Cardiomyopathies Flashcards
1) What is the definition of cardiomyopathy?
2) What is the commonest cardiomyopathy?
1) Structural and functional inability of the myocardium without CAD, hypertension and valvular or congenital heart disease
2) Dilated cardiomyopathy
Dilated cardiomyopathy - causes and pathophysiology
1) Name 2 causes of dilated cardiomyopathy
2) What are infiltrative cardiomyopathies, and name 1 cause of this
3) What is Takotsubo cardiomyopathy?
4) Which chamber of the heart is particularly dilated in dilated cardiomyopathy?
5) Dilated cardiomyopathy causes particular dysfunction to what?
1) Ischaemic changes post MI, high BP, thyrotoxicosis, infections (secondary to myocarditis or directly due to Lyme disease or HIV), idiopathic, infiltrative cardiomyopathies, stress induced (Takotsubo) and toxin related (excessive alcohol consumption - vit B1 deficiency, cocaine and medications i.e. doxorubicin, cyclophosphamide, chloroquine and clozapine)
2) Cardiac diseases characterised by deposition of abnormal substances i.e. haemochromatosis and sarcoidosis
3) Stress induced cardiomyopathy - broken heart syndrome
4) Left ventricle
5) Systolic dysfunction
Dilated cardiomyopathy - symptoms, examination findings and investigations
1) The commonest symptoms are those related to HF - name 2 of those
2) Name a consequence of the cardiomyopathy
3) Name 2 potential examination findings in a patient with dilated cardiomyopathy
4) What imaging modality is diagnostic?
5) What may be seen on an ECG?
6) What may be seen on CXR?
1) Exertional dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea, peripheral oedema, fatigue
2) Arrhythmias, conduction disturbances, sudden cardiac death
3) Displaced apex beat, S3 sound on auscultation (due to rapid ventricular filling), mitral regurgitation murmur, signs of HF i.e. ascites, hepatomegaly, oedema and raised JVP
4) Echocardiogram
5) Poor R wave progression
6) Balloon appearance of heart
Hypertrophic cardiomyopathy
1) What kind of condition is hypertrophic cardiomyopathy and what is it characterised by?
2) Dysfunction of what does it primarily cause?
3) Why is it considered an important condition?
4) Name a consequence of the resulting abnormal LV morphology
5) Although asymptomatic in many patients - name a symptom it may present with
6) Name an examination finding
7) Name an ECG finding
8) How is it diagnosed
9) Name a condition it’s associated with
10) How is it managed?
11) It’s most commonly caused by a mutation in what gene?
1) Genetic condition (autosomal dominant) characterised by asymmetrical left ventricular hypertrophy
2) Diastolic dysfunction
3) Commonest cause of sudden cardiac death in infants (death is due to arrhythmias)
4) Left ventricular outflow tract obstruction (LVOTO), diastolic dysfunction, ischaemia, mitral regurgitation
5) Syncope (typically following exercise), exertional dyspnoea, fatigue and chest pain
6) Jerky pulse, double apex beat, ejection systolic murmur (louder on valsalva, quieter on squatting), apical thrill
7) Deep Q waves and abnormal/inverted T waves
8) Echocardiography which shows left ventricular wall hypertrophy in the absence of any other cause
9) Friedreich’s ataxia, WPW syndrome
10) Cardioverter defibrillator (CCBs, BB can reduce workload of heart. Amiodarone can decrease arrhythmia chance)
11) Beta myosin light chain
Restrictive cardiomyopathy
1) What is restrictive cardiomyopathy?
2) Name a cause of restrictive cardiomyopathy
3) Presentation of restrictive cardiomyopathy is normally similar to what condition?
4) What condition does 75% of restrictive cardiomyopathy cases present with
5) Diagnosis is usually done with what?
6) Cardiac MRI is useful in distinguishing between restrictive cardiomyopathy and what other condition?
1) Condition involving non-dilated, non-hypertrophied ventricles with impaired ventricular filling
2) Infiltrative causes i.e. amyloidosis, sarcoidosis, Gaucher disease and Hurler syndrome, storage disorders i.e. haemochromatosis, diabetic cardiomyopathy, radiation, chemotherapy drugs and hypereosinophilic syndrome (Löffler’s)
3) HF/constrictive pericarditis
4) AF
5) Echocardiogram
6) Constrictive pericarditis
Arrhythmogenic right ventricular cardiomyopathy (ARVC)
1) What is this condition?
2) Name a way it can present as
3) Name an ECG change that may occur
4) How is it managed (3)?
1) Inherited condition where the right ventricular myocardium is replaced by fatty and fibrofatty tissue
2) Palpitations, syncope and sudden cardiac death
3) Epsilon wave and T wave inversion in V1-V3
4) Sotalol is the most widely used antiarrhythmic. Catheter ablation to prevent ventricular tachycardia and an implantable cardioverter-defibrillator (ICD)
