Cardiomyopathy

Question 1

Cardiomyopathy

Answer 1

Three ways it can occur: power failure(extensively dilated heart muscles-> dilated cardiomyopathy), small pump(muscle walls become thick and scared, can’t expand and relax -> restrictive myopathy), blockage(bigger and thicker septum, blocking blood flow-> hypertrophic cardiomyopathy)

Question 2

Signs and symptoms

Answer 2

Heart failure(right side heart failure: shortness of breath, peripheral edema, left side, heart failure: angina(heart muscles are not getting oxygen), weakness, and fatigue, pulmonary edema(rails, and crackles lung sounds)

Question 3

Dilated cardiomyopathy

Answer 3

Symptoms: jugular vein distention, S3. Heart sounds, increase heart size.

Question 4

Restrictive cardiomyopathy

Answer 4

Symptoms: jugular vein distention, S4 heart sound

Question 5

Hypertrophic cardiomyopathy

Answer 5

Symptoms: S 4 heart sound, systolic ejection murmur(increases with the valsalva maneuver(murmur occurs during systolic phase due to turbulent blood flow,valsalva maneuver: bearing down while having a bowel movement))

Question 6

Dilated cardiomyopathy, pathophysiology and diagnosis

Answer 6

Dysfunctional heart ability to contract(systolic failure) -> ejection fraction goes down-> chambers dilate, causes(genetics, myocarditis, alcoholism), diagnosis(history and physical, labs(BNP increases due to stretching of cardiac muscle), EKG, chest x-ray(shows cardiomegaly), echocardiogram(shows dilated chamber and ejection fraction), angiogram, biopsy

Question 7

Hypertrophic, cardiomyopathy, pathophysiology and diagnosis

Answer 7

When heart muscles have decreased contractility, the heart muscle cells get bigger, the septum gets asymmetrically bigger compared to the outer walls, chambers become smaller, reduced filling-> reduced ejection, diastolic heart failure. Diagnosis.(history and physical.), symptoms: (sudden death, dyspnea, syncope, systolic ejection murmur that increases with valsalva maneuver), chest, x-ray, ECG, echocardiogram(can show enlargement of septum), genetic testing, cardiac muscle, biopsy(cells would be seen aligned abnormally(multi directional instead of unidirectional)

Question 8

Restrictive cardiomyopathy, pathophysiology, and diagnosis

Answer 8

Causes(fibrous(scarring) due to radiation or idiopathic, infiltration(Amyloidosis - deposit of proteins in muscle,Sarcoidosis - deposits of granulomas in muscle,Hemachromatosis (deposit of iron in heart, muscles, metabolic deposits in heart -> IEM) , heart muscles are stiff and can’t expand/dilate to fill blood-> low ejection fraction, diastolic heart failure.
Diagnosis: history and physical, shortness of breath, peripheral edema, chest, x-ray (pulmonary congestion, but normal heart size), ECG(show low QRS complex), echocardiogram(shows increased ventricular thickness, bilateral atrium enlargement, normal ejection fraction), angiogram, cardiac MRI(to rule out myocarditis), biopsy.

Question 9

Cardiomyopathy treatment

Answer 9

Dilated cardiomyopathy(low salt, diet, diuretics, ACE inhibitors, beta blockers, Digoxin, pacemaker, heart transplant)
Restrictive cardiomyopathy (low salt diet, diuretics, ACE inhibitors, pacemaker, heart transplant)
Hypertrophic cardiomyopathy (beta blockers, septal reduction, heart transplant)