cv path 2 - epicardium, pericardium, endocardium

normal contents of pericardium

clear, viscous pericardial fluid

normal contents of pericardium- vol in horse/cow

100ml

normal contents of pericardium- vol in dog/cat

10ml

pericardial diseases- hydropericardium def

clear to yellow watery, serous fluid in pericardial sac

pericardial diseases- hydropericardium fluid SG

transudate → <1.015

pericardial diseases- hydropericardium causes

BV injury - mulberry heart disease (fibrin so clots when exposed to air (exudate))

oedema - from inc BV permeability (influenza, arterivirus, clostridium, e coli shiga like toxin, e rhusopathiae, type 3 hypersensitivity, toxins), from inc IV hydrostatic pressure (pul hypertension, iatrogenic fluid overload), dec IV osmotic pressure (dec albumin, protein loss), dec lymphatic drainage

pericardial diseases- hydropericardium gross

acute - smooth, glistening pericardial surface

chronic - opaque, mild fibrous thickening from villous proliferation of fibrous tissue

pericardial diseases- hydropericardium causes (infectious)

influenza, arterivirus, clostridium, e coli shiga like toxin, e rhusopathiae, type 3 hypersensitivity → inc BV permeability

pericardial diseases- hydropericardium effects

cardiac tamponade, compression → impair filling + venous return

pericardial diseases- haemorrhagic pericardial effusion def

deposition of small amounts of blood

pericardial diseases- haemorrhagic pericardial effusion breeds

great dane, st bernard, german shepherd

pericardial diseases- haemopericardium def

large blood accumulation

pericardial diseases- haemopericardium effects

cardiac tamponade → compression → interfere with filling + emptying

pericardial diseases- haemopericardium causes

haemangiosarcoma → atrial rupture (dogs)

intrapericardial aorta rupture (horses)

intracardiac inj complications

pericardial diseases- pneumopericardium def

pericardial sac filled with air

pericardial diseases- pneumopericardium causes

pulmonary / pericardial ruptures

oesophagus + stomach perforation

pericardial diseases- chylopericardium def

gelatinous + white exudate build up

SG > 1.015

pericardial diseases- chylopericardium causes

thoracic duct rupture

pericardial diseases- melanosis causes

normal/ incidental

serous atrophy of epicardial adipose tissue - causes

anorexia, starvation, cachexia → fat catabolism

serous atrophy of epicardial adipose tissue - gross

transformation of white/yellow epicardial fat deposits into grey gelatinous material

serous atrophy of epicardial adipose tissue - histo

atrophic lipocytes, interstitial oedema

peri/epicarditis - route of entry

foreign body presentation - from reticulum

local extension of severe infl process from adjacent structures

haematogenous spread of inf

peri/epicarditis - types of exudate

serous - excess watery fluid, low protein, low cells

fibrinous - fibrin exudate from inc BV permeability

purulent - neutrophil infl

sero-fibrinous

fibrino-purulent

proliferative fibrosing - replacing unrepaired tissue with scarring

granulomatous - chronic infl (macrophages)

pericarditis - fibrinous gross

pericardium covered by yellow fibrin deposits → parietal + visceral adherence

easy to tear away

pericarditis - fibrinous histo

eosinophilic fibrin layer with neutrophils over congested pericardium

pericarditis - fibrinous effects

septicaemia → death

constructive pericarditis (proliferative fibrosing) → firm fibrous adhesions → obliterate pericardial sac, interfere with filling + emptying → compensatory hypertrophy → CHF

pericarditis - fibrinous causes

cats - FIP

cattle - pasteurellosis, blackleg (clostridium chauvoei), colisepticaemia

pig- glassers disease (haemophilus parasuis), streptococcus, pasteurellosis, mycoplasma hyopneumoniae, salmonellosis

horses - streptococcus

birds - chlamydia psittaci

Pericarditis gross

Adhesive/ sticky layer on surface

Fibrinous = transudate, modified transudate

SG of transudate

<1.015

SG of exudate

>1.015

when does transudate occur

metabolic disorders - hhypalbuminaemia, hepatopathies, nephropathies, cachexia

when does exudate occur

infl - viral/bact inf

porcine polyserositis features (Glässer's disease) fibrinous pericarditis

infectious polyarthritis → fibrinous polyserositis from haemophilus parasuis in stressed young pigs

