Cardiomyopathy Flashcards
What is cardiomyopathy?
Primary disease of the myocardium.
What are the 4 different types of cardiomyopathy?
Dilated
Hypertrophic
Restrictive
Arrhythmogenic Right Ventricular (ARVC)
Describe the aetiology of cardiomyopathy
Majority are IDIOPATHIC
Describe the epidemiology of cardiomyopathy
Prevalence of dilated + hypertrophic cardiomyopathy is 0.05-0.20%
Restrictive is even rarer
List 4 features of dilated cardiomyopathy
Sx of HF: fatigue, dyspnoea
Arrhythmias
Thromboembolism
FH of sudden death
List 10 causes of dilated cardiomyopathy
Post-viral myocarditis Alcohol Drugs (e.g. doxorubicin, cocaine) Familial Thyrotoxicosis Haemochromatosis Peripartum or postpartum HTN AI Congenital (x linked)
What causes hypertrophic cardiomyopathy?
Up to 50% are genetic: autosomal dominant
List 6 causes of restrictive cardiomyopathy
Amyloidosis Sarcoidosis Haemochromatosis Scleroderma Loffler’s eosinophilic endocarditis Endomyocardial fibrosis
List 5 features of restrictive cardiomyopathy
Dyspnoea Fatigue Arrhythmias Ankle or abdominal swelling FH of sudden death
What are the signs and symptoms of restrictive cardiomyopathy similar to?
Constrictive pericarditis
List 12 signs of dilated cardiomyopathy
Raised JVP Displaced apex beat Functional mitral + tricuspid regurgitations 3rd heart sound Tachycardia AF Hypotension Pleural effusion Oedema Jaundice Hepatomegaly Ascites
List 4 signs of hypertrophic cardiomyopathy
Jerky carotid pulse
Double apex beat
Ejection systolic murmur
Systolic thrill at lower left sternal edge
List 7 signs of restrictive cardiomyopathy
Raised JVP Kussmaul Sign: paradoxical rise in JVP on inspiration due to restricted filling of the ventricles Palpable apex beat 3rd heart sound Ascites Ankle oedema Hepatomegaly
What 3 common ECG features are seen in all types of cardiomyopathy?
Non-specific ST changes
Conduction defects
Arrhythmias
What may be seen on CXR in cardiomyopathy?
Cardiomegaly
Signs of heart failure: pulmonary oedema
What is seen in the ECG of restrictive cardiomyopathy?
Low voltage complexes
Which investigation is diagnostic and can differentiate between types of cardiomyopathy?
Echocardiography
What is seen on echocardiography in dilated cardiomyopathy?
Dilated ventricles with global hypokinesia + low ejection fraction
MR, TR, LV thrombus
What is seen on echocardiography in hypertrophic cardiomyopathy?
Ventricular hypertrophy (asymmetrical septal hypertrophy)
What is seen on echocardiography in restrictive cardiomyopathy?
Non-dilated non-hypertrophied ventricles
Atrial enlargement
Preserved systolic function
Diastolic dysfunction
Granular/ sparkling appearance of myocardium in amyloidosis
List 3 other investigations that may be performed in patients with cardiomyopathy
Cardiac Catheterisation: help exclude coronary disease
Endomyocardial Biopsy
Pedigree or Genetic Analysis
What is dilated cardiomyopathy?
Dilated, flabby heart of unknown cause.
Thickening of inner layer of heart chambers, heart muscles stretch + weaken
Impairment of contractility (systolic function)
What is hypertrophic cardiomyopathy?
thickening of the cardiac muscle (intraventricular septum)
Impairment of compliance (diastolic function)
What is restrictive cardiomyopathy?
Cardiac cells replaced with abnormal tissue e.g. scar tissue, causing muscle walls of ventricles to become stiff so relaxation (filling) phase is abnormal.
Impairment of compliance (diastolic function)
