Cardiology Misc

Question 1

Hypertrophic obstructive cardiomyopathy

Answer 1

Leading cause of sudden cardiac death in young athletes. Autosomal dominant condition that results in the hypertrophy of the myocardium (especially in the septum). Often asymptomatic and caught in screening programs. Can present with exertional dyspnea, syncope palpitations and angina. Risk of arrhythmias and sudden cardiac death and thus are advised to avoid sporting activities. Treatment includes Beta blockers amiodarone, calcium channel blockers. Pace makers and debulking ablation are further down treatments.

Question 2

Cardiac tamponade

Answer 2

Clinical syndrome where accumulation of fluid in the pericardium causes reduced ventricular filling and thereby haemodynamic compromise. Typically presents with becks triad (muffled heart sounds, low blood pressure and raised JVP. Associated pulsus paradoxus (drop in BP on inspiration) and electrical alternans (variation of the amplitude of QRS complexes). Debatable association with Kussmaul’s sign (raise in JVP on inspiration). Treated via pericardiocetesis and relief of underlying cause.

Question 3

Infective causes of dilated cardiomyopathy

Answer 3

Coxsackie B, HIV, parasitic, diptheria

Question 4

dilated cardiomyopathy

Answer 4

dilated heart leading to systolic (+/- diastolic) dysfunction
All 4 chambers affected but LV more so than RV. Features include arrhythmias, emboli, mitral regurgitation. Absence of congenital, valvular or ischaemic heart disease. Variety of causes alcohol, genetic postpartum etc

Question 5

Restrictive cardiomyopathy

Answer 5

Cardiomyopathy in which the walls of the heart are rigid (but not thickened). Thus the heart is restricted from stretching and filling with blood properly. It is the least common of the three original subtypes of cardiomyopathy: hypertrophic, dilated, and restrictive. Can cause biatrial enlargement or thickening of ventricular walls with maintenance of chamber volume.

Question 6

Arrhythmogenic right ventricular cardiomyopathy

Answer 6

The second most common cause of sudden cardiac death in the young after hypertrophic cardiomyopathy. Inherited in an autosomal dominant pattern with variable expression, the right ventricular myocardium is replaced by fatty and fibrofatty tissue. Presents with syncope, palpitations and sudden cardiac death. Sotolol, ablation and pacemakers are the popular therapies