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7. heart pathology; myocadial diseases


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7. heart pathology; myocadial diseases

  1. 1. Heart -Pathology  Types  Myocardial diseases Cardiomypathies Dilated (DCM), Hypertrophic (HCM), Restrictive (RCM) Feature DCM HCM RCM Cause Idiopathic in most ( 1/3 –Genetic), alcohol, viral, vit. B1 deficiency Genetic mutations in myocyte proteins in All cases ( MCbeta myosin chain mutations) Rx related ( radiation) and infiltrative disorders ( amyloidosis, Metastasis, storage diseases, Sarcoidosis) Dysfunction Systolic Diastolic Diastolic Ejection fraction (normal 60%) <25% - - Chambers enlarged All four Lt. atrium Both atria 1 Dr. Krishna Tadepalli, MD,
  2. 2. CARDIOMYOPATHY Dilated Cardiomyopathy – Mural thrombi Globoid shape ( inferior part of heart rounded shape )  Hypertrophy < dilatation ( increased, normal, or decreased thickness)  Hypertrophic Cardiomyopathy – Massive hypertrophy in septum and free wall of ventricle Impaired diastolic filling Dilation of atrium Restrictive Cardiomyopathy ventricle walls stiff (not dilated) Both atria are dilated Impaired diastolic filling 2 Dr. Krishna Tadepalli, MD,
  3. 3. Heart -Pathology Myocardial diseases  Dilated (DCM) globoid heart  Hypertrophic (HCM) hypertrophic inter ventricular septum (3 times thicker than left ventricular wall -3:1), banana shaped septum  Myocyte disarray, fibrosis  What is normal septal to ventricular wall thickness ratio? Which Cardiomyopathy? 3 Dr. Krishna Tadepalli, MD,
  4. 4. Heart -Pathology Myocardial diseases  Myocarditis  Causes   viral ( MC in North America – Coxsackie B)  Trypanosoma cruzi – (MC in South America)  Hypersensitivity  drugs  Giant cell Idiopathic  Clinical  nonspecific( Flu like – fever, Dyspnea), pain, palpitations  Types 4 Dr. Krishna Tadepalli, MD,
  5. 5. Heart -Pathology Myocarditis  Types Feature Lymphocytic Chaga’s (Viral) Giant cell Hypersensitivity Cause Viral (Coxsackie B) Trypanosoma Idiopathic Drugs ( antibiotics, anti –HTN) Geography North America South America - - Cell response Lymphocytes Necrosis +PMN +organisms Giant cells, PMN, Eosiophils Prognosis - - Poor 5 Dr. Krishna Tadepalli, MD,
  6. 6. Myocarditis - Types 6 Dr. Krishna Tadepalli, MD,
  7. 7. Myocarditis - Types 6 Dr. Krishna Tadepalli, MD,