cardiomyopathies Flashcards
cardiomyopathy
- disorder within the cardiac myocytes themselves
- typically leads to irreversible decline in function
- patients with long term cardiomyopathy often candidates for transplant
Predictor for mortality/morbidity with cardiomyopathy?
Reduced EF
Types of cardiomyopathy
dilated
hypertrophic
restrictive
dilated cardiomyopathy
-chamber dilation and contractile impairment = decreased EF and/or SV
dilated cardiomyopathy remodeling
- begins as a ballooning of LV
- often leads to dilation of other chambers
dilated cardiomyopathy remodeling results in
- heavier
- hypertrophied cardiac myocytes
- loss of myofibrils
- fibrosis
- chamber walls thinned
- systolic dysfunction/red EF
- HF
T/F: dilated is the most common form of cardiomyopathy
True
dilated cardiomyopathy causes:
- genetics
- viral infections (HIV)
- toxins (ETOH, cocaine, cancer drugs)
- metabolic disorders
- myocarditis
Dilated Cardiomyopathy sign/symptoms
signs:
tachypnea, tachycardia, hyper/hypotension
symptoms:
- fatigue
- dyspnea
- SOB
- orthopnea
- paroxysmal nocturnal dyspnea
- increasing edema, weight, or abdominal growth
dilated cardiomyopathy pertinent findings
- JVD
- hypoxia (cyanosis, clubbing)
- pulmonary edema
- enlarged liver
- ascites or peripheral edema
nonpharmacological management of dilated cardiomyopathy
sodium diet restriction
fluid restriction
dilated cardiomyopathy:
frank-starling law
overstretching (increased LVEDV) leads to failure of myocardial contractile unit.
What type of cardiomyopathy is the single most common cause of death in apparently healthy young people?
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy
thickened LV wall with non dilated LV chamber
Hypertrophic cardiomyopathy:
cause
genetic disease with autosomal (not sex linked) dominance
How does Hypertrophic cardiomyopathy start?
- Normal BP perceived as excessive by defective myocytes
- LV free wall hypertrophy to compensate
- Septal wall may also hypertrophy disrupting normal LV outflow tract
- heart decompensates
T/F: The majority of hypertrophic cardiomyopathy cases are asymptomatic
True
What is the most common 1st clinical symptom of Hypertrophic cardiomyopathy?
sudden death
Obstructive HCM
septal wall thickens and LV free wall of ventricles stiffen.
obstructs blood flow into aorta
Non-obstructive HCM
- walls of LV stiffen
- reduces LVEDV and SV
- blood flow isn’t blocked
Hypertrophic cardiomyopathy
signs and symptoms
- chest p!
- SOB (especially with physical exertion)
- fatigue
- arrhythmias
- lightheadedness
- Fainting
- swelling in ankles, feet, legs, abdomen, and veins in neck
Hypertrophic cardiomyopathy:
long term complications
- A-fib
- dysrhythmias
- HF
- History of MIs
Hypertrophic cardiomyopathy:
treatment
- alcohol septal ablation
- implantable cardioverter defibrillator
- heart transplants
Restrictive Cardiomyopathy
- characterized by diastolic filling/loss of compliance
- characterized by idiopathic fibrosis, rigid heart walls, and reduced compliance
- systolic function is normal
- EDVs diminshed (chambers can’t expand)
- ESV and EF normal
- SV compromised
- Ventricular filling pressures very high
Restrictive Cardiomyopathy:
symptoms
- dyspnea w/exertion
- abdominal swelling
- ankle edema
- fatigue
Restrictive Cardiomyopathy:
causes
- scleroderma
- amyloidosis
- sarcoidosis
- diabetes
- hemochromatosis
- chemotherapeutic agents
- radiation (mediastinal)
