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Cardiovascular > Cardiomyopathy > Flashcards

Cardiomyopathy Flashcards

1
Q

What is dilated cardiomyopathy?

A

The most common cardiomyopathy, in which heart muscle becomes thin and stretched out

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2
Q

What are the causes of dilated cardiomyopathy?

A

Idiopathic

Genetic

  • Duchenne Muscular Dystrophy
  • Haemochromatosis

Infection

  • Chagas disease

Alcohol

Drugs

Wet Beriberi/B1 deficiency

Peripartum cardiomyopathy

Secondary

  • HTN
  • Valve disease
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3
Q

How does dilated cardiomyopathy present?

A

Fatigue

Dyspnoea

Cough

Weight gain

Auscultation

  • Pansystolic murmur
  • S3
  • Gallop

Arrythmia/palpitations

Progress to HF

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4
Q

What investigations are used in dilated cardiomyopathy diagnosis?

A

CXR

  • Dilated heart

ECHO

  • Dilated left ventricle
  • No regional wall motion abnormalities
  • Decreased left ventricular ejection fraction

Biopsy

  • Visably stretched fibres

ECG

  • LBBB

>BNP

FBC

  • Polycythaemia
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5
Q

How is dilated cardiomyopathy managed?

A

Reduce strain on heart

  • Diuretic
  • ACEI

Increase contractility

  • Digoxin

Anticoagulation

  • Warfarin

Left Ventricular Assist Device (LVAD)/mechanical pump

Heart transplant

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6
Q

What is restrictive/infiltrative cardiomyopathy?

A

Condition in which the heart muscle becomes restricted, meaning stiffened and less compliant

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7
Q

What are the causes of restrictive cardiomyopathy?

A

Amyloidosis

Sarcoidosis

Haemochromatosis

Genetics

Fibrosis

Diabetes

Radiation

Loffler Syndrome/eosinophils accumulationin

Fabry’s Disease

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8
Q

What is Fabry’s disease?

A

Rare genetic disease in which there is a deficiency of the enzyme alpha-galactosidase A (a-Gal A) that causes a build up of a type of fat called globotriaosylceramide (Gb3, or GL-3) in the body

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9
Q

How does restrictive cardiomyopathy present?

A

Dyspnoea

Cough

Angina

Progresses to HF

Auscultation

  • Audible S3/4

Hepatomegaly

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10
Q

What investigations are used for restrictive cardiomyopathy diagnosis?

A

ECG

  • Small QRS

Biopsy

  • Visible sarcoid/amyloidosis

MRI

ECHO

  • Fibrosis

CXR

>Fe

  • Haemochromatosis
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11
Q

What is the management for restrictive cardiomyopathy?

A

Treat underlying cause

  • Removing excess iron

Reduce strain on heart

  • B Blockers
  • ACEI
  • Diuretics

Anti-coagulation/thrombus prophylaxis

  • Warfarin

Implantable Cardioverter Defibrillator (ICD)

Heart transplant

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12
Q

What is hypertrophic/obstructive cardiomyopathy?

A

Autosomal dominant genetic mutation in proteins that code for sacromeres, causing hypertrophy and left ventricular outflow obstruction, known as the most common genetic heart condition and common cause of sudden death in young athletes

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13
Q

How does obstructive cardiomyopathy present?

A

Can be asymptomatic

Dyspnoea, angina, dizziness,

Syncope

Palpitations, arrythmias

Auscultation

  • Pansystolic murmur, mitral regurgitation
  • S4, ventricular hypertrophy

Notched pulse/pulse bisferins

Jerky pulse

Displeaced apex beat, hypertrophy

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14
Q

What investigations are used in obstructive cardiomyopathy diagnosis?

A

ECG

  • LV hypertrophy

CXR

  • Cardiomegaly

CMR

  • Asymmetric septal hypertrophy and systolic anterior movement (SAM) of the anterior leaflet of mitral valve

ECHO

Genetic Analysis

MRI

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15
Q

What are the complications of obstructive cardiomyopathy?

A

Mitral regurgitation

Pulmonary oedema

Arrythmias

Ischaemia

Sudden death

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16
Q

What is the management of obstructive cardiomyopathy?

A

ABCD

Amiodarone

B Blockers

Implantable cardioverter defibrillator, reduces risk of sudden cardiac death

Dual chamber pacemaker

17
Q

What drugs should be avoided in obstructive cardiomyopathy?

A

Nitrates

Digoxin/+ Ionotropes

ACEI

18
Q

What is Takotsubo cardiomyopathy?

A

Cardiomyopathy induced by severe stressful triggers and emotional upset, also known as broken heart syndrome

19
Q

What causes cardiac tamponade

A

Malignancy

Pericarditis

Severe thoracic trauma

20
Q

Give features of cardiac tamponade

A

Beck’s triad

  • Hypotension
  • Raised JVP
  • Muffled heart sounds

Chest pain

Dyspnoea

Pulsus paradoxus

Distended neck veins

Electrical alternans and small QRS complexes on ecg

21
Q

How is cardiac tamponade managed?

A

Emergency thoracotomy

Pericardiocentesis, can be considered if surgery delay

22
Q

Give features of brugada syndrome

A

Sodium channelopathies

Palpitations

Syncope

Coved ST elevation and negative t waves

23
Q

How is brugada syndrome managed?

A

Implantable cardiac defibrillator

Cardiovascular (12 decks)

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