cardiomyopathies

Question 1

What are causes of dilated cardiomyopathies?

Answer 1

ABCCCD: alcoholism, beri beric, chronic cocaine, coxsackie, Chagas disease doxorubicin toxicity. also hemochromatosis and pregnancy

Question 2

What are the findings in dilated cardiomyopathy?

Answer 2

dilation of all four chambers of the heart.

heart failure, S3, dilated heart on echo, balloon appearance on CXR. eccentric hypertrophy- sarcomeres added in series.

Question 3

Treatment of dilated cardiomyopathies

Answer 3

mostly supportive, maybe a heart transplant (may also try BBs, ACE-Is, diuretics, digoxin)

Question 4

What is the main problem with a dilated cardiomyopathy?

Answer 4

this is a systolic problem

Question 5

What is a hypertrophic cardiomyopathy?

Answer 5

disorganized ventricular hypertrophy of the heart that causes problems with filling. often septum is particularly hypertrophied. there may be fibrosis.

Question 6

What are some causes of hypertrophic cardiomyopathy?

Answer 6

usually autosomal dominant defects with the sarcomere proteins. may rarely be caused by friedrich’s ataxia.

Question 7

Findings in hypertrophic cardiomyopathy

Answer 7

disorganized hypertrophic tissues, leading cause of sudden death in young athletes. may hear an S4.
patients may have decr. cardiac output, syncope with exercise (subaortic hypertrophy ofo

Question 8

What is the main problem with hypertrophic cardiomyopathy?

Answer 8

this is a filling problem (diastolic issue)

Question 9

What are the major causes of restrictive cardiomyopathy?

Answer 9

amyloidosis, sarcoidosis, endocardial fibroelastosis (thick fibroelastic tissue in the endocardium of young kids), Loffler syndrome (endomyocardial fibrosis with a prominent eosinophilic infiltrate), and hemochromatosis

Question 10

What is the main problem with restrictive cardiomyopathy?

Answer 10

this is a also filling/diastolic issue

Question 11

Findings of restrictive cardiomyopathy?

Answer 11

low voltage EKG in spite of thick myocardium.

Question 12

What interventions decrease mortality in CHF?

Answer 12

ACE-I, BBs (except in acute decompensated), ARBs, and spironolactone. hydralazine with nitrates helps in select patients.

Question 13

What are the classic findings in CHF lung biopsy?

Answer 13

hemosiderin laden macrophages.

Question 14

What are some signs of right heart failure?

Answer 14

nutmeg liver/hepatomegaly: incr. central venous pressure casues incr. resistance to portal flow. rarelym leads to cardiac cirrhosis.
may also see peripheral edema and jugular venous distention

Question 15

What are the types of acute pericarditis?

Answer 15

fibrinous (dressler syndrome, uremia, radiation), serous (viral pericarditis or SLE/RA), suppurative/purulent: usually d/t pneumococcus or streptococcus but now rare
presents with pain aggravated by inspiration and relieved by sitting up, friction rub, widespread ST seg elevation and/or PR depression

Question 16

What are the findings of syphilitic heart disease?

Answer 16

teritiary syphilis disrupts the vasa vasorum of the aorta and causes atrophy of the vessel wall and dilation of the aorta and valve ring. this manifests as calcification of the aortic root and ascending arch aorta. leads to a tree bark appearance. can cause an aneurysm of the ascending aorta or aortic arch and aortic insufficiency.

Question 17

What is an angiosarcoma?

Answer 17

blood vessel malignancy seen in the head, neck, and breast areas. very aggressive and difficult to resect. associated with arsenic exposure or radiation therapy.