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LYMPHOCYTIC INFILTRATES are the USUAL pattern of ALL myocarditis, buteosinophils, giant cells, and even trypanosomes can be seen occasionally

OTHER Myocarditides

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OTHER Myocarditides Adriamycin Cyclophosphamide Catecholamines (Pheochromocytomas)

Amyloid, systemic or primary cardiac Congo red stain: green birefringence withpolarization

Amyloid, aging

Congo red stain: green birefringence withpolarization Hemochromatosis (Prussian Blue) BOTH HYPER-, HYPO- -thyroidism

PERICARDIUM

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PERICARDIUM Normally 30-50 ml clear serous fluid

Visceral (epicardium) Parietal (Fibrous pericardium)

PERICARDIAL EFFUSIONS TAMPONADE Ruptured MI

Traumatic perforation Ruptured aortic dissection

PERICARDITIS

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PERICARDITIS SEROUS : Rheum. Fever (RF), SLE,

scleroderma, tumors, uremia FIBRINOUS : MI (Dressler), uremia, radiation,

RF, SLE, s/p open heart surgery PURULENT : infective, bacterial HEMORRHAGIC : Malignancy, TB

CASEOUS : TB CHRONIC : (ADHESIVE, CONSTRICTIVE)

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TUMORS

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TUMORS 90 % benign mesenchymal, i.e., stromal

MYXOMAS (LEFT ATRIUM MOSTCOMMON)

FIBROMAS LIPOMAS FIBROELASTOMAS (valvular, usually papillary)

RHABDOMYOMA (Most common cardiac tumor inchildren) 10% SARCOMAS

MYXOMA

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MYXOMA

Cardiac effects of NON-cardiac tumors

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Direc t Cons equ enc es o f Tum or Pericardial and myocardial metastases Large vessel obstruction Pulmonary tumor emboli

Ind i rec t Cons equ enc es o f Tum or (Com pl ica t ions o f Ci rcu la t ing Media tors) Nonbacterial thrombotic endocarditis (Trousseau) (NBTE) Carcinoid heart disease Pheochromocytoma-associated heart disease

Myeloma-associated amyloidosis Effec ts o f Tum or Therapy Chemotherapy Radiation therapy

CARDIAC TRANSPLANTO OG

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PATHOLOGY Most patients are on

immunosuppressives 5 year survival >60%

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