Cardiomyopathy Flashcards
what does cardiomyopathy mean?
disease of the heart muscle
heart failure that occurs when the heart muscle is weak
systolic failure
heart failure that occurs when the heart muscle is stiff and unable to relax normally
diastolic failure
systolic dysfunction includes which type of cardiomyopathy?
dilated cardiomyopathy
diastolic dysfunction includes which 2 types of cardiomyopathy?
hypertrophic CM
restrictive CM
what is the most common cause of heart failure?
DCM
what is the primary indication for cardiac transplant?
idiopathic DCM
dilation and impaired systolic function of one or both ventricles
dilated cardiomyopathy
what 2 valvular diseases occurs as a result of DCM?
mitral regurg
tricuspid regurg
what is the most common cause of DCM?
idiopathic
what are 2 other causes of DCM?
viral myocarditis
alcohol toxicity
most cases of DCM present as what?
left-sided heart failure
a patient presents with fatigue, DOE, lightheadedness, murmurs, cool/clammy skin, and JVD. what are they likely experiencing?
DCM
what is the main diagnostic modality for DCM?
echocardiogram
what would an echo of DCM show? (4)
four chamber enlargement
hypokinesis
LVEF less than 40%
MR / TR
what diagnostic would help to determine co-existent coronary artery disease in a patient with suspected DCM?
cardiac catheterization
what are 3 treatments for DCM?
diuretics
ACE/ARB
Beta blockers
what medication can be given in advanced disease of DCM?
spironolactone
what can be considered after 1 week of no clinical improvement with treatment of DCM?
consider biopsy
what kind of procedure is indicated in severe heart failure of DCM that has not responded to treatment?
transplant
unexplained ventricular hypertrophy - not due to systemic HTN
hypertrophic cardiomyopathy
what is the most common HCM?
septal hypertrophy
what is the #1 cause of cardiac death in athletes?
HCM
what wall thickness is present in HCM?
over 15 mm
a patient presents with double pulsation of carotid, arrhythmias/palpitations, SOB on exertion, fatigue, and angina. what are they likely experiencing?
HCM
on exam, you note a localized PMI, murmur after S1 at the LLSB that increases with valsalva/standing and decreases with squatting/sitting/handgrips. what is the diagnosis?
HCM
what screening diagnostic is used for HCM in young athletes?
2D echo
what 2 diagnostics should ALL patients received if we suspect they have HCM?
echo
ECG
if a patient has evidence of HCM in echo/ecg, what should be done next?
exercise stress test (ambulatory ecg)
in a patient with HCM, what would an ECG show? (2)
LVH
LAD
a patient with suspected HCM is experiencing palpitations/lightheadedness. what diagnostic should we use?
24 hr event monitor
what is the 1st line medication for HCM?
beta blockers
what is the 2nd line medication for HCM?
disopyramide
what is an alternative to beta blockers as the first line med for HCM?
CCB (verapamil)
what surgical treatment is used in HCM cases with LV outflow gradient that is unresponsive to medical therapy?
septal myectomy
restricted ventricular filling in a non-dilated, non-hypertrophied ventricle usually due to stiffening, fibrosis, or decreased compliance.
restricted cardiomyopathy
what is the most common cause of RCM?
amyloidosis
what is the most common storage disease of RCM?
hemochromatosis
a patient presents with arrhythmias, elevated JVP, S3, mitral/tricuspid valve regurg. what are they likely experiencing?
RCM
what will an ECG of RCM show? (3)
low voltage
heart blocks
afib
what will a CXR of RCM show?
pulmonary venous congestion
what will an echo of RCM show?
starry night or speckled pattern due to infiltrates
what is an essential test in patients with RCM due to infiltrative disease?
endomyocardial biopsy
What diagnostic should be used to differentiate between RCM and constrictive pericarditis?
cardiac MRI
what is the 2nd infiltrative disease that causes RCM, besides amyloidosis?
sarcoidosis
what is the general treatment goal for RCM?
treat heart failure
what are medications used to treat RCM? (3)
diuretics
BBs/CCBs
anticoagulants
what is used as a treatment for RCM with advanced AV block?
dual chamber pacemaker