Cardiomyopathies Flashcards
Define
refers to a disease of the heart muscle associated with cardiac dysfunction
WHO definitions are based on what
ventricular morphology
Dilated CM
Hypertrophic CM
Restrictive CM
Dilated CM Cavity Size: Wall thickness: Systolic fx: Diastolic fx:
enlarged
normal
severely reduced
abnormal
Hypertrophic CM Cavity Size: Wall thickness: Systolic fx: Diastolic fx:
Small
Markedly thickened
Hyperdynamic
Abnormal (dec)
Restrictive CM Cavity Size: Wall thickness: Systolic fx: Diastolic fx:
Normal
Normal
Normal or min. reduced
Abnormal (dec)
Cause of dilated CM
Ischemic Idiopathic Viral Genetic Valvular dx Alcoholic From chemo Metabolic disorders Chagas Nutritional Peripartum
Hypertrophic CM - characterized by
thickened LV walls and reduced cardiac volume
Mutation of sarcomere proteins
Can be hereditary
Hypertrophic CM - myocytes
are not arranged in an organized manner - high change of arrhythmias and fibrosis
Presentation - Hypertrophic CM
Variable from asymptomatic to significant functional limitation
Typically - dyspnea on exertion, exertional angina, syncope/presyncope
hypertrophic CM - septum
Gets thick too and can lead to outflow obstruction - can lead to immediate death
Outflow tract obstruction is inc by
Hypovolemia
Inc contractility
Reduced afterload (peripheral VD)
Murmus of outflow tract obstruction - how to make it worse
Standing, vasalva
Low venous return
Murmurs of outflow tract obstruction - how to reduce
Leg raising, squatting, hand grip
Inc venous return with leg raise, other inc afterload
What proves hypertrophic CM
ECG
Management with Hypertrophic CM
Reduce LV outflow tract obstruction
Avoid hypovalemia or VD
Screen relatives
Avoid competitive athletics
Therapy to reduce LV outflow tract obstruction
Beta blockers Ca channel blockers Pacemaker Surgical myectomy Alcohol septal ablation
Risk factors for sudden cardiac death in those with hypertrophic cardiomyopathy
Young age (less than 30) Family hx Recurrent syncope Nonsustained VT Abnormal BP response to ex (dec) Severe septal hypertrophy (more than 2.5cm)
Restrictive CM define
Resulting in restricted ventricular filling and reduced diastolic volume with normal or near normal sys function AND wall thickness
RARE
Abnormal compliance of LV
Short relaxation time
Etiology of Restrictive CM
Myocardial
Endomyocardial
(anything that will make your heart stiffer)
Clinical manifestations of Restrictive CM
Sx of R and L heart failure
Jugular venous distension
Echo doppler abnormalities
Amyloid heart disease
related to chronic conditions - infiltrates between myocytes
Takotsubo CM AKA
apical ballooning syndrome
stress induced CM
broken heart syndrome
What happens in Takotsubo CM
Distal tip does not contract
Takotsubo CM - contributed to having
excess catecholamines
NE is elevated
