Cardiomyopathy

Question 1

Macroscopic pathology of dilated cardiomyopathy (5)

Answer 1

• Global enlargement (>500g)
• Dilated chambers
• Thin walls
• Mural thrombi
• Replacement thrombosis (numerous focal fibrotic scars replacing myocardial cells)

Question 2

Microscopic pathology of dilated cardiomyopathy

Answer 2

Normal!

Question 3

Causes of dilated cardiomyopathy (8)

Answer 3

• Alcohol
• Chemotherapy (e.g. doxorubin)
• Idiopathic
• Congenital
• Takotsubo cardiomyopathy
• Infection (viral myocarditis, Chagas disease)
• Peri-partum
• Neuromuscular disease

Question 4

Macroscopic pathology of restrictive cardiomyopathy

Answer 4

• Thick, fibrotic walls
• Normal size ventricles

Question 5

Microscopic pathology of restrictive cardiomyopathy

Answer 5

Reveals aetiology

• Amyloid on Congo red stain
• Sarcoid granulomas
• Haemochromatosis (iron blue stains)

Question 6

Causes of restrictive cardiomyopathy (2)

Answer 6

• Deposits
• Chemotherapy in children

Question 7

Macroscopic pathology of hypertrophic cardiomyopathy (HCM)

Answer 7

Ventricular hypertrophy mostly affecting septum leading to ‘banana shaped’ left ventricle and subaortic stenosis of the left ventricle

Question 8

Microscopic pathology of hypertrophic cardiomyopathy (HCM)

Answer 8

• Irregular disordered myofibres
• Fibrosis between fibres

Question 9

Complications of cardiomyopathy (3)

Answer 9

1. Heart failure
2. Arrythmias
3. Sudden cardiac death