cardiomyopathies Flashcards
dilated
- most common
- systolic
- remodeling of ventricle wall (enlargement)
- Hemodynamic instability
- Big risk for MI
hypertrophic
- diastolic
- young person killer
restrictive
-diastolic
etiology of dilated
- 50% idiopathic
- infective mycoarditis (coxsackie, kowasackie, chagas)
- prolong ETOH use, MC reversible cause
how does dilated present
- SS right and left CHF
- DOE and at rest
- syncope
- flu-like symptoms weeks prior
how to dx dilated
- CXR first showing cardiomegaly
- echo is the best showing dilated chambers and reduced EF
how to manage dilated
- supportive care (diuretics, ACEI, Carvedilol if needeD)
- LVAD bridge to transplant
takeaway points for dilated
- history is key (virus, etoh, drugs)
- EKG:RVH/LVH, RBBB
hypertrophic obstructive cardiomyopathy
- septum hypertrophy
- common in young adults
- incomplete RBBB
- They die from either pulmonary edema from fluid backing up or most commonly from the SA signal getting lost which turns into V-fib
symptoms of HOCM
- Angina: Atypical feature-pain primary occur at rest and always ***related to exercise.
- syncope
murmur for HOCM
Harsh Cresendo-decresendo systolic murmur (commonly seen in AS, but these are young pts) best at left sternal border. Increase murmur sound by (valsalva- not in AS). Squatting dismissing the intensity of the murmur
hwo to dx HOCM
ECG-abnormal
echo-shows asymmetric septal hypertrophy, best test
when would you perform a septal myectomy
age <55
If they don’t respond to ACE/ARBs or going into VFIB a lot
restrictive cardiomyopathy
ventricles to become stiffer and restricts left ventricular filling ->increase filling pressure and reduce stroke volume
how to manage RC?
- steroids for AI
- diuretics/ACEI
- transplant referral
