Cardiomyopathy Flashcards
Cardiomyopathy is an ____ disease of the myocardium that causes hemodynamic dysfunction
Intrinsic
What is the usual cause of cardiomyopathy?
Non-ischemic and NOT related to valve disease or HTN
What are the types of cardiomyopathy by cause?
- Primary intrinsic (d/t myocardial disease - genetic)
- Secondary intrinsic (d/t systemic disease or another cause)
What are the 3 main patterns of cardiomyopathy?
- Dilated
- Hypertrophic
- Restrictive
In early cardiomyopathy, all patients present with:
- DOE (increased LV/LA/PA pressure)
2. Fatigue (decreased CO)
What is the MC pattern (type) of cardiomyopathy?
Dilated cardiomyopathy (90% of cases)
What is dilated cardiomyopathy?
Enlarged LV with decreased systolic function and EF less than 50%
- Causes 25% of HF cases
- Blacks, males, 20-50 yo
What type of cardiomyopathy causes 25% of all HF cases?
Dilated cardiomyopathy
In dilated cardiomyopathy, ____ (systolic/diastolic) failure is more pronounced
Systolic
What are the causes of dilated cardiomyopathy?
- Genetic in 20-50% cases
- Idiopathic
What heart sound is present in dilated cardiomyopathy?
S3
Treatment of dilated cardiomyopathy
Standard tx for heart failure
Describe hypertrophic cardiomyopathy (HCM)
- Obstructive and non obstructive
- MC seen 20-40 yo
- Increased LV hypertrophy without underlying cause
- Main dysfunction is increased diastolic filling pressure from a stiff and small LV
What is the MC genetic cause of cardiac death in young people?
HCM
What is the main dysfunction in HCM?
Increased diastolic filling pressure from a stiff and small chambered hypertrophied LV
Pathophys of non-obstructive HCM
Increased wall thickness (hypertrophy w/o dilation) decreases wall tension, increases EF
Pathophys of obstructive HCM
Asymmetric interventricular septal hypertrophy that can obstruct outflow by narrowing LV tract and decreasing EF
What are the causes of HCM?
- Genetic 50-80% cases
- Idiopathic
- Infants of DM mothers
What is the biggest difference between the pathophys of dilated and hypertrophic cardiomyopathy?
HCM has HYPERcontractility
What heart sound is present with HCM?
Loud S4 from stiff, hypertrophic ventricle
What is found on physical exam of HCM?
- Systolic ejection murmur (decreases w/squatting, increases w/standing)
- Bisferiens carotid pulse
What is the main cause of restrictive cardiomyopathy?
Amyloidosis
What population is affected by restrictive cardiomyopathy?
Males, 40+ yo
What is the pathophys of restrictive cardiomyopathy?
- Impaired LV/RV diastolic filling
- Reasonably preserved contractility
- Decreased ventricular compliance
- R heart failure dominates over L sided heart failure
What is the difference between restrictive and constrictive cardiomyopathy?
In restrictive:
- NO pulsus paradoxus
- PA pressure is elevated
