Cardiomyopathy Flashcards

1
Q

What is cardiomyopathy?

A

Primary disease of the myocardium.

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2
Q

What are the 4 different types of cardiomyopathy?

A

Dilated
Hypertrophic
Restrictive
Arrhythmogenic Right Ventricular (ARVC)

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3
Q

Describe the aetiology of cardiomyopathy

A

Majority are IDIOPATHIC

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4
Q

Describe the epidemiology of cardiomyopathy

A

Prevalence of dilated + hypertrophic cardiomyopathy is 0.05-0.20%
Restrictive is even rarer

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5
Q

List 4 features of dilated cardiomyopathy

A

Sx of HF: fatigue, dyspnoea
Arrhythmias
Thromboembolism
FH of sudden death

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6
Q

List 10 causes of dilated cardiomyopathy

A
Post-viral myocarditis  
Alcohol 
Drugs (e.g. doxorubicin, cocaine) 
Familial 
Thyrotoxicosis  
Haemochromatosis 
Peripartum or postpartum  
HTN  
AI
Congenital (x linked)
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7
Q

What causes hypertrophic cardiomyopathy?

A

Up to 50% are genetic: autosomal dominant

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8
Q

List 6 causes of restrictive cardiomyopathy

A
Amyloidosis  
Sarcoidosis  
Haemochromatosis  
Scleroderma  
Loffler’s eosinophilic endocarditis 
Endomyocardial fibrosis
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9
Q

List 5 features of restrictive cardiomyopathy

A
Dyspnoea 
Fatigue  
Arrhythmias  
Ankle or abdominal swelling  
FH of sudden death
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10
Q

What are the signs and symptoms of restrictive cardiomyopathy similar to?

A

Constrictive pericarditis

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11
Q

List 12 signs of dilated cardiomyopathy

A
Raised JVP  
Displaced apex beat  
Functional mitral + tricuspid regurgitations  
3rd heart sound  
Tachycardia 
AF
Hypotension  
Pleural effusion 
Oedema 
Jaundice 
Hepatomegaly 
Ascites
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12
Q

List 4 signs of hypertrophic cardiomyopathy

A

Jerky carotid pulse
Double apex beat
Ejection systolic murmur
Systolic thrill at lower left sternal edge

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13
Q

List 7 signs of restrictive cardiomyopathy

A
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
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14
Q

What 3 common ECG features are seen in all types of cardiomyopathy?

A

Non-specific ST changes
Conduction defects
Arrhythmias

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15
Q

What may be seen on CXR in cardiomyopathy?

A

Cardiomegaly

Signs of heart failure: pulmonary oedema

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16
Q

What is seen in the ECG of restrictive cardiomyopathy?

A

Low voltage complexes

17
Q

Which investigation is diagnostic and can differentiate between types of cardiomyopathy?

A

Echocardiography

18
Q

What is seen on echocardiography in dilated cardiomyopathy?

A

Dilated ventricles with global hypokinesia + low ejection fraction
MR, TR, LV thrombus

19
Q

What is seen on echocardiography in hypertrophic cardiomyopathy?

A

Ventricular hypertrophy (asymmetrical septal hypertrophy)

20
Q

What is seen on echocardiography in restrictive cardiomyopathy?

A

Non-dilated non-hypertrophied ventricles
Atrial enlargement
Preserved systolic function
Diastolic dysfunction
Granular/ sparkling appearance of myocardium in amyloidosis

21
Q

List 3 other investigations that may be performed in patients with cardiomyopathy

A

Cardiac Catheterisation: help exclude coronary disease
Endomyocardial Biopsy
Pedigree or Genetic Analysis

22
Q

What is dilated cardiomyopathy?

A

Dilated, flabby heart of unknown cause.
Thickening of inner layer of heart chambers, heart muscles stretch + weaken
Impairment of contractility (systolic function)

23
Q

What is hypertrophic cardiomyopathy?

A

thickening of the cardiac muscle (intraventricular septum)

Impairment of compliance (diastolic function)

24
Q

What is restrictive cardiomyopathy?

A

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)

25
Q

What is arrhythmogenic cardiomyopathy?

A

progressive fatty + fibrous replacement of the ventricular myocardium
Inherited
Asymptomatic –> symp of arrhythmias during exercise