diseases of the pericardiumpeople.upei.ca/lmiller/2009_cv_pericardial... · diseases of the...
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DISEASES OF THE PERICARDIUM
• Primary disease rare
• Secondary disease common
– Direct extension
– heart, pleura, lungs
– Systemic
• Reaction is limited
• May provide clues
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Non-Inflammatory Pericardial Disease
• Hydropericardium– Definition: Excess accumulation of transudate
• Causes– Hypoproteinemia
– Congestive heart failure
– Neoplasia
– Systemic disease
• Significance– Acute
• cardiac tamponade
– Chronic - extensible
– Reversible - if cause can be removed
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Systemic DiseasesResulting in Hydropericadium
• Mulberry Heart Disease– Swine
• Septicemia in pigs
• “Heartwater” – Richettsial disase
• Viral Diseases– African Horse
Sickness
– Bovine Ephemeral Fever
– African Swine Fever
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Hemopericardium
• Definition – Accumulation of blood in
pericardial sac
• Causes– Aortic or Pulmonary
artery - rupture within pericardial sac
– Iatrogenic
– Bleeding from a tumour within pericardial sac
– Atrial rupture
• Significance– Cardiac tamponade
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Hemopericardium
Canine – Valvular endocardiosis, LHF ruptured atrium
Sow with aortic stenosis and rupture of aorta at origin.
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Idiopathic Hemorrhagic Pericardial Effusion of Dogs
• Etiology
– Unknown
– Bleeding tumour inside of pericardium
• Breeds affected
– Large Breed Dogs
• Golden retriever
• Great Dane
• St Bernard
• Great Pyrenees
• German shepherd
• Right heart failure
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Serous Atrophy of Fat
• Definition– Degeneration (atrophy)
of adipose tissue with replacement by loose, edematous connective tissue.
• Causes– Inadequate nutritional
supply
– Starvation or inanition
– Illness
• Significance– Condition of health
– Little effect on function
NORMAL SEROUS ATROPHY
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Congenital and Miscellaneous Disorders1. Absence
2. Diaphragmatic-Pericardial Hernia
3. Visceral Gout
4. Epicardial mineralization
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Inflammatory Diseases of the Pericardium
• Infectious process
– Out from myocardium
– In from pleural space
– Via the vasculature
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Fibrinous PericarditisLesions
• Gross• Fluid and fibrin within
pericardial space
• Surfaces my be opaque
• Fibrin will break loose
– “bread and butter
• Histo• Mild inflammation
– Neutrophils
– Macrophages
• Fibrin on surface
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EtiologiesFibrinous Pericarditis
• Cow– Mannheimia, blackleg, coliform
septicemias– Fetus – Brucella, Arcanobacter pyogenes
• Pig– Glasser’s disease, Streptococcus,
Mannheimiosis, Mycoplasma, Salmonella• Horse
– Streptococcal infections• Birds
– Psittacosis• Cat
– FIP• Sheep
– Pasteurella, Streptococci
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SignificanceFibrinous Pericarditis
• Death– Often associated with
pathogenic organism
– Acute lesions seen at necropsy
• Progression– Fibrous adhesions
– Could become suppurative
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Purulent PericarditisSuppurative
• Gross
– Cloudy, thick fluid
– Liquefied inflammatory debris
– May not smell good!
• Histo
– Moderate #’s of pmn’s, macs
– Fibrous connective tissue
• If present for a period of time
• Cause
– Pyogenic bacteria
– Pyothorax – horses, cats
– Migrating plant awns – dogs
– Traumatic reticulopericarditis
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Bovine Traumatic Reticulopericarditis“Hardware Disease”
• Extension of foreign material (usually sharp, metal object) through wall of reticulum, diaphragm and pericardial sac
• Development of inflammation within pericardium
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Bovine Traumatic Reticulopericarditis - Chronic
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OutcomePericarditis
• Mild fibrinous– May resolve completely
– May have focal areas of scarring
• Severe fibrinous– May have focal areas of
scarring
– May result in constrictive pericarditis
• Suppurative– Rarely resolve
– Fibrous adhesions
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Constrictive Pericarditis
• Definition
– Chronic inflammation with fibrous adhesions of pericardial sac to epicardium
• Result
– Compensatory cardiac hypertrophy
– Right heart usually fails
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Bovine Traumatic Reticulopericarditis - Chronic
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Gangrenous PericarditisA Cool Case
History
1-year-old Pit Bull
“Exercise” Intolerant
Owner elected euthanasia
Pluck – pericardial sac not open Pericardial sac open – fluid removed
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Congenital and Miscellaneous Disorders1. Epicardial mineralization – Cardiac Calcinosis mice
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Which is NOT substantiated by the photograph of dog heart
1. Subaortic Stenosis
2. Jet Lesions - Aorta
3. Endocardial Fibrosis
4. Eccentric Left Ventricular Hypertrophy
5. Interventricular Septal Defect
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Cyanosis is most often associated
with which disease process...
1. Pulmonic Stenosis
2. Patent foramen Ovale
3. Interventricular Septal Defect
4. Tetralogy of Fallot
5. Patent Ductus Arteriosus
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Persistent Right Aortic Arch –which structure is NOTassociated with the “Vascular Ring Analmy”?
Asc
ending aorta
Ligam
entum
Arte
riosu
m
Duct
us Arte
riosis
Main
Pulm
onary ar
tery
Heart
Base
20% 20% 20%20%20%
1. Ascending aorta
2. Ligamentum Arteriosum
3. Ductus Arteriosis
4. Main Pulmonary artery
5. Heart Base