cardiomyopathy Flashcards
what is inheritance pattern of HOCM? how common?
autosomal dominant, 1 per 500
four classes of cardiomyopathies?
hypertrophic
restrictive
dilated
ARVD
diagnose HOCM?
ECG changes suggestive of LVH eg:
- large QRS complexes (V1 + V6 r waves > 35mm)
- ST depression
- Deep T inversion
- non-specific changes
Echocardiography
- unexplained left ventricular wall thickening in absence of dilation
symptoms/complications of HCM?
obstrcutive HCM - syncope
VT/VF as HCM muscle more prone to arrhythmias - can lead to death more than obstruction
medical management of HCM?
anti-HTN beta blockers CCB amiodarone caution with diuretics
indications for surgical management of HCM?
marked LVOT gradient >50 mmhg severe exertional dyspnoea chest pain syncope refractory
what other management of HCM?
RV apical pacing
ICD
surgical septal myomectomy +/ mitral valve replacement
septal ablation with ethanol
conservative management of HCM
avoid competitive sport
CPR education
psychosocial counselling
what is DCM
progressive disease characterised by LV enlargement & normal wall thickness
- most commonly caused by ischaemic HD, but also genetic, viral, toxic, valvular, thryotoxicosis, peripartum,
how DCM diagnosed?
hx FBC TFTs cardiac biomarkers BNP ECG CXR echo MRI
Mx of DCM?
- medically, exactly same as HF
- CRT
- LVAD (LV assist device)
- restrict water & Na, moderate exercise to avoid deconditioning, counselling
what is CRT used to treat?
Cardiac resynchronization therapy is used to treat bundle branch block.
what is Restrictive cardiac myopathy?
restrictive filling (stiff) and reduced diastolic volume of either or both ventricles with normal systolic function causes: - 1o: fibrosis, endocarditis, idiopathic - 2o: amyloidosis, sarcoidosis, haemochromatosis
what is Arrhythmogenic right ventricular cardiomyopathy?
This condition causes part of the myocardium to break down over time, increasing the risk of an abnormal heartbeat (arrhythmia) and sudden death. ARVC may not cause any symptoms in its early stages.
