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PHASE 2 cardio conditions > cardiomyopathy > Flashcards

cardiomyopathy Flashcards

1
Q

what is cardiomyopathy

A

a group of disease of myocardium that affect mechanical or electrical function of heart

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2
Q

are they inherited or acquired

A

Generally, they are inherited genetic conditions but can be acquired

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3
Q

5 risk factors for cardiomyopathy

A

Family history
Hypertension
Obesity
Diabetes
Previous MI

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4
Q

4 types of cardiomyopathy

A
  1. hypertrophic
  2. dilated
  3. restrictive
  4. Arrhythmogenic
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5
Q

what happens in Hypertrophic Cardiomyopathy

A
  • Characterised by hypertrophy
  • Diastole is main issue NOT systole – hearts are stiff and don’t relax properly
  • LV becomes hypertrophied and hypertrophy is asymmetrical, blocking LV outflow tract during systoles
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6
Q

can hypertrophic cardiomyopathy be asymptomatic

A

yes

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7
Q

what is Most common cause of sudden death in young and adults

A

hypertrophic cardiomyopathy

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8
Q

cause of hypertrophic cardiomyopathy

A

Autosomal dominant mutation

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9
Q

presentation of hypertrophic cardiomyopathy

A

Angina
Dyspnoea
Palpitations
Dizzy spells
Syncope
Crescendo-decrescendo murmur – similar to aortic stenosis
S4 sound

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10
Q

3 investigations for hypertrophic cardiomyopathy

A
  1. microcopically
  2. ecg
  3. echocardogram
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11
Q

what would miscroscope of hypertrophic cardiomyopathy show

A
  • Myocyte disarray
  • Ultrastructural level, myofibrils are in disarray
  • When stained it turns blue
  • Fibrosis is an electrical insulator – electrical current has to go around the fibrosis and causes arrhythmia
  • Hypertrophy can occur in coronary arteries – causes ischaemia
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12
Q

what does ecg of hypertrhopic cardiomyopathy show

A

Usually always abnormal
Deep T wave inversion

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13
Q

5 treatment options for hypertropic cardiomyopathy

A

Amiodarone – anti-arrhythmic medication

Calcium channel blocker e.g. amlodipine, diltiazem

Beta blocker – atenolol

DIGOXIN CONTRAINDICATED

Surgery

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14
Q

what happens in dilated cardiomyopathy

A

dilatations of ventricle

  • Walls either normal or thin
  • weak contraction
  • less pumped out
  • biventricular congestive HF
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15
Q

most common type of cardiomyopathy

A

dilated

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16
Q

causes of dilated cardiomyopathy

A

Idiopathic – majority of time
Infection – coxsackie B
Ischaemia
Alcohol
Thyroid
Genetic

17
Q

presentation of dilated cardiomyopathy

A

Often present with heart failure symptoms
SOB
Arrhythmias
Increased JVP

18
Q

investigations for dilated cardiomyopathy

A

CXR – large heart
ECG
Echo

19
Q

treatment for dilated cardiomyopathy

A

HF and AF treated in normal way
Left ventricular assist device
Heart transplant

20
Q

what is Arrhythmogenic Cardiomyopathy

A

heart muscle (myocardium) is replaced by both scar (fibrosis) and fat.

can affect predominantly the right ventricle, the left ventricle, or both ventricles.

21
Q

main feature of arrhythmogenic cardiomyopathy

A

arrthymia

22
Q

4 investigations for arrhythmogenic cardiomypathy

A
  1. histology
  2. ecg
  3. echo
  4. genetic testing
23
Q

what would histology show for arrhythmogenic cardiomopathy

A

Red – normal myocardium
Blue – fibrous tissue
White – not stained

23
Q

what ecg changes are seen with arrhythmogenic cardiomyopathy

A

In leads V1, 2 and 3
Epsilon wave
T wave inversion

23
Q

treatment for arrhythmogenic cardiomyopathy

A

Beta blockers e.g. bisoprolol
Arrhythmias - amiodarone

24
Q

what happens in restrictive cardiomyopathy

A
  • ventricles stiffer and less compliant
  • 🡪 less CO 🡪 HF
  • Poor dilatation of heart restricts its ability to take on blood and pass it to the rest of body
25
Q

6 causes of restrictive cardiomyopathy

A
  1. Amyloidosis – misfolded protein (insoluble)
  2. Sarcoidosis – formation of granulomas in heart wall
  3. Idiopathic
  4. Endocardial fibroelastosis
  5. Löffler endo(myo)carditis – eosinophils in the heart
  6. Haemochromatosis – iron overload
26
Q

what is presentation of restrictive cardiomyopathy similar to

A

constructive predicarditis

27
Q

presentation of restrictive cardiomyopathy

A

Dyspnoea
Elevated JVP
Hepatomegaly
Ascites
3rd and 4th heart sounds

28
Q

investigations for restrictive cardiomyopathy

A

CXR
ECG
Echo
Cardiac catheterisation

29
Q

what would ecg for restrictive cardiomyopathy show

A

low amplitude signals

smaller QRS

30
Q

how to treat restrctive cardiomyopathy

A

treat underlying cause

heart transplant

PHASE 2 cardio conditions (20 decks)

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