Cardiomyopathies Flashcards
Review this slide on the objectives of this lecture
There are 3 patterns of cardiomyopathy, name ___
There are 3 patterns of cardiomyopathy, namely dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy
The most common cardiomyopathy is ___ and is characterized by dilation of all 4 chambers of the heart
Dilated cardiomyopathy
Which type of cardiomyopathy is is characterized by a flabby heart w/ all 4 chambers enlarged, and leads to progressive cardiac dilation and systolic failure?
Dilated cardiomyopathy (remember, even though I have a flabby heart, huge chambers, a dilated heart still gives good lovin…until it fails >> systolic failure)
Review this summary slide on dilated cardiomyopathy
What are some of the common causes of dilated cardiomyopathy? (hint:ABCCCD)
Alcohol abuse
wet Beri Beri
Coxsacki B virus
Chagas disease (note that both coxsackie and chagas cause myocarditis)
Chronic cocaine use
Doxorubicin
Genetic mutations leading to DCM are usually (AD/AR) and affect genes encoding ___ and result in ___ in children
How does alcohol cause DCM?
Other causes of DCM include ___ (Y has to have this forst b4 she can have those 6 kids) and ___ (means we don’t know)
Genetic mutations leading to DCM are usually AD and affect genes encoding myocyte cytoskeletal proteins and result in MTOC defects in children
Alcohol has a direct toxic effect on the myocardium
Other causes of DCM include pregnacy (Y has to have this forst b4 she can have those 6 kids) and idiopathic
**note the other causes on the slide**
A 30 year old male with a history of HTN comes to your clinic complaining of worsening dyspnea and peripheral edema over the last year. PMH is noteable for previous Coxsackie B virus infection. He has a family history of heart disease. Physical exam is noteable for a systolic regurgitant murmur and a chest xray reveals a balloon appearance of the heart. Measured EF is 35%.
What pattern of cardiomyopathy is on your Ddx?
Name two complications of this patter.
How how you Rx this pt?
A 30 year old male with a history of HTN comes to your clinic complaining of worsening dyspnea and peripheral edema over the last year. PMH is noteable for previous Coxsackie B virus infection. He has a family history of heart disease. Physical exam is noteable for a systolic regurgitant murmur and a chest xray reveals a balloon appearance of the heart. Measured EF is 35%.
What pattern of cardiomyopathy is on your Ddx: Dilated cardiomyopathy
2 complications: arrythmia and emboli
Rx: see slide (but treatment involves strategies to reduce congestion, control blood pressure, improve EF etc)
___ is a pattern of cardimyopathy characterized by myocardial hypertrophy, decreased LV compliance and leads to diastolic dysfunction.
T/F: This pattern of cardiomyopathy is caused by genetic mutations in sarcomere proteins
Hypertrophic obstructive cardiomyopathy is a pattern of cardimyopathy characterized by myocardial hypertrophy, decreased LV compliance and leads to diastolic dysfunction.
True: This pattern of cardiomyopathy is caused by genetic mutations in sarcomere proteins
What type of cardiomyopathy is characterized by disproportionate hyptertrophy of the left ventricular septum, endocardial thickening and mural plaque deposition?
What causes the formation of the mural plaque?
Hypertrophic cardiomyopathy
The mural plaque deposition is caused by the anterior motion of the anterior leaflet of the mitral valve forcing contact with the septum
(so basically the mitral valve keeps touching the septum which somehow results in this formation of a mural plaque during systole)
___ is histologically characterized by myocyte hypertrophy with disarray
Hypertrophic cardiomyopathy is histologically characterized by myocyte hypertrophy with disarray
What is the cardiomyopathy characterized by the pathology below?
This is myocyte disarray - HCM
A key clinical finding in HCM is ___ due to the systolic anterior motion of the mitral valve. Another finding is a systolic murmur that is exacerbated by the ___ maneuver
A key clinical finding in HCM is pulsus bisferiens due to the systolic anterior motion of the mitral valve. Another finding is a systolic murmur that is exacerbated by the valsava maneuver
Genetic mutations in HCM are most commonly AD mutations in sarcomere proteins. The most commonly mutated gene is __. Mutations in __, __ and __ account for most of HCM cases
Genetic mutations in HCM are most commonly AD mutations in sarcomere proteins. The most commonly mutated gene is B-MHC (myosin heavy chain). Mutations in B-MHC, MYBP-C and TnT account for most of HCM cases
HCM is the most common cause of sudden death in young atheletes. What are 3 pathologies that develop in HCM that can lead to sudden cardiac death?
Why is there reduced stroke volume in HCM. What kind of murmur can be heard in HCM?
Pts with HCm can also present with ___ (type of myocardial ischemia) and ___ (aka chest pain)
How do you treat HCM?
HCM is the most common cause of sudden death in young atheletes. 3 pathologies that develop in HCM that can lead to sudden cardiac death: a-fib, exertional syncope (syncope with exercise), and mural thrombus
Why is there reduced stroke volume in HCM?: not enough diastolic filling.
HCM murmur: harsh systolic ejection murmur (coz the muscle is hypertrophied and rigid I think)
Pts with HCM can also present with focal myocardial Rx: beta blockers, surgical rmeoval of hypertrophied septal muscle, alcohol ablation?
What is the most likely finding in a pt with this myocardial biopsy?
A.A balloon shaped heart
B.Echocardiogram showing systolic anterior motion of the mitral valve
C.Recent viral infection
D.Patient holding a basketball
B
What diseases will be on your differential Ddx for hypertrophic cardiomyopathy? (4)
Deposition diseases
HTN heart disease + age related subaortic septal hypertrophy
Aortic stenosis
Friedreich ataxia
**see below**
Review this slide comapring DCM and HCM
