Cardiomyopathies and Selected non-coronary heart disease Flashcards
What are the major causes of dilated cardiomyopathy?
- myocarditis
- ischemic heart disease
- peripartum
- hypertensive
- valvular
- infectious
- systemic
- toxic (drugs/alcohol)
- metabolic
- neuromuscular
- familial
What are the treatment of cardiomyopathy?
- ACE inhibitor
- beta blockers
- diuretics
- digoxin/vasipressin antagonist
- antiarrhythmic drugs
- anticoagulants
- Pacemaker - severe
- Heart transplant - very severe
Diagnostic tools for cardiomyopathy?
TTE
EKG - non-specific change or LBBB or AFIB
What are the three unfavourable features of dilated cardiomyopathy?
- significant LV enlargement
- Lower EF
- LBBB
Hypertrophic cardiomyopathy is characterized by what?
Myocardiac hypertrophy; hypertrophy is thickening of the heart muscle, primarily left ventricle.
LV outflow tract can be obstructed due to anterior mitral leaflet impinging on the hypertrophied septum, what are these cases referred to?
Hypertrophic obstructive cardiomyopathy/HOCM.
What differentiate athlete heart to HCM in diagnostic?
Athletic heart has an LV wall thickness that exceeds 13mm, and systolic anterior motion of the mitral apparatus is confirmatory for HCM.
Treatment for HCM?
- beta blocker/calcium channels
- Anticoagulant
- Surgery
- Alcohol injection into septal artery
EKG abnormalities in HCM?
- LVH by voltage criteria
- Major St-T changes in the absence of known causes.
- abnormal Q waves
- large negative T waves
High Risk Characteristic of HCM?
symptomatic
fhx of sudden death
septal thickness of 25mm
outflow gradient over 30 mmHg
arrhythmias/AF
Ventricular tachycardia
Low exercise capacity/fall in BP with exercise
More favourable prognosis with HCM?
over 40
no progression in echocardio
no symptoms
no fhx of sudden death
intraventricular septum less than 16mm
no outflow gradient less than 10mmHg
no hx or arrhythmia
no strenuous exercise
EKG changes in athlete’s heart?
- sinus bradycardia
- first-degree atrioventricular block/PR interval prolongation
- Wenckeback 2AV block
- early repolarization, ST elevation
- primary T wave inversion
- complete RBBB or LBBB
In Athlete’s heart, an echocardiogram can show?
- Heart diamete increased by 5-10% max
- increased LV posterior wall and septum thickness.
- heart volume index/mass index 25% above normal values.
What is restrictive cardiomyopathy?
Heart disease in which the heart chambers are unable to properly fill with blood due to heart stiffness.
What is Arrhythmogenic right ventricular cardiomyopathy?
rare disorder characterize by replacement of the right ventricular free wall with fiber and fat