Cardiomyopathy

Question 1

Cardiomyopathy

Answer 1

Primary abnormality in the myocardium

Question 2

Dilated CM epidemiology/general

Answer 2

MC type of CM

Due to long standing volume changes

Question 3

Dilated CM characteristics

Answer 3

1. Dilated chambers–large, flabby
2. Thin walls, partially replaced with fibrosis
3. Decreased contractility: LVEF<25%
4. 2-3X normal size
5. Eventual CHF

Question 4

Dilated CM etiology

Answer 4

1. Primary: Autosomal dominant most common
2. Secondary
   Toxic: Alcohol=MCC, Anti-CA drugs (Adriamycin & Cytoxin), Cocaine, Cobalt
   Viral=Coxsackie
   Pregnancy
   Increased catelcholamines (pheochromocytoma)

Question 5

Hypertrophic CM names

Answer 5

1. Hypertrophic obstructive CM

2. IHSS: Idiopathic hypertrophic subaortic stenosis

Question 6

Hypertrophic CM gross findings

Answer 6

1. Asymmetrical thickening of septum>LV free wall
   Banana septum
2. Extensive hypertrophy of LV myocardium
3. May find: Endocardial thickening & Mural plaque formation of LV outflow tract

Question 7

Restrictive CM physiology

Answer 7

Decreased compliance, filling. Heart cannot expand adequately.
Normal LVEF.

Question 8

Restrictive CM etiology

Answer 8

1. Idiopathic

2. Infiltrate: Amyloid, Sarcoidosis, Metastasis, Radiation fibrosis

Question 9

Restrictive CM gross findings

Answer 9

1. Myocardium firm
2. Ventricles normal/slightly enlarged
3. Chambers not dilated

Question 10

Restrictive CM histologic findings

Answer 10

Patchy/Diffuse interstitial fibrosis

In between infiltrates

Question 11

Diagnosis of CM

Answer 11

1. Definitive=Endomyocardial biopsy
   Catheter thru groin (femoral) or neck (jugular), get 3-4 pieces
2. Also helpful=EKG & Echo