fibrinous pericarditis in streptococcus inf

horse → proliferative fibrosis → muscular hypertrophy

fibrino-suppurative pericarditis - gross

thick pericardial surface with white, rough, shaggy masses of fibrin

purulent exudate (neutrophils with fibrin)

fibrino-suppurative pericarditis - effects

septicaemia → death

constrictive pericarditis - fibrous exudate → adhesions (proliferative fibrosing)

effects of fibrinous adhesions on pericardial sac

obliterates sac

constrict heart filling + emptying

compensatory hypertrophy → CHF

traumatic reticulopericarditis (fibrino-suppurative pericarditis) / wire hardware disease

foreign bodies penetrate reticulum + diaphragm → enters pericardial sac → bact transfer

traumatic reticulopericarditis (fibrino-suppurative pericarditis) / wire hardware disease chronic gross

Fibrin replaced by fibroblasts making fibrous CT

traumatic reticulopericarditis (fibrino-suppurative pericarditis) / wire hardware disease Histo

Acute - fibrin

Chronic - fibrous CT (collagen)

endocardial diseases- mineralization causes

hypervitaminosis D, calcinogenic plants (solanum, cestrum, trisetum), hyperparathyroidism, renal failure, johnes disease

Elastic fibres susceptible to mineralisation

endocardial diseases- mineralization gross

multiple large white rough firm gritty plaques of mineralised fibroelastic tissue in endocardium + elastic arteries intima

endocardial diseases- fibrosis causes

chronic dilated hearts, healed ulcerative endocarditis (uraemia), jet lesions (valvular stenosis/regurgitation)

endocardial diseases- pigmentation causes + effects

melanosis → nothing

endocardial diseases- valvular endocardiosis / myxomatous degeneration causes

age (small, toy breeds) from degeneration of valvular collagen

endocardial diseases- valvular endocardiosis / myxomatous degeneration effects

shortened + thickened valves → valvular insufficiency, CHF, jet lesions (atrial endocardium lesion from blood regurgitation), chordae tendinae rupture

endocardial diseases- valvular endocardiosis / myxomatous degeneration gross

shortened thickened smooth shiny nodular valves

endocardial diseases- valvular endocardiosis / myxomatous degeneration histo

inc fibroblastic proliferation, mucopolysaccharide deposition

endocardial diseases- valvular endocardiosis / myxomatous degeneration which valves affected

mitral > tricuspid > aortic > pul

endocardial diseases- L ventricular endocardial fibroelastosis breeds

siamese, burmese

endocardial diseases- L ventricular endocardial fibroelastosis effects

myocardial lymph drainage defect → chronic oedema, fibroelastic tissue proliferation → (restricted output → CHF)/ (incarcerate purkinje fibres → L bundle branch block)

endocardial diseases- endocarditis causes

endothelial injury

extracardiac inf → haematogenous dissemination

Valve injury → bacteria adhere

endocardial diseases- endocarditis infectious causes (pre existing → spreads through septicaemia)

pigs- streptococcus, e rhusiopathiae

cattle - arcanobacterium pyogenes

SA- streptococcus, e coli

endocardial diseases- endocarditis gross (mainly affects valves)

rough granular surface

large adhering friable yellow/grey masses with layers of fibrin added to thrombus (vegetations)

endocardial diseases- endocarditis histo

fibrin, platelets, bact, leukocytes, RBC

chronic - fibrous CT → irregular mineralised fibrous nodular masses

endocardial diseases- endocarditis how does death occur

valvular dysfunction → cardiac failure

bacteraemia

septic emboli disseminate → infarction, abscess

multifocal purulent lesions throughout organ (embolic showers)

endocardial diseases- R cardiac endocarditis causes (mainly cattle)

stenosis of R valve

chronic hepatic congestion

pul embolism

endocardial diseases- L cardiac endocarditis causes (mainly dog, horse, pig)

L valve stenosis

chronic pul congestion

systemic embolism

endocardial diseases- ulcerative endocarditis causes

uraemia (acute renal insuffiency)

endocardial diseases- ulcerative endocarditis gross

ulcer replaced by raised white plaques of fibrous + mineralised tissue

Endocarditis - effects

Septic emboli disseminate

Emboli showers - MF purulent lesions scattered throughout organ

Ulcerative endocarditis - cause

Uraemia

Ulcerative endocarditis - Gross (after healing)

Area replaced by raised whiter plaques of fibrous + mineralised tissue