Cardiomyopathy Flashcards
Define Cardiomyopathy?
Primary disease of the myocardium
What are the different types of Cardiomyopathy?
Dilated
Hypertrophic
Restrictive
What is the aetiology of Cardiomyopathy?
The majority are idiopathic
What are some of the causes of Dilated Cardiomyopathy?
Post-viral myocarditis Alcohol Drugs (e.g. Doxurubicin, cocaine) Familial Thyrotoxicosis Haemochromatosis Peripartum
What are the causes of Hypertrophic Cardiomyopathy?
Up to 50% are genetic
What are the causes of Restrictive Cardiomyopathy?
Amyloidosis
Sarcoidosis
Haemochromatosis
What is the epidemiology of Cardiomyopathy?
Prevalence of dilated and hypertrophic cardiomyopathy is 0.05-0.20%
Restrictive is even rarer
What are the presenting symptoms of Dilated Cardiomyopathy?
Symptoms of Heart Failure
Arrhythmias
Thromboembolism
Family History of sudden death
What are the presenting symptoms of Hypertrophic Cardiomyopathy?
Usually NO Symptoms Syncope Angina Arrhythmias Family history of sudden death
What are the presenting symptoms of Restrictive Cardiomyopathy?
Dyspnoea Fatigue Arrhythmias Ankle or Abdominal Swelling Family History of sudden death
What are the signs of Dilated Cardiomyopathy on physical examination?
Raised JVP
Displaced apex beat
Functional mitral and tricuspid regurgitations
Third heart sound
What are the signs of Hypertrophic Cardiomyopathy on physical examination?
Jerky carotid pulse
Double apex beat
Ejection Systolic Murmur
What are the signs of Restrictive Cardiomyopathy on physical examination?
Raised JVP - Kussmaul Sign Palpable apex beat Third heart sounds Ascites Ankle Oedema Hepatomegaly
What is Kussmaul Sign?
Paradoxical rise in JVP on inspiration due to restricted filling of the ventricles
What investigations would you do for Cardiomyopathy?
CXR ECG Echocardiography Cardiac Catheterisation Endomyocardial Biopsy Pedigree or Genetic Analysis
What would you see on an CXR for Cardiomyopathy?
May show cardiomegalu
May show signs of heart failure
What would you see on an ECG for Cardiomyopathy?
Non-specific ST changes
Conduction defects
Arrhythmias
What would you see specifically on an ECG for Hypertrophic Cardiomyopathy?
Left-axis deviation
Signs of left ventricular hypertrophy
Q waves in inferior and lateral leads
What would you see specifically on an ECG for Restrictive Cardiomyopathy?
Low voltage complexes
What would you see on an Echocardiography with Dilated Cardiomyopathy?
Dilated ventricles with global hypokinesia
What would you see on an Echocardiography with Hypertrophic Cardiomyopathy?
Ventricular hypertrophy (asymmetrical septal hypertrophy)
What would you see on an Echocardiography with Restrictive Cardiomyopathy?
Non-dilated non-hypertrophied ventricles
Atrial enlargement
Preserved systolic function
Diastolic dysfunction
Granular or sparkling appearance of myocardium in amyloidosis
