Cardiomyopathies and Myocarditis Flashcards
Mechanical prosthetic heart valves have a risk of?
Thromboembolism
Bioprosthetic (tissue) heart valves have an increased risk of?
Mechanical failure
Heart is structurally and functionally abnormal with mechanical/electrical dysfunction
Cardiomyopathy
3 common types of heart muscle diseases (cardiomyopathies)?
- Dilated
- Hypertrophic
- Restrictive
Dilated Cardiomyopathy
Enlargement of all chambers with hypertrophy of muscle mass
Enlargement of all chambers with hypertrophic muscles of the heart?
Dilated Cardiomyopathy
What type of dysfunction is seen with dilated cardiomyopathy?
Systolic
What are the possible signs of Dilated Cardiomyopathy?
- Progressive CHF
- Arrhythmias
- Thromboembolism
- 20-50 years old
Dilated Cardiomyopathy can be inherited autosomal ____ with what mutations?
Autosomal Dominant
- TTN gene with Titin mutation
Which drugs (chemo agents) can cause Dilated Cardiomyopathy?
Doxorubicin
Daunorubicin
What other gene mutation/mineral overload may cause Dilated Cardiomyopathy?
Hemochromatosis
– HFE gene
= IRON overload
“bronze diabetes” suggests what disease that can be associated with Dilated Cardiomyopathy?
Hemochromatosis – elevated iron
Takotsubo Cardiomyopathy is a type of dilated cardiomyopathy. Describe how it arises.
- Emotional distress
- Elevated catecholamines
- Ballooning of LV
= > Ischemic cardiomyopathy
“broken heart syndrome” has elevated?
Takosubo cardiomyopathy
- elevated catecholamines
Hypertrophic Cardiomyopathy is a genetic disorder with mutations commonly in?
Beta-myosin heavy chain
Hypertrophic Cardiomyopathy is a genetic disorder with mutations commonly in?
Beta-myosin heavy chain
With Hypertrophic Cardiomyopathy, where is the hypertrophy and disarray of myoctes?
SEPTAL
Symptoms of Hypertrophic Cardiomyopathy?
= Sudden death during exercise of teenager
– systolic ejection murmur
Symptoms of Hypertrophic Cardiomyopathy?
= Sudden death during exercise of teenager
- Systolic ejection murmur
Restrictive Cardiomyopathy is what and is possible due to?
Stiffness of ventricles – impaired filling
– may be due to amyloid deposition or fibrosis
Restrictive Cardiomyopathy is what and is possibly due to?
Stiffness of ventricles – impaired filling
- May be due to amyloid deposition or fibrosis
What is the result of Restrictive Cardiomyopathy?
Congestive Heart Failure
Insoluble beta-pleated sheet deposits in the myocardium?
Amyloid
– Restrictive Cardiomyopathy
(+) apple green birefringence with congo red stain
Amyloid
Hypertrophic and Restrictive Cardiomyopathies are both _____ dysfunctions
Diastolic
Arrhythmogenic Right Ventricular Cardiomyopathy is caused by?
Defective cell adhesion proteins in desmosomes between cardiac myocytes
What is seen with Arrhythmogenic Right Ventricular Cardiomyopathy?
RV myocardium is replaced by adipose tissue and fibrosis
RV myocardium is replaced by adipose tissue and fibrosis
Arrhythmogenic right ventricular cardiomyopathy
What 4 things can Arrhythmogenic Right Ventricular Cardiomyopathy cause?
- Ventricular Tachycardia
- Premature contractions
- Fibrillation
- Death
Naxos Syndrome
Arrhythmogenic Right Ventricular Cardiomyopathy + plantar/palmar hyperkeratosis and wooly hair
Naxos Syndrome and associated mutation
Arrhythmogenic Right Ventricular Cardiomyopathy + plantar/palmar hyperkeratosis and wooly hair
– Plakoglobin mutation
Myocarditis
Inflammation of cardiac muscle
The clinical presentation for myocarditis varies. What 2 viruses are the most common cause?
Coxsackie B virus
COVID19
What are the 2 most common viruses that cause myocarditis?
Coxsackie B virus
COVID19
What type of myocarditis is caused by Coxsackie B virus or COVID 19?
Lymphocytic myocarditis
Eosinophilic myocarditis may be due to?
Underlying allergy or drug reaction
- rule out parasites
Idiopathic Giant Cell Myocarditis
Giant cells + eosinophils = pooooor prognosis!
Myocardial sarcoidosis
Giant cells with Non-necrotizing granulomas
What are 3 other causes of myocarditis?
Lyme disease
Trichinella spiralis - undercooked pork
Chagas disease
