Cardiomyopathies Flashcards

1
Q

What is the contemporary definition of cardiomyopathy?

A

A myocardial disorder in which the heart muscle is structurally and functionally abnormal without coronary artery disease, hypertension, valvular disease, or congenital heart disease.

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2
Q

What are the three main types of cardiomyopathies?

A

Dilated, Hypertrophic, and Restrictive Cardiomyopathy.

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3
Q

Which cardiomyopathy is the most common?

A

Dilated Cardiomyopathy (DCM), accounting for up to 60% of cases.

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4
Q

What is the WHO 1980 definition of cardiomyopathy?

A

Heart muscle disease of unknown cause.

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5
Q

How does the AHA 2006 define cardiomyopathies?

A

A heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction, often genetic, and can lead to heart failure or death.

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6
Q

What are the classifications of cardiomyopathy according to WHO/ISFC 1995?

A

Dilated, Hypertrophic, Restrictive, Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), and Unclassified Cardiomyopathy.

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7
Q

What is the primary characteristic of Dilated Cardiomyopathy (DCM)?

A

Dilation and impaired systolic function of the left or both ventricles with an ejection fraction <40%.

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8
Q

What are the main causes of Dilated Cardiomyopathy?

A

Genetic mutations, myocarditis, toxins (alcohol, drugs), endocrine disorders, nutritional deficiencies, pregnancy, and infections.

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9
Q

Which infection is commonly associated with DCM in Nigeria?

A

Toxoplasma gondii and Coxsackievirus B.

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10
Q

What are the clinical features of Dilated Cardiomyopathy?

A

Heart failure symptoms, acute pulmonary edema, systemic or pulmonary embolism, and syncope.

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11
Q

What is the characteristic ECG finding in DCM?

A

Sinus or atrial tachycardia, atrial fibrillation, low voltage complexes, left axis deviation, and conduction abnormalities.

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12
Q

What echocardiographic findings suggest DCM?

A

Dilated chambers, thin walls, global hypokinesia, LVEF <40%, and mural thrombi.

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13
Q

What is the role of diuretics in DCM treatment?

A

They help manage fluid overload but do not improve survival.

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14
Q

Which drug classes are essential for DCM management?

A

ACE inhibitors, Beta-blockers, Aldosterone antagonists, and SGLT2 inhibitors.

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15
Q

What is Hypertrophic Cardiomyopathy (HCM)?

A

Unexplained left ventricular hypertrophy (LVH) in the absence of other causes such as hypertension or aortic stenosis.

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16
Q

What is the prevalence of HCM in the general population?

A

Approximately 1 in 500 people.

17
Q

Which genetic mutation is most commonly associated with HCM?

A

Beta-myosin heavy chain gene mutation.

18
Q

What is the main histological feature of HCM?

A

Myofibrillar disarray with fibrosis.

19
Q

What are the key clinical features of HCM?

A

Chest pain, dyspnea, syncope, arrhythmias, and systolic murmur.

20
Q

What are the ECG findings in HCM?

A

LVH, ST-T wave abnormalities, and deep Q waves in lateral leads.

21
Q

What is the first-line drug treatment for symptomatic HCM?

A

Beta-blockers or non-dihydropyridine calcium channel blockers (e.g., verapamil).

22
Q

Which interventions are considered for high-risk HCM patients?

A

Implantable cardioverter-defibrillator (ICD) for sudden cardiac death prevention.

23
Q

What is Restrictive Cardiomyopathy (RCM)?

A

A condition characterized by impaired diastolic function due to reduced ventricular compliance with near-normal systolic function.

24
Q

What are the common causes of RCM?

A

Amyloidosis, sarcoidosis, endomyocardial fibrosis, and Loeffler’s endocarditis.

25
Q

What is the hallmark clinical feature of RCM?

A

Severely limited exercise tolerance due to fixed stroke volume.

26
Q

What are the echocardiographic features of RCM?

A

Bi-atrial enlargement and restrictive mitral inflow pattern.

27
Q

What is the treatment focus for RCM?

A

Managing symptoms of heart failure and addressing the underlying cause.

28
Q

Which cardiomyopathy is commonly associated with sudden cardiac death in young athletes?

A

Hypertrophic Cardiomyopathy (HCM).

29
Q

Which genetic inheritance pattern is seen in most cases of HCM?

A

Autosomal Dominant.

30
Q

What is the recommended screening for family members of a patient with HCM?

A

Echocardiography and ECG for first-degree relatives.