Cardiomyopathy Flashcards
1
Q
Patho
A
- Group of diseases that directly affect myocardial structures or function → malfunction of heart
2
Q
Primary Patho
A
only involves heart muscle and is idiopathic
3
Q
Secondary Patho
A
known cause and is secondary to another disease process
4
Q
Dilated Cardiomyopathy
A
- Most common type
- Ventricles become dilated; walls become thin
- Chamber size and volume are increased
- Thin muscle can’t pump blood effectively
5
Q
Causes
A
- Often follows infectious myocarditis
- Cardiotoxic agents: alcohol, cocaine, chemo agents
- CAD, pregnancy, HTN, valve disease
6
Q
Manifestations
A
- S&S of HF
- Fatigue
- SOB, dyspnea, orthopnea, dry cough
- Abdominal bloating
- Anorexia
- Dysrhythmias; heart murmur
- Edema
- Hepatomegaly
- JVD
7
Q
Diagnostic Studies
A
- Patient history and exclusion of other causes of HF
- Echo
- Labs: elevated BNP in presence of HF
Beta natriuretic peptide: HF/fluid overload - Heart catheterization: determine ejection fraction
Normal: 55-65%
Cardiomyopathy: ~20%
8
Q
Interprofessional Care
A
- Control HF
- Enhance contractility; decrease preload and afterload
- Reduced activity during decompensation
- Cardiac rehab program to increase exercise tolerance
- Sodium restriction
- Small frequent meals during liver congestion
- Increase nutrition
- Increase protein intake
- Vitamins; no alcohol
9
Q
Medications
A
- Nitrates & diuretics: vasodilate; decrease preload
- ACE inhibitors: decrease afterload
- Beta blockers & aldosterone antagonists: control neuro-hormonal stimulation (help heart beat better)
- Antidysrhythmics
- Anticoagulants: risk for blood clots with stagnant blood in heart
- Dobutamine & milrinone: continuous IV to increase cardiac contractility
10
Q
Surgical Therapy
A
- VADs: does work of ventricle for heart
- Implantable defibrillators
- Cardiac transplant: 50% of transplants are to treat dilated cardiomyopathy
11
Q
Hypertrophic Cardiomyopathy
A
- Massive ventricular hypertrophy
- Rapid forceful contraction of L ventricle
- Impaired relaxation → doesn’t allow blood to flow into ventricle → noncompliant
- Obstruction to aortic outflow (not always present)
- Thickened septum and ventricular wall
12
Q
Causes
A
- Familial (genetics)
- Idiopathic
- Autosomal dominant trait causing encoding of cardiac sarcomere
- Disease that causes sudden cardiac death in young athletes
13
Q
Contributing Factors
A
- Increased contractility: exercise, + inotropes
- Increased HR: exercise, fever, increased CO
- Decreased preload: hypovolemia, sepsis, fluid shifts
- Loss of atrial kick: a fib, ventricular arrhythmias
**Arrhythmias can occur and cause sudden death
14
Q
Manifestations
A
- Sudden death may be first sign
- Exertional dyspnea
- Fatigue
- Angina
- Syncope
15
Q
Diagnostic Studies
A
- Echo
- Apical pulse exaggerated and displaced to left on palpation
- S4, systolic murmur
