Cardiomyopathy Flashcards
What are the main types of cardiomyopathy?
Dilated
Restricted
Hypertrophic
What is dilated cardiomyopathy?
Impaired ventricular function due to dilated chambers
What causes dilated cardiomyopathy?
Genetic Autoimmune Toxic Inflammatory Infectious
What is the presentation of dilated cardiomyopathy?
Progressive slow onset dyspnoea Orthopnoea Fatigue Oedema Generally heart failure Displaced apex beat
What investigations are done for dilated cardiomyopathy?
FBC, U&Es B natriuretic peptide BNP ECG CXR Echo Cardiac MRI CT coronary angiogram
What is seen on CXR with dilated cardiomyopathy?
Cardiomegaly
Pulmonary oedema
What is seen on echo with dilated cardiomegaly?
Ventricular dilatation
Reduced LV ejection fraction
Whats the management of dilated cardiomyopathy?
Manage symptoms and hypertension -ACEi, BB, CCB, diuretics Surgical -pacemaker -implantable defibrillators -heart transplant
What is the prognosis for dilated cardiomyopathy?
Generally poor
What is restricted cardiomyopathy?
Reduced compliance of myocardium, causing ineffectively filled ventricle
Least common
What causes restricted cardiomyopathy?
Scleroderma Amyloidosis Sarcoidosis Fibrosis Radiation Familial
What is the presentation of restrictive cardiomyopathy?
Generally heart failure SOB, orthopnoea Fatigue Oedema Hepatomegaly
What investigations are done for restrictive cardiomyopathy?
BNP ECG CXR Echo Cardiac MRI Investigate cause- e.g. autoantibodies
What is the management of restrictive cardiomyopathy?
Manage symptoma and hypertension
-ACE, BB, diuretics
Manage cause
Heart transplant
What should not be given in restrictive cardiomyopathy?
CCBs
What i hypertrophic cardiomyopathy?
Impaired relaxation of myocytes, causing poor compliance
Thick myocardium
Leading cause of sudden cardiac death in young
What causes hypertrophic cardiomyopathy?
Genetic
What is the presentation of hypertrophic cardiomyopathy?
Often presents as sudden cardiac death Exertional dyspnoea Syncope, pre syncope Palpitations Often presents in adolescence
What investigations are done for hypertrophic cardiomyopathy?
ECG
CXR
Echo
Cardiac MRI
What is seen on echo with hypertrophic cardiomyopathy?
Hypertrophy
Thickened walls
Mitral regurgitation
What is the management of hypertrophic cardiomyopathy?
Amiodarone
BB or CCB
Cardioverter defibrillator
What is TAkotsubo cardiomyopathy?
Stress cardiomyopathy aka broken heart syndrome
Sudden and transient weakening of myocardium due to stress
What is the pathophysiology of Takotsubo?
Stress –> catecholamine (adrenaline) release –> hypertension, coronary artery spasm and myocardial stunning
What is the presentation of Takotsubo?
Chest pain +/- SOB and associated ECG changes mimicking anterior MI
Stressful precipitant
What is the management of Takotsubo?
Supportive
