Cardiomyopathy

Question 1

Which heart chambers are involved in dilated cardiomyopathy? What does it result in? What are some complications?

Answer 1

All four chambers. Results in systolic dysfunction, leading to biventricular CHF. Complications include mitral and tricuspid valve regurgitation and arrhythmia.

Question 2

What are the causes of dilated cardiomyopathy? How is it treated?

Answer 2

Treatment is heart transplant
1. Autosomal dominant Genetic mutation 2. Myocarditis usually due to coxsackie A or B 3. Alcohol abuse 4. Doxorubicin 5. Pregnancy 6. Hemochromatosis

Question 3

What does myocarditis lead to in dilated cardiomyopathy?

Answer 3

Characterized by a lymphocytic infiltrate in the myocardium. Results in chest pain, arrythmia with sudden death or heart failure. Dilated cardiomyopathy is a late complication.

Question 4

When does dilated cardiomyopathy occur in pregnancy/

Answer 4

Seen during late pregnancy of weeks to months after child birth

Question 5

What is hypertrophic cardiomyopathy? What usually cause it? What is seen on biopsy?

Answer 5

Massive hypertrophy of the left ventricle. Usually due to genetic mutations in sarcomere proteins. Most common form is autosomal dominant. Biopsy shows myofiber hypertrophy with disarray

Question 6

What are the clinical features of hypertrophic cardiomyopathy?

Answer 6

1. Decreased cardiac output
2. Sudden death due to ventricular arrythmias, most common cause of sudden death in young athletes
3. Syncope with exercise - Subaortic hypertrophy of the ventricular septum results in functional aortic stenosis

Question 7

What are the clinical features of hypertrophic cardiomyopathy?

Answer 7

1. Decreased cardiac output
2. Sudden death due to ventricular arrythmias, most common cause of sudden death in young athletes
3. Syncope with exercise - Subaortic hypertrophy of the ventricular septum results in functional aortic stenosis

Question 8

What is restrictive cardiomyopathy? What causes it?

Answer 8

Decreased compliance of the ventricular endomyocardium that restricts filling during diastole. Causes include amyloidosis, sarcoidosis, endocardial fibroelastosis, Loeffler syndrome

Question 9

What is Loeffler syndrome?

Answer 9

Endomyocardial fibrosis with an eosinophilic infiltrate and eosinophilia

Question 10

A patient presents with symptoms of congestive heart failure. You do an eKG which shows low-voltage and diminised QRS amplitude. What is this indicative of?

Answer 10

Restrictive Cardiomyopathy