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ICC1 > cardiomyopathies and myocarditis > Flashcards

cardiomyopathies and myocarditis Flashcards

1
Q

what is the most common cardiomyopathy ?

A

dilated congestive cardiomyopathy (DCM)

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2
Q

what is the pathology in dilated cardiomyopathy ?

A

progressive dilatation of all chambers , a big heart with very big chambers

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3
Q

what type of dysfunction is associated with dilated cardiomyopathy ?

A

systolic dysfunction

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4
Q

what are the causes of dilated cardiomyopathy ?

A

non genetic
genetic
idiopathic

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5
Q

what are the causes of DCM?

A

a bunch of stuff can cause cardiac dilatation

Alcohol abuse
Beriberi
Coxsackie
Cocaine
Chagas disease
Doxorubicin
peripartum cardiomyopathy
takutsobo cardiomyopathy
tachycardia cardiomyopathy

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6
Q

what are the genetic causes of DCM ?

A

Duchenne and Becker muscular atrophy

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7
Q

what are the treatments of DCM ?

A

conventional management of heart failure with thee option of cardiac resynchronization therapy and ICDs for patients with a score 3 in thee NYHA

cardiac transplantation

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8
Q

what is the pathology in hypertrophic cardiomyopathy ?

A

-massive myocardial hypertrophy without ventricular dilatation ( asymmetrical hypertrophy of the interventricular septum )

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9
Q

what is the echo finidings in hypertrophic cardiomyopathy ?

A

banana like ventricular cavity

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10
Q

what type of dysfunction is associated with HCM?

A

diastolic dysfunction

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11
Q

what is the gross picture of HCM ?

A

asymmetrical septal hypertrophy

asymmetrical left ventricular hypertrophy

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12
Q

what are the causes of HCM ?

A

distinct genetic disorder, where there is a defect in one of the genes encoding cardiac contractile proteins
is also a storage disease found in babies to diabetic mothers

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13
Q

what are the genes affected in HCM?

A

heavy chain myosin

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14
Q

what are the effects of HCM

A

commonest cause of sudden cardiac death in young during vigorous exercise
syncopal attacks on exercise

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15
Q

what is the treatment for HCM?

A

according to risk stratification
ICD insertion for patients with high risk of sudden death
risk is lower ? amiodarone

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16
Q

what is the most common cause of sudden death in adolescent during vigorous exercise ?

A

hypertrophic cardiomyopathy

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17
Q

what is the pathology in restrictive cardiomyopathy ?

A

infiltration of the myocardium resulting in a firm myocardium and eventually failure of relaxation

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18
Q

what are the causes of restrictive cardiomyopathy ?

A

RASH
radiation fibrosis
amyloidosis
sarcoidosis
hemochromatosis

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19
Q

what is amyloidosis ?

A

extracellular deposition of amyloid substance mainly of walls of blood vessels

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20
Q

what stain can be used with amyloid ?

A

congo red stain

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21
Q

what is seen on clinical examination with restrictive cardiomyopathy ?

A

1- elevated JVP with diastolic collapse - friedreich’s sign
2- elevation of venous pressure with inspiration (Kussmmaul’s sign )

right ventricular hypertrophy

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22
Q

what is the treatment of restrictive cardiomyopathy ?

A

medical
prevention of progression
cardiac transplantation

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23
Q

what is myocarditis ?

A

primary inflammation of the myocardium

24
Q

what are the causes of myocarditis ?

A

may be :
infectious causes
non-infectious causes
unknown

25
what are the infectious causes of myocarditis ?
``` cardioselective viruses (adenovirus) non-selective viruses non-viral causes ```
26
what are the non-infectious causes of myocarditis ?
immune reaction post-viral rheumatic heart disease SLE
27
what are the effects of myocarditis ?
-wide spectrum from totally asymptomatic to acute heart failure to sudden cardiac death via arrhythmia
28
what is the treatment of myocarditis ?
- supportive therapy | - appropriate antimicrobials
29
how to differentiate between cardiomyopathies and other cardiac problems ?
myocardial disease due to intrinsic defect if it is due to HTN, coronary artery disease or valvular heart disease or inflammation its not cardiomyopathy
30
what are the signs in HCM ?
double apical pulsation jerky carotid pulse ejection systolic murmur pansystolic murmur
31
what are the signs seen in HCM ?
jerky carotid pulse double apical pulsation
32
what are the manoeuvres that decrease afterload ?
standing valsalva
33
what manoeuvres increase afterload ?
squatting
34
what type of murmur is associated with left ventricular outflow obstruction ?
ejection systolic murmur
35
what are the common causes of LV outflow obstruction ?
aortic stenosis HCM
36
what happens as a result of the systolic anterior motion which happens in HCM ?
mitral regurg - pansystolic murmur
37
s4 cannot coexist with what heart condition ?
atrial fibrillation
38
when is s4 heard ?
with LV hypertrophy
39
what investigation can be used to differentiate between HCM and infiltrative cardiomyopathies ?
CMR
40
in patients with HCM who have significant left ventricular outflow obstruction , what is the management ?
dual-chamber pacing plus disopyramide
41
what class of drugs should be avoided in HCM ?
vasodilators
42
what waves are specifically seen in arrhythmogenic right ventricular cardiomyopathy ?
epsilon waves
43
what is the first line treatment for patients with non life threatening arrhythmias ?
beta blockers
44
management for refractory or life threatening arrhythmia ?
ICD
45
diagnostic testing for arrhythmogenic right ventricular cardiomyopathy ?
genetic testing
46
what is the presentation of takotsubo CM ?
middle aged woman history of stressful event apical ballooning
47
what are the features of peripartum cardiomyopathy ?
affects women in the llast trimesster or within 5 mmonths of preegnancy
48
what condition is peripartum cardiomyopathy associated with ?
preeclampsia
49
what is the prognosis of peripartum CMM ?
half of the patients will recover to normal function within 6 months other half may develop heart failure and sudden death
50
what is the cause of tachycardia cardiomyopathy ?
prolonged periods of supraventricular or ventricular tachycardia
51
what is the management for tachycardia cardiomyopathy ?
cardioversion and ablation
52
what is characteristic for cardiac amyloidosis ?
voltage mass-mismatch ground glass appearance of the myocardium macroglossia bruising around the eye
53
what is the novel therapy for patients with familial amyloidosis ?
tafamidis liver transplantation
54
what is the appearance of left ventricular noncompaction ?
congenital cardiomyopathy sponge like appearance of the left ventricle and excessive trabeculations
55
what is the next diagnostic step for patients with amyloidosis ?
TTE

ICC1 (50 decks)

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