02.13 Cardiomyopathy and Myocarditis Flashcards
Disease of heart muscle that results from myriad insults, not the result of congenital, acquired valvular, hypertensive, coronary arterial or pericardial abnormalities
Cardiomyopathy
Consisting of heart muscle disease predominantly involving the myocardium and/or unknown cause
Primary type of cardiomyopathy
Consisting of myocardial disease of known cause or associated with a systemic disease such as amyloidosis or chronic alcohol use
Secondary type
Primary type of cardiomyopathy
Dilated
Hypertrophic
Restrictive
Unclassified
Secondary type of cardiomyopathy
Infective Metabolic Systemic disease Heredofamilial Sensitivity Toxic
Dilatation
Reduction in ventricular contractile function
Large volume heart
Systolic dysfunction
Dilated cardiomyopathy
Thick myocardium
LV outflow tract obstruction
Diastolic dysfunction
Hypertrophic cardiomyopathy
Rigid myocardium
Diastolic dysfunction
Restrictive cardiomyopathy
Most common cause of systolic dysfunction
Coronary artery disease
Most common form of CM
Dilated CM
Diastolic dysfunction Ischemia Arrhythmias Outflow obstruction Syncope, chest pain, sudden cardiac death
Hypertrophic CM
ICD is indicated when
Previous cardiac arrest
Spontaneous sustained ventricular tachycardia
Non-sustained spontaneous ventricular tachycardia
Unexplained syncope
Blunted increase/decrease in systolic BP with exercise
Left ventricular wall thickness >/= 30 mm
1st degree relative with sudden death
Dilated cardiomyopathy with ejection fraction
Rare condition
Ventricular filling is impaired because ventricles are stiff
Leads to high atrial pressure with atrial hypertrophy, dilatation, and later atrial fibillation
Restrictive CM
Most common cause of restrictive CM
Amyloidosis
Rigid myocardium leads to ____ diastolic ventricular pressure, ___ ventricular filling
Increased
Decreased
Holiday heart syndrome
Consumption of large quantities of alcohol
Consistently drinking
Alcoholic CMP
Occurs during last trimester or within 6 months after delivery
Peripartum CMP
Anthracycline derivatives
Cyclophosphamide
Cocaine abuse
Drug-induced CMP
Unusual, often familial, condition characterized by the replacement of myocardial tissue by fat and fibrous tissue
Arrhythmogenic right ventricle dysplasia (ARVC)
Most common location for tissue transformation in ARVC is referred to as
Triangle of dysplasia (between the anterior infundibulum, RV apex, and inferior or diaphragmatic aspect of the RV)
Diagnostic modality of choice of ARVC
MRI
Apical ballooning syndrome
Abrupt onset of severe chest discomfort preceded by very stressful emotional or physical event
Common among . 50 years of age
Takotsubo/stress-induced CM
Trigger massive catecholamine release causing multi-vessel apicardial spasm, microvascular dysfunction, myocardial stunning and minor injury
Takotsubo/stress-induced CM
Mayo Clinic criteria for diagnosis of Takotsubo
Transient reversible akinesis of LV apical and mid-ventricular segments
Absence of obstruction coronary artery stenosis
New electrocardiographic abnormalities consisting of ST-elevation or T-wave inversion
Absence of recent head trauma, intracranial bleeding, pheochromocytoma, obstructive epicardial coronary artery disease, myocarditis, hypertrophic CM
Characterized by myocardial inflammation, necrosis, fibrosis
Cardiomegaly and diminished systolic function occur due to myocardial damage
Myocarditis
ECG changes are nonspecific
In CXR, cardiomegaly, pulmonary vascular prominence, pulmonary edema or pleural effusions
Inflammatory cell infiltrates
Myocarditis
Primary therapy for acute myocarditis
Supportive
Accepted therapy for myocarditis
Conventional heart failure therapy
