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CVD > 10. Cardiomyopathy and Myocarditis > Flashcards

10. Cardiomyopathy and Myocarditis Flashcards

1
Q

What is cardiomyopathy?

A

Abnormality in heart muscle which has nothing to do with coronary artery disease

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2
Q

What are the most common forms of cardiomyopathy?

A

Dilated
Hypertrophic
Restrictive

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3
Q

What are rarer cardiomyopathies?

A

Long QT
Selective RV
Brugada syndrome

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4
Q

What are the primary causes of dilated cardiomyopathy?

A

Progressive hypertrophy
Cardiac failure
Genetically due to a Ca disorder

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5
Q

What are the secondary causes of dilated cardiomyopathy?

A

Alcohol
Previous myocarditis
Drugs eg. chemo
Immunologic reaction

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6
Q

What is the patient profile for dilated cardiomyopathy?

A

Men age 20-60

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7
Q

How does early dilated cardiomyopathy present?

A

Reduced LV contractibility

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8
Q

Hows does end stage dilated cardiomyopathy present?

A

Ejection fraction of 25%

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9
Q

What is the treatment for dilated cardiomyopathy?

A

Heart transplant

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10
Q

What is the macroscopic appearance of the heart in dilated cardiomyopathy?

A

> 900g heart
All 4 chambers are dilated
Thin ventricular walls

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11
Q

What conditions does dilated cardiomyopathy increase the risk of?

A 
Mural thrombi (not all blood leaves heart on systole)
Functional mitral regurg (valve leaflets too far apart)
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12
Q

What is the microscopic appearance of the heart in dilated cardiomyopathy?

A

Cardiac muscle cells vary in size, some hypertrophic
Interstitial fibrosis
Some infiltration by WBCs

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13
Q

Why is stroke volume reduced in hypertrophic cardiomyopathy?

A

Heart doesn’t fill on diastole

Outflow may be obstructed

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14
Q

What kind of genes can be mutated in hypertrophic cardiomyopathy?

A 
Muscle fibre (Duchenne muscular dystrophy)
Ca++
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15
Q

What is the clinical presentation of hypertrophic cardiomyopathy?

A

Angina without coronary artery disease
Ventricular arrhythmia
Sudden death

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16
Q

What is the gross appearance of a heart with hypertrophic cardiomyopathy?

A

Heart >800g, both septum and walls hypertrophic
Outflow obstruction of LV
LA may be dilated
Myocyte hypertrophy

17
Q

Why does restrictive cardiomyopathy cause a decrease in stroke volume?

A

Ventricles lack compliance and don’t fill in diastole

18
Q

What are the causes of restrictive cardiomyopathy?

A

Idiopathic, familial
Amyloidosis, sarcoidosis, metastatic tumour
Haemochromatosis
Radiation fibrosis

19
Q

What is the appearance of a heart with restrictive cardiomyopathy?

A

Stiff, thick LV wall
LA dilated
Endo-myocardium replaced by amyloid, iron etc

20
Q

What is myocarditis?

A

Primary inflammation of the myocardium causing injury to myocytes

21
Q

What is the presentation of myocarditis?

A 
Mild fever
ECG changes
Arrhythmias
Heart failure
Sudden cardiac death
22
Q

What are the infective causes of myocarditis?

A 
CMV
Coxsackie
Neisseria
Candida
Toxoplasmosis
23
Q

What are the immune causes of myocarditis?

A 
Post virus or strep
SLE
Drug hypersensitivity
Transplant rejection
Sarcoid
Giant cell myocarditis
24
Q

What is the microscopic appearance of a heart with myocarditis?

A

Signs of inflammation, the type of cell depending on the cause

CVD (22 decks)

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