Cardiomyopathy Flashcards
What are the types of Cardiomyopathies?
Dilated Cardiomyopathy
Hypertrophic Cardiomyopathy
Restrictive
What is Dilated Cardiomyopathy?
Dilation and weakening of the Left ventricle (contractile dysfunction)
Most common
What is Hypertrophic Cardiomyopathy?
Hypertrophy left ventricular dysfunction and arrhythmias (bad systole)
familial
What is Restrictive Cardiomyopathy?
Excessive myocardial stiffening with resultant ventricular dysfunction (bad diastolic filling)
What are the etiologies of Dilated Cardiomyopathies?
Idiopathic Ischemic (CAD) Hypertensive Alcoholic Infectious- Chagas Metabolic`
What is normal ejection fraction?
65%
How does the heart compensate for a pathologic low ejection fraction?
Increases Heart Rate
What are the symptoms of LV Failure?
Fatigue, weakness Dyspnia -exertional -orthopnea (cant lie flat) -PND Pallor (poor perfusion), tachycardia
What are the signs of LV Failure?
Pale dyspnic Vital signs vary, Tachy Cardiac apex displaced left and down Apical lift or thrill often present S1-2 normal. P2 varies S3 always present Murmurs (many possible)
What is the most common cause of RV failure?
Right ventricular failure!
What are the symptoms of RV Failure?
Similar to LVF dyspnia improves as LV fails
What are the signs of RV Failure?
JV pulses elevates Cardiomegaly, RV lift P2 varies RV and LV S3 are universal various murmurs pulsus alternans hepato/splenomegaly ascites peripheral edema evidence of poor nutrition (protein calorie malnutrition)
What is the therapy of Dialated Cardiomyopathy?
.
What is Alcoholic (dilated) cardiomyopathy?
major, Non-ischemic cardiomyopathy Direct alcohol myotoxicity
Cardiodepression even without toxicity
A-Fib very common
Same physical findings as other dilated cardiomyopathies
Labs similar
ECGs often show arrhythmia
What is the treatment of Alcoholic Cardiomyopathy?
Treat the same as other dilated cardiomyopathy
MUST STOP DRINKING!!!
Thiamine Supp
What are the types of Hypertrophic Cardiomyopathy?
IHSS:
HOCM:hypertrophic, obstructive
HCM: obstructive or non obs.
Aymmetric septal Hypertrophy
What are the findings of hypertrohic Cardiomyopathy?
Macroscopic: Increased Myo Mass Asymmetric Septal Hyp Concentric Hyp Apical Hyp (rare) Microscopic: Myofibrillary Dysarray-Whorls of Deformed myocyttes Fibrosis Abn. intramural Coronaries
What are the Signs and Symptoms of Hyp Cardiomyopathy?
Symptoms: Young Sudden death dyspnia angina pectoris fatigue, syncope Signs: Displaced bifid LV impulse bisfiriens carotid pulse S4 common systolic murmur
ECG findings For HCM
.
How is HCM diagnosed?
Echocardiogram
What anatomical changes are seen in HCM?
LV Hypertrophy -symmetric -asymmetric septal hypertrophy -systolic antrior motion of MV LV normal in size and normal contractility
What is seen in Restrictive Cardiomyopathy?
Rare in western countries DIASTOLIC Dysfunction Caused by: amyloidosis hemochromatosis sarcoidosis Loeffler's fibrosis
