistent_foramen_ovale_2 (image/png)
persistent_foramen_ovale_3 (image/png)
persistent_foramen_ovale (image/png)
VSD (image/png)
VSD2 (image/png)
VSD3 (image/png)
pulmonic_stenosis (image/png)
Pulmonic_stenosis2 (image/png)
Aortic_stenosis (image/png)
patent_ductus_arteriosus (image/png)
patent_ductus_arteriosus2 (image/png)
Aortic_arch_syndrome (image/png)
vascular_ring__aortic_arch_syndrome_ (image/png)
valvular_dysplasia__short_chordae_ (image/png)
valvular_dysplasia__web_ (image/png)
pericarditis (image/png)
pericarditis2 (image/png)
traumatic_reticulopericarditis (image/png)
epicardial_disease (image/png)
myocardial_fatty_change (image/png)
myocardial_infarct (image/png)
Myocardial_infarct2 (image/png)
myocardial_mineralization (image/png)
myocarditis (image/png)
Myocardial_parasitism (image/png)
White_muscle_disease2 (image/png)
white_muscle_disease (image/png)
endocardial_fibrosis (image/png)
saddle_thrombus (image/png)
Endocarditis (image/png)
Endocarditis_sequelae_-_septic_embolism__thrombus_ (image/png)
Valvular_endocardiosis (image/png)
Equine_valvulopathy (image/png)
Necrotising_endocarditis (image/png)
Valvular_cysts (image/png)
Endocardial_calcification (image/png)
Histiocytic_sarcoma (image/png)
Heart_Base_Tumor (image/png)
Haemangiosarcoma_2 (image/png)
Cardiac_lymphoma (image/png)
Cor_pulmonale (image/png)
Arteriosclerosis (image/png)
Amyloidosis2 (image/png)
Aortic_mineralization (image/png)
Aoric_mineralization__Johne_s_disease_ (image/png)
Mineralization (image/png)
Fibrinoid_Necrosis (image/png)
Arteritis_-_Beagle_pain_syndrome (image/png)
Arteritis_-_type_III_hypersensitivity (image/png)
Bacterial_arteritis (image/png)
Idiopathic_arteritis (image/png)
Mycotic_arteritis (image/png)
Parasitic_arteritis (image/png)
Parasitic_arteritis2 (image/png)
Viral_arteritis (image/png)
Rupture (image/png)
Aneurysm (image/png)
common_cardiac_diseases_cats (image/png)
common_cardiac_diseases_dogs (image/png)
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