Cardiac changes in a moderately sever anaemic patient

[Oak]

A patient with long standing, moderately severe anemia dies in an automobile accident. He was driving, and an autopsy is performed to determine the cause of death. Which of the following cardiac changes will most likely be seen when the heart is examined?

A. Endocarditis
B. Fatty change of myocytes
C. Fibrinous pericarditis
D. Fibrosis of valve leaflets
E. Frank myocardial infarction

[Hero]

I go with (B) Fatty change of myocytes.
Endocarditis may lead to anemia, but anemia is not a cause for endocarditis. Anemia is also not a cause for pericarditis and fibrosis of valve leaflets. Anemia may cause MI--but is not a common cause for MI. So, I should better go with B. Good question, waiting for the exact answer.

[kenneth masamaro]

I'd go for E. Trauma can cause an MI.As for the rest of the choices I think there would have been more history.

[agya]

i go for fatty changes in the fatty changes in the myocytes.......in anemia the viscosity of blood falls n decreases the resistanceof blood flow to the peripheralblood vessels n greater than nomal quantities of blood flows through the tissues and return to the heart.....but hypoxia due to decreased transport of oxygen by blood causes peripheral vessels to dilate allowing still further increase of blood to the heart thus increasing cardiac output.this offsets the oxygen carrying capacity of anemia.but during exercise which greatly increasesthe tissue demand for oxygen extreme tissue hypoxia results.This causes fatty changes in the myocardium {as well asin liver**.this change along with circulatory compensatory changes weakens the myocardium so that acute cardiac failure is easily precipitated.

[Hero]

good explanation agya

[bharat]

well option E and B sound promising.
well i think this time history is little short .
as per question i will also go for option B like hero "omite the impossible then remaning must be the answer". but i am not sure this time so waiting for your reply

[Hero]

Originally Posted by kenneth masamaro

I'd go for E. Trauma can cause an MI.

kenneth masamaro will u please let me know how trauma causes an MI? Thank you in advance

[Oak]

The correct answer is B. Chronic anemia is not simply a disease of the blood. Other changes that can occur with long-standing, moderately severe anemia include skin atrophy and koilonychia (spoon-shaped nails, particularly in iron-deficiency anemia). Fatty change of cardiac myocytes, renal proximal convoluted tubule cells, and centrilobular hepatic cells, and degeneration of neurons of the cerebral cortex and basal ganglia are also seen. With time, some of these cells may die, producing a patchy cell loss.

Endocarditis (choice A) usually has an infectious etiology.

Fibrinous pericarditis (choice C) typically is seen following myocardial infarction.

Fibrosis of valve leaflets (choice D) can be seen with aging or as a complication of infective endocarditis.

Frank myocardial infarction (choice E) can occur in very severe anemia, particularly if superimposed by an additional hypoxic insult, such as hemorrhage, shock, or pneumonia, but is not typical of long-standing moderately severe anemia.

[kenneth masamaro]

Originally Posted by Hero

kenneth masamaro will u please let me know how trauma causes an MI? Thank you in advance

For the simple reason that trauma causes haemorrhage and haemorrhage may cause ischaemia leading to infarction.Though rare, I think one would have chosen MI if the accident from the history was important- let alone the fact that he already had severe anaemia

[Hero]

Originally Posted by kenneth masamaro

For the simple reason that trauma causes haemorrhage and haemorrhage may cause ischaemia leading to infarction.

though not a good reason