Myocardial and Pericardial Diseases and Cardiac Tumors MCQs

Takotsubo cardiomyopathy is an entity characterized by left ventricular contractile dysfunction after extreme psychological stress (thus also called broken heart syndrome); affected myocardium may be stunned or show contraction band necrosis. For unclear reasons, the left ventricular apex is most often affected, leading to "apical ballooning" that resembles a takotsubo, Japanese for "fishing pot for trapping octopus" (hence, the name). The mechanism of catecholamine cardiotoxicity is uncertain but likely relates either to direct myocyte toxicity due to calcium overload or to focal vasoconstriction in the coronary arterial macro- or microcirculation in the face of an increased heart rate. Reference: Robin's basic pathology 10 th edition, 570

Myxomas are the most common primary tumor of the adult heart These are benign neoplasms arising from primitive multipotent mesenchymal cells. Although sporadic myxomas do not show consistent genetic alterations, familial syndromes associated with myxomas have activating mutations in the GNAS1 gene, (in association with McCune-Albright syndrome) or null mutations in PRKAR1A, encoding a regulatory subunit of a cyclic-AMP-dependent protein kinase (Carney complex). About 90% of myxomas arise in the atria, with a left-to-right ratio of approximately 4:1. Reference: Robin's basic pathology 10 th edition, 579