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Pathophys > Cardiomyopathies > Flashcards

Cardiomyopathies Flashcards

1
Q

What is cardiomyopathy?

A
  • Disorder within the cardiac myocytes themselves which results in abnormal cellular and hence cardiac performance
  • Typically leads to irreversible decline in cardiac function
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2
Q

T/F Patients with a cardiomyopathy are often candidates for transplantation

A

True

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3
Q

What is the primary cause of cardiomyopathy?

A

Pathologic processes intrinsic to cardiac myocytes themselves

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4
Q

What is the secondary cause of cardiomyopathy?

A

Result of a pathological change in cardiac myocytes brought on by a systemic disease process

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5
Q

What are the 3 types of cardiomyopathies? Describe them briefly.

A
  1. Dilated - enlarged ventricles and thinned walls
  2. Hypertrophic - thickened, stiffened walls
  3. Restrictive - stiffened walls
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6
Q

What is the most common form of cardiomyopathy?

A

Dilated

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7
Q

Describe common characteristics of dilated cardiomyopathy? (3)

A
  1. Impaired systolic function with cardiac enlargement
  2. Hypertrophied myocytes with mitochondrial abnormalities
  3. Fibrosis is common – reduced ROM
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8
Q

Causes of dilated cardiomyopathy? (5)

A
  1. Toxic substances
  2. Poor nutrition (B1 deficiency)
  3. Idiopathic, family hx
  4. AIDs
  5. Cancer therapies
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9
Q

symptoms of dilated cardiomyopathy? (4)

A
  1. Fatigue
  2. Dyspnea on exertion, shortness of breath, cough
  3. Orthopnea (SOB while lying down), paroxysmal nocturnal dyspnea
  4. Increasing edema, weight, or abdominal girth
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10
Q

Signs of dilated cardiomyopathy? (3)

A
  1. Tachypnea: Increased respiratory rate
  2. Tachycardia: Increased heart rate
  3. Hypertension or hypotension
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11
Q

Other pertinent findings of dilated cardiomyopathy?

A
  1. Signs of hypoxia (eg, cyanosis, clubbing)
  2. Jugular venous distension (JVD)
  3. Pulmonary edema (crackles and/or wheezes)
  4. Enlarged liver
  5. Ascites (fluid in peritoneal cavity) or peripheral edema
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12
Q

Nonpharmacologic management of dilated cardiomyopathy?

A
  1. Sodium diet restricted to 2g/day

2. Fluid restriction

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13
Q

Describe overstretching of LVEDV on Frank starling law.

A

Overstretching (↑ LVEDV) leads to failure of the myocardial contractile unit Frank Starling law becomes compromised.

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14
Q

What type of CARDIOMYOPATHY is the single most common cause of death in young people?

A

HYPERTROPHIC CARDIOMYOPATHY

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15
Q

What is HYPERTROPHIC CARDIOMYOPATHY characterized by?

A
  • a thick LV wall with a non-dilated cavity
  • resulting cardiac hypertrophy is out of proportion to the hemodynamic load
  • 9 gene defects which cause defects in sarcomeric proteins
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16
Q

What is genetic HYPERTROPHIC CARDIOMYOPATHY with autosomal (not sex linked) dominance?

A
  1. Normal blood pressures perceived as excessive by defective myocytes
  2. Hypertrophy occurs as a compensatory mechanism
  3. Ultimately heart decompensate (decrease functional capacity
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17
Q

T/F Majority of cases of HYPERTROPHIC CARDIOMYOPATHY are symptomatic and are caught before death.

A

False, Majority of cases are asymptomatic

First clinical manifestation is often sudden death

18
Q

Describe effect of septal wall thickening on O2 delivery.

A

Thickening of septal wall -> Myocytes less effective -> blood flow reduced (ejection fraction/stroke volume compromised) -> O2 delivery compromised

19
Q

Restrictive/infiltrative cardiomyopathy is characterized by what?

A
  • restrictive diastolic filling/loss of compliance (ventricles stiffer – more difficult to fill up or incapable of doing so)
  • idiopathic fibrosis
20
Q

T/F Systolic function if normal in Restrictive/infiltrative cardiomyopathy

A

True

21
Q

In Restrictive/infiltrative cardiomyopathy what volume/s are diminished? What volume/s are normal?

