Cardiomyopathy Flashcards
Types of cardiomyopathy
Dilated, Hypertrophic, Restrictive
Causes of viral cardiomyopathy
Coxsackie virus, parvovirus B19, HHV6, adenovirus, enterovirus
Echo: dilated ventricles w/ diffuse hypokinesis
Major abnormalities in dilated, hypertrophic, and restrictive cardiomyopathy
Dilated: impaired contractility
Hypertrophic: impaired relaxation
Restrictive: impaired elasticity
Dilated cardiomyopathy etiology
Most cases are idiopathic
ABCD: alcohol, beriberi, Coxsackie, cocaine, doxorubicine, pregnancy
Most common causes of secondary: ischemia and long-standing HTN
Alcohol, drugs (doxo, AZT, cocaine), beriberi
Coxsackie, HIV, Chagas, parasites
Thyroid dysfxn, acromegaly, pheo, postpartum status
Genetic factors
Myocarditis
Dilated cardiomyopathy on imaging
Globular heart, big circular heart
ECG: nonspecific ST-T changes, low-voltage QRS, sinus tachycardia and LBBB
What is dilated cardiomyopathy?
Dilation of the LV with decreased ejection fraction
-presents with CHF symptoms, displaced PMI, JVD, S3/S4, and mitral/tricuspid regurg
Tx for dilated cardiomyopathy
Like CHF: diuretic, beta-blocker, ACEi, statin
- avoid CCBs in heart failure
- digoxin is second line
Definition of hypertrophic cardiomyopathy
Impaired LV relaxation and filling (nonsystolic dysfunction) 2/2 thickened ventricular walls
-hypertrophy frequently involves septum which then obstructs LV outflow
HOCM
Hypertrophic obstructive cardiomyopathy
-hypertrophic cardiomyopathy that is congenital and affects the interventricular septum, leading to outflow obstruction
Causes of hypertrophic cardiomyopathy
HTN, aortic stenosis, HOCM
Hypertrophic cardiomyopathy murmur
SEM crescendo-decrescendo that increases with a DECREASED PRELOAD
-ie Valsalva manuever will increase murmur as will standing up
It decreases w/ increased preload: ie passive leg raise
Murmur does not radiate to carotids
Dx of hypertrophic cardiomyopathy
B-blockers for sx, CCB = second line
Surgical options for HOCM: dual-chamber pacing, partial excision or alcohol ablation of the septum, ICD placement, and mitral valve replacement
Definition of restrictive cardiomyopathy
Decreased elasticity of myocardium leading to impaired diastolic filling without significant systolic dysfunction
Causes of restrictive cardiomyopathy
Infiltrative disease: amyloidosis, sarcoidosis, hemochromatosis or fibrosis and scarring 2/2 radiation
Which cardiomyopathy has a decreased EF?
Dilated cardiomyopathy
