Cardiomyopathies Flashcards
On a routine echo, you notice that your patient has a dilated LV, rounded heart, decreased endocardial systolic motion, a large LA, and RV dysfunction. What is your diagnosis? What is the underlying etiology?
Dilated Cardiomyopathy Idiopathic (50%) Myocarditis Ischemia Chemo agents
A new pt presents to your office. During he history you learn that her father had a hypertrophic Cardiomyopathy. What does this mean for your pt?
Monitor her for hypertrophic Cardiomyopathy via an Echo
A pt presents with a mid-systolic harsh murmur that worsens with valsalva. An echo shows RVH and LVH. What diagnosis do you suspect? What treatment should you recommend?
Hypertrophic Cardiomyopathy
B-blockers (1st line)
Dihydro CCBs (2nd line)
Avoid stress
A pt present with a mid-systolic murmur that worsens with valsalva. He has arrhythmias and diastolic dysfunction. You suspect hypertrophic Cardiomyopathy which is confirmed with an Echo. What risk are you most worried about?
Increased risk of sudden cardiac death
A pt presents with arrhythmias and diastolic dysfunction. Echo shows signs of hypertrophic Cardiomyopathy. What is the most likely etiology of this disease?
Genetic (60-70%) - sarcomere protein mutation
Acquired - HTN, aortic stenosis
LVH, concentric/Apical hypertrophy, normal/reduced LV volume
What is the pathology behind restrictive Cardiomyopathy?
Non- dilated, non-hypertrophic ventricles
Impaired ventricular filling
Biatrial enlargement
RV failure
What are the 4 types of restrictive Cardiomyopathy?
Infiltrative
Non-infiltrative
Storage Dz
Edomyocardial Dz
How do you treat amyloid restrictive Cardiomyopathy?
Transplant, chemo, stem cell transplant
How do you treat sarcoid restrictive cardiomyopathy?
Steroids
How do you treat endomyocardial restrictive Cardiomyopathy?
Warfarin
How do you treat Fabry’s restrictive Cardiomyopathy?
a-galactosidase replacement
Which type of cardiomyopathy is associated non-dilated, non-hypertrophic ventricles, impaired filling, and biatrial enlargement?
Restrictive
Which cardiomyopathy is genetically linked and characterized by RV free wall fibrosis, regional/global akinesis/dyskinesis, and ventricular arrhythmias?
Arrhythmogenic cardiomyopathy
A pt presents with benign arrhythmias. He has been feeling fine but yesterday after his marathon training his heart felt funny so he came in today to get it checked out. Echo shows symmetric LVH of 15mm and increased LV cavity size and mass. What is the most likely diagnosis?
Athlete’s Heart
What type of cardiomyopathy is associated with endocardial fibroelastosis and LV noncompaction?
Unclassified cardiomyopathy
A 65yo female pt presents with symptoms of MI. Echo shows apical ballooning of the LV during systole. What cardiomyopathy could this be?
Takotsubo (Stress-Induced) Cardiomyopathy
A 35 yo African American woman presents with her 6 mo old son to the ER. Last month she was treated for heart failure and today her BP is 160/95 despite being on lisinopril and esmolol. What cardiomyopathy could this be? What is her prognosis?
Peripartum cardiomyopathy Prognosis is poor Transplant (4-7%) Mortality (6-23%) Recover (~54%)
A pt presents with Wet Beriberi. Echo shows LV dilation, increased Lv mass, and diastolic/systolic failure. What cardiomyopathy does the pt most likely have? What is the treatment?
Alcoholic cardiomyopathy
Stop drinking!
Which cardiomyopathy can be caused by coxsackie virus, the flu, adenovirus, Chagas, or Lyme?
Infectious Cardiomyopathy
What can cause toxic cardiomyopathy?
EtOH, cocaine, chemo drugs, trace element overload
What can cause miscellaneous cardiomyopathy?
Tahcycardia, SLE, end-stage renal Dz, celiac’s Dz, autoimmune disorders, endocrine disorders
