CABS Cardiomyopathies Flashcards
Ejection fraction = _____ / ________
SV / end diastolic volume
can fluctuate between 50-65%
Right on the frank-starling curve means
the sarcomeres are stretched out they no longer have a good contraction/ good communication
Left on the frank-starling curse means
the sarcomeres are so close together there is no more room for contraction
Types of cardiomyopathies
hypertrophic
restrictive (l/c)
dilated (m/c)
Systolic dysfunction is when
decreased contractility leading to reduced ejection fraction (can’t squeeze well)
Diastolic Dysfunction is when
inability for the ventricle to completely relax to allow for appropriate passive filling (impaired filling and relaxation)
Dilated cardiomyopathy causes ______ dysfunction
systolic dysfunction
Hypertrophic and restrictive cardiomyopathy causes ______ dysfunction
diastolic dysfunction
Dilated cardiomyopathy leads to
dilation of the ventricle and leads to reduced contractility
Dilated cardiomyopathy is ______ hypertrophy
eccentric
Dilation of LV leads to
increased preload
increased atrial pressure
atrial dilation (pulm edema)
decreased CO
Thin and floppy - matches with
dilated cardiomyopathy
Takotsubo is
transient ballooning of the cardiac apex due to profound stress (usually the LV)
“broken heart”
Presentation of Dilated Cardiomyopathy
sx of left sided HF
S3 associated with max compliance of the LV
Cause of Dilated Cardiomyopathy (drug)
cocaine
Dilated Cardiomyopathy can present with what type of arrhythmia
Afib
Hypertrophic Cardiomyopathy is
thickening of the myocardium leading to poor diastolic filling and may lead to outflow obstruction
(due to sarcomere dysfunction)
The type of genetic mutation for Hypertrophic Cardiomyopathy is
Autosomal dominant missense mutation of the myosin
leads to decreased sarcomere dysfunction
Where does hypertrophic cardiomyopathy usually take place in the heart
often more pronounced in the septum but can happen anywhere
Most common causes of hypertrophic cardiomyopathy
genetics
HTN
Aortic stenosis
Amyloidosis
Hypertrophic cardiomyopathy is concentric or eccentric?
concentric
Type of hypertrophic cardiomyopathy that leads to SCD in younger pts
HOCM (hypertrophic obstructive cardiomyopathy)
HOCM is
LV hypertrophy along the septum can begin to occlude the outflow tract (aortic valve)
Further closure of the outflow tract is called the Venturi Effect
Hypertrophy will further cause a
supply and demand mismatch
Supply and demand mismatch (CO and bodies need for O2) presents as
angina d/t ischemia
dyspnea
increased risk of arrythmia
Hypertrophic Cardiomyopathy presents as
systolic murmur - crescendo-decrescendo
S4
HF
arrhythmia (m/c afib)
may also have mitral regurgitation (venturi effect)
Restrictive Cardiomyopathy is
fibrosis of the myocardium
muscle becomes tense and scarred which leads to decreased compliance
Restrictive Cardiomyopathy can lead to
decreased preload
decreased CO
supply/ demand mismatch –> ischemia
can eventually lead to both RV HF and LV HF secondary to decreased compliance
Restrictive Cardiomyopathy: Endomyocardial fibrosis - can be associated with
initial infection (toxoplasmosis, rheumatic heart disease, malaria)
autoimmune issue marked by eosinophils –> inflammatory reaction –> fibrosis
Restrictive cardiomyopathy: amyloidosis is when
misfolded antibodies which are able to be deposited within the tissues leads to fibril deposition and chronic inflammation –> myocardial fibrosis and decreased compliance
Restrictive Cardiomyopathy: Sarcoidosis is hallmarked by
non-caseating granuloma formation
deposits within heart, lungs, skin, eyes, joints
Sarcoidosis: Granuloma exterior is made up of
macrophages and fibrotic tissue
centrally contains epithelioid cells
Restrictive Cardiomyopathy: Hemochromatosis is when
excess iron d/t poor protein modulation within the liver leading to increased absorption and release from spleen –> iron deposits within the myocardium
