CARDIOVASCULAR PATHOLOGY LABORATORY CASES AND SLIDES VPM 222 2009 Lisa Miller CARDIOVASCULAR LAB
Case 1 Heart - Echoplane section from a 7-month-old Labrador retriever Give two morphologic diagnoses 1. 2. What other pathological changes might be associated with these changes?
Case 1 Heart - Echoplane section from a 7-month-old Labrador retriever Give two morphologic diagnoses 1. Tricuspid dysplasia (severe) 2. Right ventricular hypertrophy 3. Right atrial dilation with endocardial fibroelastosis What other pathological changes might be associated with these changes? This lesion might produce significant right heart failure resulting in clinical and pathological signs of right heart failure (nutmeg liver, ascites,etc).
Case 2 Heart - Echoplane section from a 4-month-old calf. Give three morphologic diagnoses 1. 2. 3. Name the condition: If a pulmonic stenosis had been observed what would this condition be called?
Case 2 Heart - Echoplane section from a 4-month-old calf. Give three morphologic diagnoses 1. Right Ventricular Hypertrophy 2. Ventricular septal defect (membranous) 3. Over-riding Aorta Name the condition: Eisenmenger s Complex If a pulmonic stenosis had been observed what would this condition be called? Tetralogy of Fallot
Case 3 15-week-old, female Beagle puppy with facial and submandibular edema. Jugular pulses, grade VI/VI holosystolic murmur. Cardiomegaly. Puppy has always been quiet and smaller than other littermates. What changes can you see looking at the outside of the heart?
Case 3 15-week-old, female Beagle puppy with facial and submandibular edema. Jugular pulses, grade VI/VI holosystolic murmur. Cardiomegaly. Puppy has always been quiet and smaller than other littermates. What changes can you see looking at the outside of the heart? 1. Cardiomegaly with prominent vasculature 2. Heart is wider at base (RVH) 3. Dilated pulmonary artery at origin 4. Right atrium is large 5. Thymus present
Case 3 15-week-old, female Beagle puppy with facial and submandibular edema. Jugular pulses, grade VI/VI holosystolic murmur. Cardiomegaly. Puppy has always been quiet and smaller than other littermates. List two morphologic diagnoses: 1. 2. Do these pathological findings support the clinical signs?
Case 3 15-week-old, female Beagle puppy with facial and submandibular edema. Jugular pulses, grade VI/VI holosystolic murmur. Cardiomegaly. Puppy has always been quiet and smaller than other littermates. List two morphologic diagnoses: 1. Pulmonic Stenosis - valvular 2. Post-stenotic dilation of pulmonary artery (with jet lesions) Do these pathological findings support the clinical signs? YES
Case 4 11-week-old English Springer Spaniel with bilateral cardiomegaly. The heart weight was 3.1% body weight(!!!). The lung weight was 3.08% body weight(!!!). Morphologic Diagnosis (primary): Secondary Morphologic Diagnosis: Do these Describe the pathophysiology associated with this condition.
Case 4 11-week-old English Springer Spaniel with bilateral cardiomegaly. The heart weight was 3.1% body weight(!!!). The lung weight was 3.08% body weight(!!!). Morphologic Diagnosis (primary): Secondary Morphologic Diagnosis: Do these Describe the pathophysiology associated with this condition.
Case 4 11-week-old English Springer Spaniel with bilateral cardiomegaly. The heart weight was 3.1% body weight(!!!). The lung weight was 3.08% body weight(!!!). Morphologic Diagnosis (primary): Patent Ductus Arteriosus Secondary Morphologic Diagnosis: Do these Eccentric left ventricular hypertrophy Describe the pathophysiology associated with this condition. Review notes (or see next slide)
Patent Ductus Arteriosus Blood initially shunts from the left to right - from aorta to pulmonary artery. This results in over circulation of blood to the lungs and excess work load on the left heart. This may produce pulmonary hypertension and left ventricular eccentric hypertrophy. Eventually when there is severe pulmonary hypertension this may reverse the flow (right to left). This will result in differential cyanosis (blue hind limbs and abdomen with normal appearing oral mucous membranes).
Case 6 Radiographs and thoracic contents from a young German shepherd. Morphologic Diagnosis: What is the most common cause of death in these cases?
Case 6 Radiographs and thoracic contents from a young German shepherd. Morphologic Diagnosis: What is the most common cause of death in these cases?
