9-10. Cardiomyopathies Flashcards
Differentiate dilated, hypertrophic, and restrictive cardiomyopathies
Dilated: ventricular dilation, systolic dysfunction
Cause: Alcohol, pregnancy, weird viral causes
Hypertrophic: Usually LV + septum hypertrophy
Cause: Genetic, young athletes
Restrictive: Rigid, less compliance
Cause: Amyloidosis, hemochromatosis
Difference between heart failure and dilated cardiomyopathy
Etiology
Dilated cardiomyopathy signs
S4 - 100%
S3 - 75%
Dilated cardiomyopathy diagnosis
Chest x-ray:
Big heart, cephalization/stag sign
EKG:
50% show LVH
Arrythmias = A+V premature beats
Dilated cardiomyopathy treatment
Medical = treat cause
Same meds as HF (ACE/ARB/ARNI, BB, Spiro, SGLT2)
Arrythmia: Amiodarone
Anticoags: NOACs
Inotrope: Dobutamine
Hypertrophic obstructive cardiomyopathy cause
Typically genetic, family history is important!
Hypertrophic obstructive cardiomyopathy signs
HARSH CRESCENDO DESCRESCENDO MURMUR
Heard at apex, left sternal border
Louder with valsalva, upright posture (decreased chamber size)
Quieter with squatting
Hypertrophic obstructive cardiomyopathy diagnosis
Echocardiography is best
But do EKG first:
Q-waves = hypertrophy/fibrosis
Giant inverted t-waves
Hypertrophic obstructive cardiomyopathy treatment
Asymptomatic = monitor, avoid sports
Symptoms withOUT obstruction = diltiazem/verapamil
Symptoms WITH obstruction = beta blocker
Prophylactic endocarditis treatment = mandatory!
Restrictive cardiomyopathy etiology
Rigid and non-compliant myocardium
Amyloidosis
Hemochromatosis
Iatrogenic (radiation)
Restrictive cardiomyopathy symptoms/signs
Similar to CHF
Dyspnea, edema
Restrictive cardiomyopathy diagnosis
Echocardiogram - wall function
Nuclear imaging if amyloidosis
Restrictive cardiomyopathy treatment
Treat underlying cause if possible
Offload fluid
Heart transplant
