Acquired Heart Disease Flashcards
Most common cause of cardiac death in teens and young adults
Inheritance (typical)
HCM
Autosomal dominant
Pathophysiology of HCM
Enhanced systolic contractility
Impaired diastolic relaxation
May have dynamic obstruction in systole
Due to systolic anterior motion of the mitral valve against the hypertrophied septum
Effect of volume on degree of obstruction in HOCM
If LV volume falls, obstruction worsens
Do leg raises
Blood transfusion
Fluid bolus
Increase SVR
ECG in HCM
CXR
LVH
ST-T changes
Deep Q waves
Diminished R waves in V5-V6
Cardiomegaly
Globular heart
Exercise restrictions HCM
Avoid strenuous exercise and competitive sports
Beta blockers if obstruction
Most common form of cardiomyopathy
DCM
Most common cause of DCM
Then (2)
Idiopathic in 50%
Then secondary to myocarditis (46%)
Then neuromuscular (25%)
Carnitine deficiency in Heart Disease
Causes what
Due to
Two forms of primary carnitine deficiency
Cardiomegaly
Hypertrophic or dilated
Impaired mitochondrial oxidation of fatty acids
Storage of fat in muscle
Systemic form- muscle, heart, liver, encephalopathy, hypoglycaemia with fasting
Myopathic form- heart and muscle
Secondary carnitine deficiency
Causes (4)
RTA
Chronic renal failure
TPN
Organic acidemia
Arrhythmogenic RV dysplasia
Pathology
Presenting manifestations
RV myocardium totally or partially replaced with fibrous tissue
Arrhythmia: VT or SVT
CHF
IE organisms
Most common
HACEK group
Streptococcus viridans
Enterococci
Staph aureus
Haemophilus Actinobacillus Cardiobacterium Eikenella Kingella
Onset of illness myocarditis
Infancy
Older children
Most important clinical sign
Sudden- anorexia, vomiting, lethargy, +/- shock
Insidious, CHF, arrhythmia
Cardiomegaly on CXR
Myocarditis ECG
May show any of the following
Reduced voltages
ST-T changes
Prolonged QT
Arrhythmia especially PVCs and PACs
