cardiomyopathy Flashcards
types
- hypertrophic
- arrhythmogenic
- dilated
what do they affect of the heart
mechanical or electrical function of the heart
what are the secondary causes
- infiltrative
- storage related (haemochromatosis)
- drugs (alcohol)
- neuromuscular
- nutritional
- autoimmune (systemic lupus)
- cancer therapy
what are some causes of hypertrophic cardiomyopathy
- aortic stenosis
- hypertension
what is the most common cause of sudden death in young people
hypertrophic cardiomyopathy
what kind of inheritance is hypertrophic cardiomyopathy
familial autosomal dominant
what are some mutations that cause hypertrophic cardiomyopathy
- genes encoding sarcomeric proteins
- ß-myosin heavy chain MYH7
- myosin bingin protein C
- troponin T and I
- alpha myosin heavy chain
where does hypertrophic cardiomyopathy involve
interventricular septum
what can ventricular ejection cause
mitral regurgitation
what are some characteristics of a mutation in troponin T
- mild hypertrophy
- high risk of sudden death
when does hypertrophy due to myosin binding protein manifest
not until sixth decade or later
symptoms of hypertrophic cardiomyopathy
- asymptotic
- chest pain
- SOB
- syncope
- arrhythmias
- sudden death
signs of hypertrophic cardiomyopathy
- double apical pulsation
- jerky carotid pulse
- ejection systolic murmur
- pan systolic murmur
- fourth heart sound
why is there a jerky carotid pulse in hypertrophic cardiomyopathy
rapid ejection and sudden obstruction to left ventricular outflow
why is there ejection systolic murmur in hypertrophic cardiomyopathy
due to left ventricular outflow obstruction late in systole
why is there pan systolic murmur in hypertrophic cardiomyopathy
due to mitral regurgitation
what investigations are done for hypertrophic cardiomyopathy
- ECG
- echo
- CMR
- genetic analysis
what is seen in ECG of hypertrophic cardiomyopathy
- left ventricular hypertrophy
- ST and T wave changes
- abnormal Q waves
what is seen in echo of hypertrophic cardiomyopathy
- asymmetric left ventricular hypertrophy
- vigorously contracting ventricle
- patterns of hypertrophy
what is diagnostic for hypertrophic cardiomyopathy
echo
what can CMR detect in hypertrophic cardiomyopathy
- hypertrophy
- abnormal myocardial fibrosis
treatment of hypertrophic cardiomyopathy
treatment of symptoms and prevent sudden death
what are the risk factors of sudden death in hypertrophic cardiomyopathy
- massive left ventricular hypertrophy
- family history of sudden death
- non-sustained ventricular tachycardia
- prior unexplained syncope
- abnormal blood pressure on exercise
what is given if low risk of sudden death in hypertrophic cardiomyopathy
amiodarone
what is given if high risk of sudden death in hypertrophic cardiomyopathy
ICD insertion
what is given for chest pain and dyspnoea in hypertrophic cardiomyopathy
beta blockers and verapamil
alone or in combo