Cardiomyopathies

Question 1

Describe hypertrophic cardiomyopathy

Answer 1

Disorganised thickened fibres which obliterate the cavity leading to impaired filling and reduced cardiac output

Question 2

What are the symptoms of HCM?

Answer 2

Syncope
chest pain
palpitations
breathlessness

Question 3

How is HCM treated?

Answer 3

rarely requires treatment
treat heart failure, arrythmias, angina if present
avoid digoxin and use verapamil cautiously

Question 4

How is HCM inherited?

Answer 4

Autosomal dominant condition

Question 5

What is dilated cardiomyopathy?

Answer 5

Muscle fibres have stretched leading to a globally dilated LV with poor function

Question 6

How does dilated cardiomyopathy present?

Answer 6

acute presentation is uncommon

acute-on-chronic heart failure more common

Question 7

Give some causes of dilated cardiomyopathy

Answer 7

idiopathic
familial/genetic (becker's and duchenne's dystrophy)
end stage HTN 
myocarditis 
haemochromatosis

Question 8

What happens to the heart muscle in arrythmogenic right ventricular cardiomyopathy?

Answer 8

it is replaced by fibrous and fatty tissue - progressive pattern of disease

Question 9

How is arrythmogenic right ventricular cardiomyopathy inherited?

Answer 9

autosomal dominant

Question 10

What is the most common clinical manifestation of arrythmogenic right ventricular cardiomyopathy?

Answer 10

sudden death mostly in young people & athletes

Question 11

How is arrythmogenic right ventricular cardiomyopathy treated?

Answer 11

Drug therapy for symptoms
radiofrequency ablation of VT
ICD if ventricular arrythmias

Question 12

Describe restrictive cardioyopathy

Answer 12

Disorder of the heart muscle, walls of ventricles become stiff but not necessarily thickened such that resist normal filling of blood

Question 13

What is the generic treatment for cardiomyopathies?

Answer 13

ACE inhibitors 
ARBs
Beta blockers and rate limiting calcium antagonists 
diuretics
anticoagulation 
anti arrythmics - amiodarone and digoxin