cardiomyopathy Flashcards
what is cardiomyopathy
a group of disease of myocardium that affect mechanical or electrical function of heart
are they inherited or acquired
Generally, they are inherited genetic conditions but can be acquired
5 risk factors for cardiomyopathy
Family history
Hypertension
Obesity
Diabetes
Previous MI
4 types of cardiomyopathy
- hypertrophic
- dilated
- restrictive
- Arrhythmogenic
what happens in Hypertrophic Cardiomyopathy
- 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
can hypertrophic cardiomyopathy be asymptomatic
yes
what is Most common cause of sudden death in young and adults
hypertrophic cardiomyopathy
cause of hypertrophic cardiomyopathy
Autosomal dominant mutation
presentation of hypertrophic cardiomyopathy
Angina
Dyspnoea
Palpitations
Dizzy spells
Syncope
Crescendo-decrescendo murmur – similar to aortic stenosis
S4 sound
3 investigations for hypertrophic cardiomyopathy
- microcopically
- ecg
- echocardogram
what would miscroscope of hypertrophic cardiomyopathy show
- 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
what does ecg of hypertrhopic cardiomyopathy show
Usually always abnormal
Deep T wave inversion
5 treatment options for hypertropic cardiomyopathy
Amiodarone – anti-arrhythmic medication
Calcium channel blocker e.g. amlodipine, diltiazem
Beta blocker – atenolol
DIGOXIN CONTRAINDICATED
Surgery
what happens in dilated cardiomyopathy
dilatations of ventricle
- Walls either normal or thin
- weak contraction
- less pumped out
- biventricular congestive HF
most common type of cardiomyopathy
dilated
causes of dilated cardiomyopathy
Idiopathic – majority of time
Infection – coxsackie B
Ischaemia
Alcohol
Thyroid
Genetic
presentation of dilated cardiomyopathy
Often present with heart failure symptoms
SOB
Arrhythmias
Increased JVP
investigations for dilated cardiomyopathy
CXR – large heart
ECG
Echo
treatment for dilated cardiomyopathy
HF and AF treated in normal way
Left ventricular assist device
Heart transplant
what is Arrhythmogenic Cardiomyopathy
heart muscle (myocardium) is replaced by both scar (fibrosis) and fat.
can affect predominantly the right ventricle, the left ventricle, or both ventricles.
main feature of arrhythmogenic cardiomyopathy
arrthymia
4 investigations for arrhythmogenic cardiomypathy
- histology
- ecg
- echo
- genetic testing
what would histology show for arrhythmogenic cardiomopathy
Red – normal myocardium
Blue – fibrous tissue
White – not stained
what ecg changes are seen with arrhythmogenic cardiomyopathy
In leads V1, 2 and 3
Epsilon wave
T wave inversion
