Cardiomyopathy

Question 1

What is Cardiomyopathy?

Answer 1

Disease of Myocardial Fibers
Progressive disease
Many liver for years without knowing they have disease.

Question 2

What is Primary Cardiomyopathy?

Answer 2

Mostly idiopathic condition
Second most caused by genetic predisposition
First degree family members should be tested

Question 3

Dilated Cardiomyopathy

Answer 3

Myocardium too thin

Question 4

Hypertrophic Cardiomyopathy

Answer 4

Myocardium too thick

Especially in Septum

Question 5

Restrictive Cardiomyopathy

Answer 5

Left ventricle too thick, Right Ventricle Ok

Question 6

What is the most common Cardiomyopathy?

Answer 6

Dilated=87%
Affects middle-aged men mostly
decreases EJF
if untreated can lead to biventricular HF

Question 7

Risk factors of Dilated Cardiomyopathy

Answer 7

Idiopathic=50%
Familial=20-35%
Alcoholics
Chemotherapy

Question 8

What is specifically dangerous about Dilated Cardiomyopathy?

Answer 8

It can lead to Embolism due to blood pooling

Question 9

Clinical manifestations of Dilated Cardiomyopathy

Answer 9

Develop gradually
Orthopnea
Dizziness, Weakness, Dyspnea
Maybe Elevated BP
can be hard to distinguish between hypertrophic and dilated

Question 10

Diagnostic tests for Dilated Cardiomyopathy

Answer 10

1 is History and Physical

Echocardiogram
Cardiac Catheterization

Question 11

Treatments for Dilated Cardiomyopathy

Answer 11

Heart Transplant (only cure)-Alcoholics and obese may not qualify
LV (left ventricle) assist device
Anticoagulants
If untreated=death within 5 years

Question 12

General info on Hypertrophic cardiomyopathy

Answer 12

Sudden death is first sign
Usually diagnosed after puberty
Disease of Sarcomere
Sometimes septal hypertrophy impedes blood flow

Question 13

Risk factors of Hypertrophic Cardiomyopathy?

Answer 13

50% genetic
HTN
Idiopathic

Question 14

Clinical manifestations of Hypertrophic Cardiomyopathy

Answer 14

Most usually assume it is angina
Nitro doesn’t help-could hurt patient
DYSPNEA from backup pressure
Beta-blockers drug of choice

Question 15

Diagnostics for Hypertrophic Cardiomyopathy

Answer 15

Get as much info in History and Physical as you can
Echo is most useful
ECG=want to see how heart acts under exercion

Question 16

Treatments of Hypertrophic Cardiomyopathy

Answer 16

Want to prevent heart failure
Beta-blockers, Ca Channel Blockers, Anticoagulants, Antiarhytmics
Surgery if patient doesn’t respond well to meds

Question 17

General info of Restrictive Cardiomyopaty

Answer 17

Least Common
See in older adults
Heart isn’t filling properly

Question 18

What is the cause of Restrictive Cardiomyopathy?

Answer 18

Idiopathic/Genetic

Many won’t receive heart transplants as genetic factors will cause donor heart to become restrictive as well

Question 19

Diagnostic tests for Restrictive

Answer 19

Echo-most useful
H&P
Myocardial Biopsy

Question 20

Treatments for Restrictive cardiomyopathy

Answer 20

Lots of bed rest=avoid stress
May need Pacemaker or ICDs
Beta-blockers
Ca Channel Blockers
Anticoagulants

Question 21

Assessment of patient

Answer 21

Patients may be asymptomatic for a long time
Early signs can be respiratory
Do thorough check of Respiratory and CV systems

Question 22

Planning for patient

Answer 22

Make sure patient maintains BP and good gas exchange

Question 23

Implementation: Monitor Cardiac Output

Answer 23

Be familiar with lung sounds

Monitor BNP levels