Cardiomyopathy Flashcards
Define
DEFINITION: Primary disease of the myocardium. Cardiomyopathy may be:
Dilated
Hypertrophic
Restrictive
Causes
The majority are IDIOPATHIC
Dilated Cardiomyopathy:
- Post-viral myocarditis
- Alcohol
- Drugs (e.g. doxorubicin, cocaine)
- Familial
- Thyrotoxicosis
- Haemochromatosis
- Peripartum
Hypertrophic Cardiomyopathy
- Up to 50% are genetic
Restrictive Cardiomyopathy:
- Amyloidosis
- Sarcoidosis
- Haemochromatosis
Epidemiology
Prevalence of dilated and hypertrophic cardiomyopathy is 0.05-0.20%
Restrictive is even rarer
Symptoms
Dilated :
- Symptoms of heart failure
- Arrhythmias
- Thromboembolism
- Family history of sudden death
Hypertrophic
- Usually NO SYMPTOMS
- Syncope
- Angina
- Arrhythmias
- Family history of sudden death
Restrictive:
- Dyspnoea
- Fatigue
- Arrhythmias
- Ankle or abdominal swelling
- Family history of sudden death
Signs
Dilated
- Raised JVP
- Displaced apex beat
- Functional mitral and tricuspid regurgitations
- Third heart sound
Hypertrophic
- Jerky carotid pulse
- Double apex beat
- Ejection systolic murmur
Restrictive:
- Raised JVP
- Kussmaul Sign - paradoxical rise in JVP on inspiration due to restricted filling of the ventricles
- Palpable apex beat
- Third heart sound
- Ascites
- Ankle oedema
- Hepatomegaly
Investigations
CXR :
Alcoholic Dilated Cardiomyopathy
May show cardiomegaly
May show signs of heart failure
ECG
All Types:
- Non-specific ST changes
- Conduction defects
- Arrhythmias
Hypertrophic
- Left-axis deviation
- Signs of left ventricular hypertrophy
- Q waves in inferior and lateral leads
Restrictive
1. Low voltage complexes
Echocardiography
Dilated
1. Dilated ventricles with global hypokinesia
Hypertrophic
1. Ventricular hypertrophy (asymmetrical septal hypertrophy)
Restrictive
- Non-dilated non-hypertrophied ventricles
- Atrial enlargement
- Preserved systolic function
- Diastolic dysfunction
- Granular or sparkling appearance of myocardium in amyloidosis
Cardiac Catheterisation
Endomyocardial Biopsy
Pedigree or Genetic Analysis
