Cardiomyopathy

Question 1

Define Cardiomyopathy

Answer 1

Group of heart muscle (myocardium) diseases that are associated with mechanical and/pr electrical dysfunction

3 main types: dilated, restrictive, hypertrophic

Question 2

Aetiology of Dilated cardiomyopathy

Answer 2

Alcohol
Drugs e.g. doxorubicin, cocaine 
Viruses -> myocarditis 
Familial (25%)
Thyrotoxicosis 
Haemochromatosis

Question 3

Aetiology of restrictive cardiomyopathy

Answer 3

Sarcoidosis, amyloidosis
Haemochromatosis
Scleroderma

Question 4

Aetiology of hypertrophic cardiomyopathy

Answer 4

Inherited - autosomal dominant (50%) -> mutation in myosin, troponin T -> hypertrophy

Question 5

Epidemiology of cardiomyopathy

Answer 5

Dilated is the most common myopathy

Hypertrophic is the most common cause of sudden cardiac death in the young

Question 6

Symptoms and signs of dilated cardiomyopathy

Answer 6

Heart failure symptoms
Thromobembolism
FMHx sudden death

Heart failure signs
Displaced apex beat 
Mitral and tricuspid regurgitation 
S3 
Arrhythmia

Question 7

Symptoms and signs of restrictive cardiomyopathy

Answer 7

Dyspnoea
Fatigue
Arrhythmias
Ankle/abdominal swelling

Heart failure signs
Kussmaul's sign
S3 
Palpable apex beat 
Ascites/ ankle oedema / hepatomegaly

Question 8

Symptoms and signs of hypertrophic cardiomyopathy

Answer 8

Aortic stenosis: syncope, angina

Sudden cardiac death (FMHx)

Jerky carotid pulse
Double apex (NOT displaced)
Aortic stenosis: ESM, bifid pulse, S4

Question 9

Investigations for cardiomyopathy

Answer 9

Dilated: Echo - dilation of ventricles + hypokinesia

Restrictive: Gold standard is cardiac MRI

Hypertrophic: Echo - shows asymmetry, obstruction in HOCM