Cardiomyopathy Flashcards
What i hypertrophic obstructive cardiomyopathy?
Autosomal dominant disorder of muscle tissue caused by defects in the genes encoding contractile proteins. The most common defects involve a mutation in the gene encoding β-myosin heavy chain protein or myosin binding protein C.
LV outflow tract obstruction from asymmetric septal hypertrophy.
Leading cause of sudden cardiac death in young
What are symptoms and signs of HOCM?
Sudden death may be first manifestation - often asymptomatic, most commonly due to ventricular arrhythmias
Dyspnoea Angina Syncope Palpitation CCF
Jerky pulse, a wave in JVP, double apex beat
Ejection systolic murmur - increases with Valsalva manoeuvre, decreases on squatting
Systolic thrill
What tests for HOCM?
ECG: LVH, progressive T wave inversion, deep Q, AF, WPW
Echo: MR SAM ASH
Mitral regurgitation
Systolic anterior motion of anterior mitral valve leaflet
Asymmetric septal hypertrophy
What are the ECG signs for HOCM?
LVH, progressive T wave inversion, deep Q waves, AF - best P waves, irregular QRS, WPW - delta wave, prolonged PR
What are poor prognostic facts fro HOCM?
<14 years
Syncope at presentation
FHX of HOCM/sudden death
How is HOCM managed?
Amiodarone for arrhythmias AF/VT Beta blockers or verapamil for symptoms (reducing ventricular contractility) Cardioverter defibrilator Dual chamber pacemaker Endocarditis prophylaxis
Avoid: nitrates, ACEi, inotropes
What is acute myocarditis? How is it caused?
Inflammation of the myocardium often associated with pericarditis
Idiopathic Viral Bacterial Toxins Immunological Drugs
What is Takutsubo cardiomyopathy?
‘Stress’-induced cardiomyopathy e.g. patient just found out family member dies then develops chest pain and features of heart failure
Transient, apical ballooning of the myocardium
Treatment is supportive
What is permpartum cardiomyopathy?
Typical develops between last month of pregnancy and 5 months post-partum
More common in older women, greater parity and multiple gestations
What is dilated cardiomyopathy?
Dilated flabby heart of unknown cause
Classic causes include
alcohol
Coxsackie B virus
What is the presentation of dilated cardiomyopathy?
Fatigue dyspnoea pulmonary oedema RVF emboli AF VT
Signs: Raised pulse hypotenion Raised JVP displaced and diffuse apex Gallop rhythm Mitral regurgitation Pleural effusion
BNP raised
What are causes of restrictive cardiomyopathy
IDiopathic
Amyloidosis
Haemochromatosis
