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Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009

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Page 1: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Congenital Cardiac Anomalies Cardiovascular Pathology

VPM 222

Winter 2009

Page 2: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Causes of Congenital Heart Anomalies

Genetic Single or multiple defects

Infectious agents Parvovirus

Bluetongue

BVD

Teratogens Vit A deficiency

Xrays

Oxygen deficits

Teratogenic compounds

Page 3: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Cardiovascular MalformationsBreeds and Species

Page 13 lecture notes

Page 4: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

http://www.embryology.ch/images/pimgcardio/09umstellung/p9a_KreislaufvorA.gif

Page 5: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

The Atrial Septum and its

Abnormalities

Foramen Ovale

Normal

Atrial Septal Defect

Common Atrium

Haemodynamics

L to R flow

Volume Right

CVP

Boxer, Doberman

pinscher, SamoyedPathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th

ed

Page 6: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 5 September 2005 08:31 PM)

Page 7: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Atrial Septal Defect

Pathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th ed

Page 8: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Abnormalities of the

atrioventricular

Canal

1. Persistent Common Atrioventricular Canal

Endocardial Cushion Defect

Failure of endocardial cushions to form

Often have ASD and VSD

Page 9: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Abnormalities of the AV Canal1. Endocardial Cushion

Defect

2. Tricuspid dysplasia

3. Mitral valve malformations

4. Tricuspid atresia

Page 10: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Abnormalities of the

INTERVENTRICULAR SEPTUM

Interventricular Septal

Defect (VSD)

Membranous

Muscular

overload RV RV

psi RVH RVF

Could reverse flowPathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th ed

Page 11: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Membranous VSD

Pathology of Domestic Animals

Jubb, Kennedy, Palmer, Volme 3, 4th ed

Page 12: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Membranous VSD

http://www.embryology.ch/anglais/pcardio/patholcardio03.html#AtrioventrikularerSeptumdefekt

Page 13: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Muscular VSD

Page 14: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Abnormalities of the truncus arteriosus and conus cordia

Tetralogy of FallotPulmonic Stenosis

Interventricular Septal Defect

Over-riding Aorta

Right Ventricular Hypertrophy

Pathology of Domestic Animals

Jubb, Kennedy, Palmer, Volme 3, 4th ed

Page 15: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Haemodynamics of Tetralogy of Fallot

Pulmonic stenosis

RVH (psi overload)

VSD

Shunt R – L

Cyanosis

Pathology of Domestic Animals

Jubb, Kennedy, Palmer, Volme 3, 4th ed

http://www.embryology.ch/anglais/pcardio/patholcardio04.html#Fallot

Page 16: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Abnormalities of the truncus

arteriosus and conus cordia

Tetralogy of Fallot

Eisenmenger’s Complex

Tetralogy of Fallot without Pulmonic

Stenosis

Eisenmenger’s Physiology/Syndrome

- Right to left shunt

Page 17: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Persistent Truncus ArteriosusFailure of spiral ridge to truncus arteriosus and conus cordis

No separation of pulmonary artery and aorta – common truncus

Page 18: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Transposition of Great Vessels

http://path.upmc.edu/cases/case58/dx.html

Page 19: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Pulmonic StenosisPulmonic Outflow Obstruction

Circumference of

pulmonic valve <

aorta valve

Haemodynamics

Psi overload

concentric right

ventricular

hypertrophy right

heart failurePathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th edHeart disease web site - general

information – U of Manitoba

Page 20: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Pulmonic Stenosis

Page 21: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Pulmonic Stenosis

Post stenotic dilation

Pathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th ed

Page 22: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes
Page 23: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Aortic StenosisValvular

*Subvalvular

Haemodynamics

Arrythmia

Cardiac syncope

psi of LV concentric

LVH LVF (10%)

Common Swine

Newfoundland, Boxer,

German shepherd

Page 24: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Positional AbnormalitiesEctopia Cordis

Page 25: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Great Vessels Abnormalities

Patent Ductus Arteriosus

Failure of ductus arteriosus to close by 3 weeks

Haemodynamics Blood shunts LR

From aorta to pulmonary artery

pulmonary circulation

workload on LHPathology of Domestic AnimalsJubb, Kennedy, Palmer, Volme 3, 4th

ed

Page 26: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Poodles, Collies, Pomeranians, Chihuahua, Maltese, etc

Page 27: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Persistent Right Aortic Arch

PRAA

Right 4th Aortic Arch

remains – left aortic

arch disappears

Vascular ring

anomaly Ascending aorta

Ligamentum arteriosum

Pulmonary artery

Base of heart

Page 28: Congenital Cardiac Anomaliespeople.upei.ca/lmiller/2009_CV_Congenital_Heart_Disease/congenital... · Congenital Cardiac Anomalies Cardiovascular Pathology VPM 222 Winter 2009. Causes

Persistent Right Aortic Arch

PRAA