cardiomyopathy

Question 1

causes of dilated cariomoyph

Answer 1

genetic adn family
inflamatoy , infectio autoimmune
tois - drugs, exogenous chemical , endocrine
injury, cell loss, scar replacement
alcohol
triopial diase
trhypoid pbles
neuommicl diase

Question 2

what cahmber ar ofeten dilated in dilated cariomopyahy

Answer 2

lv, rv

Question 3

what are the symptoms of dilatec cardiomyopathy

Answer 3

dysmpes, fatique, orthopena, pnd, alke swlling, widhgt gain, of fluid overload, cough

Question 4

what is seen on examination of cariomopth

Answer 4

poor superfical perfusoin, thrday pusle, irrgualr in af, sob at rest, narrow ulse prssue, jvp elevated +/- tr waves, displaced apex beat, s3 and s4 Mr murrrmur often , pulomary oedema, plural effsuiopn, ankle odema,scral odeam, actis, hepatomegally

Question 5

what test are done for dialted cariomopya

Answer 5

Ecg – lbbb
Cxxr – enlarged lv and rv
Brain natrium peptide
Blood e..e u and e
Echo, cmri
Coronary angiogram
Made worth by hiv, for due to mypocarial disea, or due to doxorubicin therapy
Worse due to ischemic herat disaes

Question 6

what is the treaetmet for dilated cariopmpoya

Answer 6

Correct anemia
Revmove exeracerbing durgs such as nsaids
Reduced fludis and salt
Manage weight,
Endocarien disorder
Hf nurse recare

Ace , atil bloerks, diureaic , sca, val
Beata blocks, spirnacolate,
Anticoagulation
Scd riskassensmt with icd or crt d p inmale
Cardiac transplant

Question 7

what condion effect teh progons of cariopmyothpy

Answer 7

parepatum caripmopy - generally good
idiopathy - reduced
caripathy due to ischema heart diase
caripmopy due to boxubicn therapy
caripmopy due to ifilna myocai diae
cariomoy due to hiv

Question 8

what are the causes of inflati and restic cariomopy

Answer 8

Sarcoid and amyois - infliagtive

Storage disaehaemachromatosis
Amaloyid
Fabray – low plasma alpha galactosidase a activity

Non infialtive – familiar, forms of hcm, schlodarm, diabetic pseduthom elasticum

Endomyocaril – fibrois, carinoid, radio drgu effects

Question 9

wher are the infliatrs found in restice cariomoypy

Answer 9

vencile wall

Question 10

what is the tests for restive and infilare cariomoyphy

Answer 10

Possible lbb - ecg
Brain natuic peptide
Blood – fbc, u and e
Echo
Cmri
Biopsy

Question 11

what is teh treamte for restic and infliatre cardiopmophy

Answer 11

Use limited diuretic use – as low filling pressure will cause problems
Beta blockers limited ace use
Anticoagulants as required
Scd risk assessment with icd or crt implant but limited evidence
Cardiac transplant

Question 12

what gene is defective in hpertrophic cardomyopahty

Answer 12

sarcomeer gene defect

Question 13

what size is hypertophci carkiopay

Answer 13

greateh than 14mm or 12 mm if primary realice

Question 14

wher can hypertophc cariopmy occu

Answer 14

apical , septal or gernal

Question 15

is hyeprtorphic cariomypy resticive or obstucive

Answer 15

restictive

Question 16

what are the symptomsof hypertopchi caroipahty

Answer 16

Fatiuqe, dysponea, angia like chest pain
Exertion presyocpe,
Raised jvp
Syncope

Question 17

what are the exam finds for hypertphic cariopathy

Answer 17

Notched pulse pattern,
Irregular pulse if af or ectopy,
Double imple over apex
Tghrills and murmous
Often dynsmaic
Left ventilce outflow tract nmurm incars with vslal and decrease with squtting

Question 18

what is the test for hypertopic cariomyopathy

Answer 18

Ecg – often abdnoal
Echo
Cmri
Risk stricaot for scd

Question 19

what is the treaen for hypetoic carip mopyathy

Answer 19

Icd
Avoid heary exerciee, dehydration
Explaore fh and first degree relatice
Genetic testing
Drugs to try and enhance relaxion e.g. betablocker , verapamil, disprimie
If it is af – anticoagulation
Obstructive form – surgical or alcho sepatla ablaaion

Question 20

what are teh caues of mhocaridits

Answer 20

Mostly viral –
- Adeno virus, coxsackiveur, entervirus, vytomegalovirus, parvovirus, hep c , influenza virus, hiv, herpes, epsite bar viur

Bacterial – mycroactel , chlamia pneumia, streptococlla species, mycoplasma pnumoia, treponeam pallidum

Fungal – aspergual , candia, cccidoides, cyrpotcoccus
Protozoa, trypanosoma cruzi

