Cardiomyopathies 12/02 Flashcards
Most common cardiomyopathy? percentage?
Dilated cardiomyopathy. 90 percent.
What chambers dilate in dilated cardiomyopathy?
All 4 chambers.
What dysfunction is in dilated cardiomyopathy?
Systolic dysfunction (ventricles cannot pump).
What genetic mutation is in dilated cardiomyopathy?
Autosomal dominant.
What dilated cardiomyopathy cause is due to Coxsackie A or B?
Myocarditis.
How is described myocarditis in micro?
Lymphocytic infiltrate in the myocardium.
What cardiomyopathy is caused by alcohol and cocaine, drugs (doxorubicin) use?
Dilated cardiomyopathy.
What cardiomyopathy is caused by hemochromatosis?
Dilated and restrictive cardiomyopathy.
What cardiomyopathy is caused by Wet Beriberi and Chagas disease?
Dilated cardiomyopathy.
What cardiomyopathy is caused by sarcoidosis, thyrotoxicosis and peripartum cardiomyopathy?
Dilated cardiomyopathy.
Findings of dilated cardiomyopathy?
HF, S3, systolic regurgitant murmur. Dilated heart on ECG. Balloon appearance of heart on CXR.
Treatment of dilated cardiomyopathy?
Na restriction, ACE inh., Beta block, diuretics, digoxin, ICD. HEART TRANSPLANT.
What hypertrophy is in dilated cardiomyopathy?
Eccetric (sarcomeres in series).
How is described Takotsubo cardiomyopathy?
Ventricular apical ballooning likely due to increased sympathetic stimulation.
Which cardiomyopathy is called ,,broken heart syndrome’’?
Takotsubo.
What is the most common cause of dilated cardiomyopathy?
Idiopathic.
What is the most common cause of hypertrophic cardiomyopathy?
Familial –> autosomal dominant.
What genes are mutated in hypertrophic cardiomyopathy?
In genes encoding sarcomeric proteins (myosin binding protein C and beta-myosin heavy chain).
What are findings in hypertrophic cardiomyopathy?
S4, systolic murmur. May seen mitral regurgitation due to impaired mitral valve closure.
What hyperptrophy is seen in hypertrophic cardiomyopathy?
Concentric (sarcomeres in parallel). Often septal predominance.
Treatment of hypertrophic cardiomyopathy?
Cessation of high-intensity athletics. USe Beta blockers or nondihydropyridine Ca blockers (e.g. varapamilis). ICD if patient is high risk.
What are causes of hypertrophic cardiomyopathy excluded familial?
Chronic HTN, Friedreich ataxia.
What dysfunction is in hypertrophic cardiomyopathy?
Diastolic –> decreased CO.
Why young athletes dead having hypertrophic cardiomyopathy?
Ventricular arrhythmias.
Why there is syncope in hypertrophic cardiomyopathy?
Subaortic hypertrophy of the ventricular septum –> functional aortic stenosis –> outflow obstruction –> dypnea, syncope.
What changes are seen in biopsy of hypertrophic cardiomyopathy?
Myofiber hypertrophy with disarray, fibrosis.
Why there is …………………. dysfunction in hypertrophic cardiomyopathy?
Diastolic. Because ventricle cannot fill.
What dysfunction is in restrictive cardiomyopathy?
Diastolic dysfunction.
What are 5 causes of restrictive cardiomyopathy?
Amyloidosis, Sarcoidosis, Loffler endocarditis, Endocardial fibroelastosis, Hemochromatosis.
What is Loffler syndrome?
Endomyocardial fibrosis with an eosinophilic infiltrate and eosinophilia.
What cells are seen in Loffler syndrome?
Eosinophils.
What is classic finding in restrictive cardiomyopathy?
Low-voltage EKG with diminished QRS amplitude.