A
  1. EDVs are diminished (chambers cannot expand and therefore filling pressures are very high)
  2. ESVs and EFs are normal
22
Q

What are symptoms of Restrictive/infiltrative cardiomyopathy?

A
  1. Dyspnea with exertion
  2. abdominal swelling
  3. ankle edema
  4. fatigue
23
Q

What are causes of Restrictive/infiltrative cardiomyopathy?

A
  1. Scleroderma
  2. Diabetes
  3. Amyloidosis (abnormal protein builds up in your organs and interferes with their normal function)
  4. Sarcoidosis (fibrotic scarring secondary to myocardial infiltrates)
  5. Hemochromatosis (excessive deposition of iron)
  6. Metastatic cancers
  7. Secondary to Anthracycline treatment (antibacterial
  8. Radiation (mediastinal)
24
Q

General Cardiomyopathy review:

Hypertrophic -

A
  1. Diastolic dysfunction
  2. Risk of sudden death in young athletes
  3. Thickened left ventricular wall
25
Q

General Cardiomyopathy review:

Dilated -

A
  1. Enlargement of all cardiac chambers
  2. Systolic dysfunction
  3. Most common type
26
Q

General Cardiomyopathy review:

Restrictive -

A
  1. Rigid ventricular walls
  2. Diastolic dysfunction
  3. Least common type
27
Q

Other cardiac pathologies:

Stenosis -

A
  • Valve doesn’t open properly
28
Q

Other cardiac pathologies:

Regurgitation -

A
  • Valve doesn’t close properly
  • Permits backward flow of blood.
  • Functional and anatomic Implications (decreased SV)
29
Q

Other cardiac pathologies:

Arrhythmias -

A

Disturbance of rate and/or rhythm of heart beat

30
Q

Arrhythmias:
Bradycardia rate -
Caused by what type of injury?

A

< 50 BPM

SA node injury

31
Q

Arrhythmias:
Tachycardia rate -
Caused by what?

A

> 100 BPM

- Fear, pain, emotion, exertion, Fever, CHF, infection, anemia, hemorrhage, hyperthyroidism

32
Q

Other cardiac pathologies:

Pericardial effusion -

A

buildup of fluid -> more difficult for heart to beat against increase pressure

33
Q

What is pericarditis?

A

A swelling and irritation of the thin saclike membrane surrounding the heart (pericardium).

34
Q

pericarditis caused by what?

A
  1. Viral infection
  2. Heart attack
  3. Idiopathic
35
Q

Describe pain experienced with pericarditis? When is it worsened? What decreases pain?

A
  1. Sharp chest pain-pleural membrane rubbing against one another
  2. Pain is worsened by lying supine, inhaling deeply, or crouching.
  3. Leaning forward decreases the pain.
36
Q

What is myocarditis? Caused by what? Can lead to what?

A
  • Inflammation of the myocardium
  • Usually caused by a viral infection
  • Can lead to HF, arrhythmia, sudden death
37
Q

What is an aneurysm?

A

An abnormal stretching (dilation) in the wall of an artery, a vein, or the heart with a diameter that is at least 50% greater than normal.

38
Q

T/F Aneurysm named according to the specific site of formation.

A

True

  • Aortic
  • Thoracic aortic aneurysms
  • Abdominal aortic aneurysms
  • Femoral and popliteal aneurysm
39
Q

In a true aneurysm, layers of the vessel dilate in one of the following 3 ways?

A
  1. Saccular: a unilateral outpouching
  2. Fusiform: a diffuse dilation involving the entire circumference of the artery wall
  3. Dissecting: a bilateral outpouching in which layers of the vessel wall separate, with creation of a cavity.
40
Q

What is a false aneurysm?

A

the wall ruptures, and a blood clot is retained in an outpouching of tissue.

41
Q

What is the most common aneurysm? What type of pain?

A

Abdominal aortic aneurysm (AAA) - fusiform in shap extending from below renal arteries to involve the entire infrarenal aorta and often involved the common iliac arteries
- Pressure causes lower abdominal pain and dull lower back pain

42
Q

4 Causes of diabetic heart disease?

A
  1. Metabolic effects due to FFA, insulin resistance
  2. Structural - myocardial fibrosis and ECM changes
  3. Reduced perfusion due to small vessel disease
  4. Autonomic dysfunction reduced HRR

Pathophys (16 decks)

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