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Heart 4 chamber view

Cardiovascular pathology

Cardiovascular pathology is a subspecialty of pathology dedicated to the study of diseases that affect the heart and vessels from early development to senescence.   This subspecialty focuses on the characterization of congenital heart malformations, diseases of the cardiac muscle (cardiomyopathy), the cardiac valves (mitral, aortic, tricuspid and pulmonic), conduction system (sinoatrial and atrioventricular nodes, His bundle and Purkinje system), pericardium and the vascular system including arteries and veins.  As any organ, the heart is a complex organ made of many specialized types of subsystems which have a distinct morphologic appearance.  These morphologic features change as a function of maturation of the organ and can also change in disease states. These diverse cardiac tissues also can give origin to benign and malignant tumors of the heart. Other components of the cardiovascular system such as the arteries and veins are also involved by disease processes.  The pathology of the aorta, the pulmonary artery, systemic arteries and the great veins and systemic veins is also within the scope of cardiovascular pathology.

This web site is organized by topics centered around the morphologic features that define the diseases of the heart and blood vessels.  In some instances the morphology needs to be correlated with clinical, physiologic or genetic information to ascertain the diagnosis.  Extensive illustration of cardiovascular pathology entities is presented throughout the site in the form of photographs, illustrations and 3d models and animations.  References to peer reviewed literature, textbooks on the subject and useful links to web sites are used.

Cardiomyopathy and genetic diseases.

The pathology of the cardiovascular system includes diseases that primarily affect the heart muscle cells (also called myocytes) and are generally known as cardiomyopathies. According to the World Health Organization (1) The cardiomyopathies can be acquired (infectious, toxic, autoimmune, iatrogenic) or have a genetic basis.   From the morphologic standpoint the have been classified into four main categories, dilated cardiomyopathy (DCM), hypertrophic (HCM), restrictive (RCM) and arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD / ARVC).   However a trend to classify them on the basis of their genetic causes exists and is the basis for a new proposal (2).  

Congenital malformations and acquired diseases of the heart and vascular system

Genetic defects have been described in each one the 4 morphologic types of cardiomyopathy.  Congenital malformations have also been associated with genetic alterations, but in many instances there is no specific mutation or chromosomal alterations found.  Genetic diseases can also affect the vessels either as intrinsic structural problems in the vessel wall (in vessels such as the aorta) or by altering the metabolism of the vessel (like in atherosclerosis).
In other instances the pathogy of the heart and vessels is modified by therapeutic procedures (angioplasty) or devices (stents, balloon pumps, prosthetic valves, prosthetic vessels / conduits and ventricular assist devices (also known as artificial hearts))

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