Case 6 Radiographs and thoracic contents from a young German shepherd. Morphologic Diagnosis: Persistent right aortic arch with proximal megaesophagus What is the most common cause of death in these cases? Aspiration pneumonia
Case 7 Tissue from a middle aged cat which died suddenly. Morphologic Diagnosis: What other lesions might you look for and/or expect to see?
Case 7 Tissue from a middle aged cat which died suddenly. Morphologic Diagnosis: Hypertrophic Cardiomyopathy What other lesions might you look for and/or expect to see? Pulmonary edema Aortic thrombi (saddle thrombus) Renal Infarcts Also remember to check the thyroid glands
Case 8 Photograph of the thoracic area and echoplane section of heart from a young cat on a marginal diet. Morphologic Diagnosis:
Case 8 Photograph of the thoracic area and echoplane section of heart from a young cat on a marginal diet. Morphologic Diagnosis: Dilative Cardiomyopathy and Hydrothorax Note: Cats with congestive heart failure can develop hydrothorax or chylothorax. This cat may have had taurine deficiency.
Case 9 Photomicrograph of heart from a young calf which died to E coli enteritis. What do you think these changes represent?
Case 9 Photomicrograph of heart from a young calf which died to E coli enteritis. What do you think these changes represent? Freezing artifacts!!! Note The clear areas represent where ice crystals once were. This can happen if the tissue freezes in or out of formalin (Yikes winter is a coming ).
Case 10 Heart from a young pig. Morphologic Diagnosis: Name the Disease: Etiology:
Case 10 Heart from a young pig. Morphologic Diagnosis: Petechial and ecchymotic haemorrhages Name the Disease: Mulberry Heart Disease Etiology: Vit E/Se deficiency
Case 11 Heart from a cow. These areas represent myocardial necrosis. What are some disorders which might cause this?
Case 12 Photomicrograph of myocardium from a 13-week-old English Pointer puppy from South Texas Morphologic Diagnosis: Etiology:
Case 12 Photomicrograph of myocardium from a 13-week-old English Pointer puppy from South Texas Morphologic Diagnosis: Lymphoplasmacytic and granulomatous, diffuse, chronic, pericarditis with intrasarcoplasmic amastigotes (wow) Etiology: Trypanosoma cruzi Chagas Disease
Case 14 Tissue from an elderly Golden Retriever. Morphologic Diagnosis: Heart: Lung:
Case 14 Tissue from an elderly Golden Retriever. Morphologic Diagnosis: Heart: Right atrial hemangiosarcoma Lung: Pulmonary metastases widespread - hemangiosarcoma
Case 15 Tissue from an old Pomeranian with a chronic history of mitral insufficiency. Died suddenly. Morphologic Diagnosis: Cause of Death:
Case 15 Tissue from an old Pomeranian with a chronic history of mitral insufficiency. Died suddenly. Morphologic Diagnosis: Endocardiosis with ruptured chordae tendinae (also has jet lesions) Cause of Death: Acute pulmonary edema due to acute left heart failure
Case 16 Tissue from a calf. Morphologic Diagnosis: Significance:
Case 16 Tissue from a calf. Morphologic Diagnosis: Hematocyst (hemocyst) mitral valve Significance: No clinical significance interesting abnormal/normal finding
Case 17 Tissue from a dog from California. Morphologic Diagnosis: What clinical signs might you expect to see with this disease process?
Case 17 Tissue from a dog from California. Morphologic Diagnosis: Aortic and Mitral valvular, proliferative, fibrinonecrotic endocarditis What clinical signs might you expect to see with this disease process? Clinical signs of left heart failure, feber, polyarthritis, etc.
Case 18 These pathologic changes were found in a 7-year-old, male dog who died of acute renal failure, (2 examples from two different dogs). Etiologic Diagnosis:
Case 18 These pathologic changes were found in a 7-year-old, male dog who died of acute renal failure, (2 examples from two different dogs). Etiologic Diagnosis: Uremic Endocarditis
Case 20 Tissue from a 7-day-old calf with a history of septicaemia. Morphologic Diagnosis: Hint Urinary bladder is in the centre and is open.
Case 20 Tissue from a 7-day-old calf with a history of septicaemia. Morphologic Diagnosis: Umbilical arteries Omphalophlebitis, necrotizing, severe. Hint Urinary bladder is in the centre and is open.
Case 21 Abdominal contents from a 5-year-old Doberman Pinscher.. Morphologic Diagnosis: Prognosis:
Case 21 Abdominal contents from a 5-year-old Doberman Pinscher.. Morphologic Diagnosis: Multiple acquired portosystemic shunts with varices Prognosis: poor