Cardiomyopathies Flashcards
What are the three types of cariomyopathies?
Restrictive Dilated Hypertrophic
Cardiomyopathies can develop to compensate for other underlying diseases such as…
(secondary cardiomyopathy)
Hypertension / Valve diseases
Most common type of cadriomyopathy?
Dilated
Dilated cardiomyopathy
- All 4 chambers of the heart dilate.
- Heart walls become thin and lose contractility.
Hypertrophic cardiomyopathy
- Walls become thick, heavy and hypercontractile.
Restrictive cardiomyopathy
- Heart muscle is restricted becoming stiff and less compliant.
- This prevents the heart from filling properly.
- Muscles and size of the ventricles are only slightly enlarged.
Restrictive cardiomyopathy can be idopathic or secondary to what?
- think about what would cause restriction…
A disorder that results in the deposition of iron or amyloid in the tissue, or by fibrosis caused by immune cells / radiation.
Amyloidosis
Sarcoidosis
Hemochromatosis
What symptoms can cardiomyopathy present with and why?
Cardiomyopathies prevent the heart from doing it’s job properly so signs and symptoms are similar to that of heart failure:
Fatigue
Dyspnea
Swelling of the feet
Acute symptoms: Presyncope / syncope (represents increased risk of MI).
Arrhythmias as cardiomypothies affect the heart muscle and also pace maker cells leads to arrhythmias.
What is the main cause of mitral stenosis?
RHEUMATIC FEVER! RHEUMATIC FEVER! RHEUMATIC FEVER!
What arrhythmias can result from cardiomyopathies?
Atrial fibrillation, ventricular ectopic beats, ventricular tachycardia or fibrillation, and atrioventricular block.
Hypertrophic cardiomyopathy presents with what murmur?
Cresecendo-decrescendo murmur between S1 and S2.
ECG changes in cardiomyopathies:
How is cardiomyopathy type identified?
How does hypertrophic cardiomyopathy present on echocardiogram?
How does restrictive cm present on an echo?
Shape tends to be normal, as restrictive cardiomyopathy is characterised by non-dilated ventricles with impaired ventricular filling.
MRI is particuarly useful for diagnosising what?
X-ray in diagnosis:
Cardiac MRI is useful for diagnosing restrictive cardiomyopathy.
What is the relevance of the genetic background to these condition?
All the cardiomyopathies run in families - important to screen the immediate family with ECG and echocardiography.
This is important because many cases of sudden death are due to undiagnosed cardiomyopathies.
Hypertrophic cardiomyopathy is the most common cause of death in whom?
Young athletes
Cardiomyopathy Treatment:
No treatment except heart transplant.
Goal of treatment is symptom relief and ensuring the heart continues to function - avoiding MI and development of congestive HF.
Pacemakers may also be needed to treat arrhythmias.
Summary of Inherited cardiac condtions:
Cardiomyopathy MRI
What are the functions of the pericardium?
- Protection
- Prevents over expansion with increasing preload
- Minor shock absorber
- Immunological / hormonal
Dilated cardiomyopathy ejection fraction is…
<45%
Arrhythmogenic (right) cardiomyopathy inheritence?
Autosomal dominant inheritance with mutations in desmosome proteins found in most patients.
What is the main cause of amyloidosis?
Amyloidosis is caused by changes in proteins that make them insoluble, leading them to deposit in organs and tissues. These amyloid proteins accumulate mainly in the tissue space between cells. Changes in proteins that make them amyloid proteins occur because of gene mutations in DNA within cells.
Long QT syndrome
Long QT syndrome (LQTS) is a condition in which repolarization of the heart after a heartbeat is affected. It results in an increased risk of an irregular heartbeat which can result in fainting, drowning, seizures, or sudden death.
Brugada syndrome
Brugada syndrome is a condition that causes a disruption of the heart’s normal rhythm. Specifically, this disorder can lead to irregular heartbeats in the heart’s lower chambers (ventricles), which is an abnormality called ventricular arrhythmia.
Acute pericarditis
Acute inflammation of the pericardium of the heart.
What is the most common cause of acute pericarditis?
Usually viral cause.
How does acute pericarditis present?
Pleuritic chest pain
Other symptoms of viral illness.
If in tamponade - breathlessness / pre-syncope/syncope.
Pericardial rub on auscultation.
Pericardial effusion is
Substance in the pericadial space - usually fluid, pus or blood.
Pericardial effusion imaging:
Cardiac tamponade presents with what triad?
Beck’s Triad:
Hypotension
Jugular distension
Diminished heart sounds
Cardiac tamponade
Cardiac tamponade is when blood or fluids fill the pericardial space. This places extreme pressure on your heart. The pressure prevents the heart’s ventricles from expanding fully and keeps your heart from functioning properly.
Arrhythmogenic cm affects where?
Right ventricle
What puts a patient with cardiomyopathy at risk of sudden death?
Syncope
Cardiomyopathies summary:
inheritance is 99% what?
Autosomal dominant
