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Cardiovscular 2 (Path II) - Coggle Diagram

- - - - Definition:
        
        Acute, subacute or chronic generalized disorder of heart muscle. An intrisic disease of the myocardial fibre, with unknown causes.
        
        This is primary disease process within the myocardium.
        
        in pathologic terms, cardiomyopathy is diagnosed as gross or histological changes in the myocardium
      - Cause:
        
        etiology is unknown or obscure
        
        Idiopathic-speculation of immune or viral etiologies
      - Types
        (Based on thickness of cardiac wall)
        
        Hypertrophic Cardiomyopathy (HCM)
        
        increased heart weight relative to body weight
        
        Pathophysiology:
        
        Decrease ventricular filling decrease compliance and cause diastolic dysfunction
        
        Primarily a left ventricle problem. But can invlove both ventricle and occasionally only septal hypertrophy
        
        Referred as Eccentric Hypertrophy Cardiomyopathy
        
        Histo:
        
        Myocardial fibres are irregular in size
        
        Nuclei are large, Myofibers are disorganized (myofibre disarray)
        
        Species: cat, dog, rat, pig, human
        
        Feline: middle age males, 10-20% posterior paralysis
        
        Breeds: Maine Coon, Rag Doll, British and Americal SHorthair, Rex, Persian
        
        2. Congestive or DIlated Cardiomyopathy (DCM)
        
        Progressive cardiac dilatation and contractile dysfucntion
        
        Pathophysiology:
        
        decrease contractile force, increased end diastolic volume
        
        Cause:
        
        Taurine deficiency in cats and foxes
        
        L-carnitine deficiency may be related to DCM
        
        Histo:
        
        Myocardial fibres are thin and wavy
        
        Variable amounts of fibrosis may be present
        
        Species: cat, dog, hamster, pig, cow, turkey, foxes
        
        3. Restrictive Cardiomyopathy
        
        Least common type seen in domestic animals
        
        Gross and Histo:
        
        Diffuse endocardial fibroelastosis
        
        Excessive moderator bands in the left ventricle (Cat)
        
        Due to restriction of ventricular filling
        
        Endocardial Fibroelastosis (EFE)
        
        EFE is characterized by a thickening within the muscular lining of the heart chambers due to an increase in the amount of supporting connective tissue (inelastic collagen) and elastic fibers
        
        Species: Cat (Burmese), human
        
        Endocardial Fibrosis- endomyocarditis
        
        4. Others:
        
        Arrhythmogenic Right Ventricular Fibroadipose Dysplasia
        
        Adipose tissue and fibroblast infiltrate and replace normal right ventricular myocardial tissue
        
        Seen most often in Boxer dogs
    - - Definition:
        
        Any disease of the myocardium that is the result of a metabolic, toxic, infectious or neoplastic disease process
        
        2nd cardiomyopathy is myocardial disease that isnt inflammatory or primary cardiomyopathy
        
        Can be peracute, acute, subacute or chronic (many are peracute)
      - Endocrine/Metabolic Disease
        
        Catecholamine Toxicity
        
        CNS trauma: 'Brain-Heart syndrome" -myocardial damage 2nd to release of endogenous catecholamine dump from trauma to the head and brainstem nuclei
        
        Functional pheochromocytoma- tumor of the adrenal medulla
        
        Exogenous- overzealous administration of epinephrine etc
        
        Lesions:
        
        Multifocal myocardial necrosis with concentration of damage on the left ventricular subendocardium and papillary muscle
        
        Lesions consist of necrosis with contraction bands with subsequent macrophage invasion
        
        Excess intracellular calcium, vasoconstriction and increased heart rate
        
        Hyperthyroidism
        
        Primarily feline
        
        Cardiac hypetrophy due to increassed production of myocardial contractile proteins under the influence of excess concentration of circulating thyroid hormones
        
        Heart rate and cardiac output are also increased
        
        Reversible upon return to euthyroidism
        
        Hypokalemia
        
        Causes: potassium deficient diets, hemodialysis
        
        Lesions:
        
        Multifocal myocytolysis, myodegeneration and necrosis at left ventricle free wall and septum
      - Nutritional Deficiencies
        
        Vitamin E/Selenium deficiency
        
        synonym to the disease:
        
        White Muscle Disease - lambs and calves
        
        Mulberry Heart Disease - pigs
        
        Incidence:
        occurs in areas with soil deficient in Vit E
        
        Etiology:
        
        Low dietary levels of selenium, Vit E and sulphur-containing amino acid
        
        High dietary concentrations of polyunsaturated fats
        
        Exposure to prooxidant compounds ozone, 02, iron, radiation injury, doxarubicin
        
        Intake of selenium antagonits such as silver salts and various other metals mercury, copper, cobalt, zinc, cadmium, tin
        
        Pathogenesis:
        
        Vit E is an antioxidant that works synergistically with glutathione peroxide to catalyze the conversion of H2O2 ->H2O. Selenium is an integral structure of glutathione peroxide (metalloenzyme)
        
        Gross lesion:
        Calves: extensive pale areas of necrosis and mineralization in the left ventricular free wall and ventricular septum
        Lambs: similar areas of necrosis and mineralization but lesions are present in the subendocardial myocardium of the right ventricle
        Pigs: widespread epicardial and myocardial hemorrhages, with pale streaks scattered throughout the heart. The myocardial lesions are present in the walls of all chambers, but tend to be most severe within the atria than the ventricular myocardium
        - Histo:
        
        Calves and lambs: Areas of myocardial damage have hylaine necrosis with or w/o accompanying mineralization, macrophage invasion, with eventaul stromal collapse and fibrosis
        
        Pigs: Vascular lesions consist of fibrinoid necrosis in intramyocardial arteries and arterioles. Numerous fibrin microthrombi in myocardial capillaries
        
        Myocardial hemorrhage and edema. MUscular lesion include hyaline necrosis and mineralization with macrophage invasion and later fibrosis
        
        Copper and/or Iron deficiency
        
        Synonym- 'Falling disease" cattle
        
        Lesions:
        
        Gross: pale, atrophic and flabby hearts
        
        Micro: Myocardial fibrosis
        
        Experimental disease in pig
        
        Lesion: myocardial rupture=hemopericardium
        
        Rupture of pulmonary or coronary arteries