Cardiomyopathy Flashcards
What is cardiomyopathy?
- group of disease which the myocardium becomes structurally and functionally abnormal
- in absence of CAD, valvular disease
Can young people have cardiomyopathy?
yes
Is a heart attack cardiomyopathy?
no
What is primary and secondary cardiomyopathy?
- Primary: confined to myocardium
- Secondary: part of systemic disease
What are the 3 layers of heart?
- Epicardium: outer protective layer
- Myocardium: muscular middle layer
- Endocardium: thin inner layer
What are symptoms of cardiomyopathy?
- Symptoms of HF:
- SOB on exertion
- Fainting
- Fatigue - Sudden death often 1st presentation
- FHx
What are the examination signs for cardiomyopathy?
Signs of HF:
- resp crackles
- murmurs
- S3, S4
What Ix are done for cardiomyopathy?
- No single diagnostic test for all types
- ECHO
- Can also do bloods, BNP, CXR, ECG, cardiac catheterisation, stress test
What are different types of cardiomyopathy?
- dilated
- hypertrophic
- constrictive
What is dilated cardiomyopathy?
- Ventricles enlarge and become dilated
- Walls thning and weaken so can’t contract effectively
What is law of laplace?
increased radius leads to reduced ventricular pressure
What are RF for dilated cardiomyopathy?
- Alcohol
- Post-viral
- Haemochromatosis
- Genetic
What is the presentation of dilated cardiomyopathy?
- Signs and symptoms of HF
- Displaced Apex beat
- TR/MR murmur
- S3
What Ix are done for dilated cardiomyopathy and what is found?
- Globular heart on CXR
2. Dilated ventricle on echo
What is the patho of hypertrophic cardiomyopathy?
- Muscle thickens inwards - hench
- Increased stiffness of the muscles affects pumping
- Thickened muscle disrupts electrical conduction and causes arrythmia
What is hypertrophic obstructive cardiomyopathy (HOCM)?
thickened ventricle obstructs the outflow of blood
What is classic epid in HOCM?
- 50% is familial (autosomal dominant)
- young fit athelete collapse out of everywhere
What is the cause of death in HOCM?
arrythmia
What are symptoms of HOCM?
- usually asymptomatic
- sudden cardiac death is often the 1st presentation
- Angina, dyspnoea on exertion, palpitations, syncope
What are signs of HOCM?
- Ejection systolic murmur
- Jerky carotid pulse
- Double apex beat but NOT DISPLACED
- S4
How can you see LVH on ECG?
- deep S in V1/V2
- Tall R in V5/V6
- S in V1 + R in V5 or V6 > 7 large squares
What is the patho of restrictive cardiomyopathy?
- R for rigid – ventricles become abnormally rigid and lose flexibility
- Impaired ventricular filling during diastole
- Reduced preload to reduced blood flow and backing up of blood
What are causes of restrictive cardiomyopathy?
- Sarcoidosis, amyloidosis, haemochromatosis (the infiltrative “osis’ disease)
- Familial
- Idiopathic
- Rarer than dilated or hypertrophic cardiomyopathy
What are the symptoms of restrictive cardiomyopathy?
Asymptomatic or HF symptoms
What are signs of restirctive cardiomyopathy?
- RHF signs: raised JVP, S3, ascites and oedema, hepatomegaly
- Kussmaul’s signs = paradoxical rise in JVP during inspiration
What are other cardiomyopathies?
- Arrhythmogenic right ventricular cardiomyopathy
2. Takotsubo cardiomyopathy
What is Arrhythmogenic right ventricular cardiomyopathy?
- Progressive fatty and fibrous replacement of the ventricular myocardium
- Inherited (autosomal dominant)
What is takotsubo cardiomyopathy?
- Sudden temporary weakening of heart muscle after a significant stressor
- Broken heart syndrome
