cardiomyopathy Flashcards
causes of dilated cariomoyph
genetic adn family
inflamatoy , infectio autoimmune
tois - drugs, exogenous chemical , endocrine
injury, cell loss, scar replacement
alcohol
triopial diase
trhypoid pbles
neuommicl diase
what cahmber ar ofeten dilated in dilated cariomopyahy
lv, rv
what are the symptoms of dilatec cardiomyopathy
dysmpes, fatique, orthopena, pnd, alke swlling, widhgt gain, of fluid overload, cough
what is seen on examination of cariomopth
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
what test are done for dialted cariomopya
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
what is the treaetmet for dilated cariopmpoya
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
what condion effect teh progons of cariopmyothpy
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
what are the causes of inflati and restic cariomopy
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
wher are the infliatrs found in restice cariomoypy
vencile wall
what is the tests for restive and infilare cariomoyphy
Possible lbb - ecg
Brain natuic peptide
Blood – fbc, u and e
Echo
Cmri
Biopsy
what is teh treamte for restic and infliatre cardiopmophy
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
what gene is defective in hpertrophic cardomyopahty
sarcomeer gene defect
what size is hypertophci carkiopay
greateh than 14mm or 12 mm if primary realice
wher can hypertophc cariopmy occu
apical , septal or gernal
is hyeprtorphic cariomypy resticive or obstucive
restictive
what are the symptomsof hypertopchi caroipahty
Fatiuqe, dysponea, angia like chest pain
Exertion presyocpe,
Raised jvp
Syncope
what are the exam finds for hypertphic cariopathy
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
what is the test for hypertopic cariomyopathy
Ecg – often abdnoal
Echo
Cmri
Risk stricaot for scd
what is the treaen for hypetoic carip mopyathy
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
what are teh caues of mhocaridits
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
what happens in myocarid
inflaion of inlat cell in myhocail layer, reduction the fucionand can cuase codntuoin sysme to block leading to arrhymias
symtoms of cario myocaritis
Heart failure with faites, sobj, cp
Short cous
Fever
assesment of myocarits
ECG Abnoral
Biomarks often elevated
Echo
Cmri for odema
Biopsy
Viral dna pcr
Uto antipis
Strop antiboes
Lyme b burgoifes
hive
treamet of myocaritis
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