Parazict, lrava migrans, schisomiasis,
Hypersneity, clozapine, sulfonamides, cephospons, penicllins, tricyc antidpresenat
Auto immune ginal tcell jyocaids, chrug stap syndrome, inflator bowl disaaes, celica diase, sarcoids, systemic lpus, taka arters Wegener gramolis

Question 21

what happens in myocarid

Answer 21

inflaion of inlat cell in myhocail layer, reduction the fucionand can cuase codntuoin sysme to block leading to arrhymias

Question 22

symtoms of cario myocaritis

Answer 22

Heart failure with faites, sobj, cp
Short cous
Fever

Question 23

assesment of myocarits

Answer 23

ECG Abnoral
Biomarks often elevated
Echo
Cmri for odema
Biopsy
Viral dna pcr
Uto antipis
Strop antiboes
Lyme b burgoifes
hive

Question 24

treamet of myocaritis

Answer 24

Support of treaent with ehart failure and for brad or tachy arthies
Immunotherapy f bkiipy has specific diagnos
Stop possible durgs or toxi agent exsposure

• 30% recovery fully -2 0% morality after 1 year

Question 25

prognos for myocari

Answer 25

30% recover full
20% mortialy at 1 year
56% by 4 years

Question 26

pericaidts

Answer 26

inflaton of perialt layer with or withou micarial involemet

Question 27

causes of pericaritis

Answer 27

Idiopathic*
Infectious
Viral* (echovirus, coxsackievirus, adeno irus cytomegalovirus, hepatitis B,
infectious mononucleosis, HIV/AIDS)
Bacterial* (pneumococcus, staphylococcus, streptococcus, mycoplasma,
Lyme disease, Haemophilus influenzae, Neisseria meningitidis, and
others)
Mycobacterial* (Mycobacterium tuberculosis, Mycobacterium
avium-intracellulare)
Fungal (histoplasmosis, coccidioidomycosis)
Protozoal
Immune-inflammatory
Connective tissue disease* (systemic lupus erythematosus, rheumatoid
arthritis, scleroderma, mixed)
Arteritis (polyarteritis nodosa, temporal arteritis)
Inflammatory bowel disease
Early post-myocardial infarction
Late post-myocardial infarction (Dressler syndrome),* late post-
cardiotomy/thoracotomy*
Late post-trauma*
Drug induced* (procainamide, hydralazine, isoniazid, cyclosporine,
others)
Neoplastic disease
Primary: mesothelioma, fibrosarcoma, lipoma, others
Secondary : breast and lung carcinoma, lymphomas, Kaposi sarcoma
Radiation induced
Early post-cardiac surgery and post-orthotopic heart transplantation
Hemopericardium
Trauma
Post-myocardial infarction free wall rupture
Device and procedure related: percutaneous coronary procedures,
implantable defibrillators, pacemakers, post-arrhythmia ablation,
post-atrial septal defect closure, post-valve repair or replacement
Dissecting aortic aneurysm
Trauma
Blunt and penetrating,* post-cardiopulmonary resuscitation*
Congenital
Cysts, congenital absence
Miscellaneous
Cholesterol (“gold paint” pericarditis)
Chronic renal failure, dialysis related
Chylopericardium
Hypothyroidism and hyperthyroidism
Amyloidosis

Categories of Pericardial Disease and
Selected Specific Causes

Question 28

symptso of pericaites

Answer 28

Chest pain with plue feautes
Osteral feuates

Question 29

signs of pericarits e

Answer 29

Temp
Pericarial rub lse
Jvp – raised if effusion present
Low bp
Muffled hs
Raied jvp

High fever and very unwell sepsite no effusion may sugs bacterial

Question 30

tests for pericaridits

Answer 30

Ecg and echo 0 widespread st chages, and pr depression of pericadits
Tropoinisn

Question 31

what is the signs for pericalr effsuion

Answer 31

Overt, fatigue, sob, disszyes with low bp, possible chest pain

Question 32

what are teh test for pericais infuion

Answer 32

Drainage – test for nepolic cell, print and ldh, and exudate

Question 33

what aare the sins of pericati infuion

Answer 33

Pulsus paradoxus, jvp raised, low bp, rub, muffled hs, pulmonary odeam - rare

Question 34

what are the caues of contuion pericaties

Answer 34

Cxr
Echo
Blood –

Question 35

what is the patholyg of conticuto pericaites

Answer 35

impated filling due to thickeing of pericardium

Question 36

smpots of constucive pericarits

Answer 36

Fatiuqe, sob, cough

Question 37

sings of constiucve pericarits

Answer 37

Idopath, radion, post sugary, autoimmune, renal failue, sarcoid

Question 38

what is the assesmet of contusitve pericaritis

Answer 38

echo and righ heart catherter, must distique from restive cardiompoty

Question 39

treatment for constuuvtivqpericarits

Answer 39

dieutaic and pericaomtoy