Cardiomyopathy

Question 1

Define cardiomyopathy?

Answer 1

It is the primary disease of the myocardium. 
can be categorized into 3 sections: 
- dilated 
- hypertrophic 
- restrictive

Question 2

what is the aetiology of dilated cardiomyopathy?

Answer 2

Post-viral myocarditis
Alcohol
Drugs (e.g. doxorubicin, cocaine)
Familial
Thyrotoxicosis
Hemochromatosis
Peripartum (during pregnancy or straight after) 

Question 3

what is the aetiology of hypertrophic cardiomyopathy?

Answer 3

50% of causes are genetic

Question 4

what is the aetiology of restrictive cardiomyopathy?

Answer 4

Amyloidosis
Sarcoidosis
Haemochromatosis

Question 5

epidemiology of cardiomyopathy?

Answer 5

• very rare
• dilated and hypertrophic are 0.05-0.2% prevalent
• restrictive is EVEN rarer

Question 6

presenting complaints of dilated cardiomyopathy?

Answer 6

• symptoms of heart failure
• arrhythmias
• thromboembolism
• family history of sudden death

Question 7

presenting complaints of hypertrophic cardiomyopathy?

Answer 7

• usually no symptoms
• syncope
• angina
• arrhythmias
• family history of sudden death

Question 8

presenting complaints of restrictive cardiomyopathy?

Answer 8

• dyspnoea
• fatigue
• arrhythmias
• swelling
• family history of sudden death

Question 9

what are the signs of dilated cardiomyopathy on physical examination?

Answer 9

• Raised JVP
• displaced apex beat
• Functional mitral and tricuspid regurgitations
• Third heart sound

Question 10

what are the signs of hypertrophic cardiomyopathy on physical examination?

Answer 10

• jerky carotid pulse
• double apex beat
• Ejection systolic murmur

Question 11

what are the signs of restrictive cardiomyopathy on physical examination?

Answer 11

• raised JVP
• Kussmaul sign
• palpable apex beat
• third heart sound
• ascites
• ankle oedema
• hepatomegaly

Question 12

what is Kussmauls sign?

Answer 12

-paradoxical rise in JVP on inspiration due to restricted filling of the ventricles

Question 13

what investigations should be carried out for cardiomyopathy?

Answer 13

• CXR
• ECG
• Echo
• coronary angiography
• Endomyocardial Biopsy
• Pedigree or Genetic Analysis

Question 14

what might a CXR show?

Answer 14

• it might show cardiomegaly

- it might show signs of heart failure

Question 15

what might an ECG show? in all cases of cardiomyopathy?

Answer 15

• non-specific ST changes
• conduction defects
• arrhythmias

Question 16

what might an ECG show? in hypertrophic cardiomyopathy?

Answer 16

• Left-axis deviation
• Signs of left ventricular hypertrophy
• Q waves in inferior and lateral leads

Question 17

what might an ECG show? in restrictive cardiomyopathy?

Answer 17

-low voltage complexes

Question 18

what might an echo show for dilated cardiomyopathy?

Answer 18

-Dilated ventricles with global hypokinesia

Question 19

what might an echo show for hypertrophic cardiomyopathy?

Answer 19

-Ventricular hypertrophy

Question 20

what might an echo show for restrictive cardiomyopathy?

Answer 20

-Non-dilated non-hypertrophied ventricles
- Atrial enlargement
- Preserved systolic function
- diastolic dysfunction