Cardiomyopathy and myocarditis Flashcards

1
Q

How do the ECGs differ between myocarditis and DCM?

A

Myocarditis: Typically small voltages
DCM: Large voltages reflective of ventricular hypertrophy

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2
Q

Location of LGE in myocarditis

A

Subepicardial, usually on the free wall

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3
Q

When are steroids indicated for the treatment of myocarditis?

A

Giant cell myocarditis

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4
Q

Associations:

Myocarditis + New england + CHB + Arthritis

A

Lyme myocarditis

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5
Q

Lyme myocarditis:
- Treatment
- When is IV preferred to oral?

A

Ceftriaxone x 3 days

IV preferred in 1st degree HB when PR > 300 ms or if higher degree of heart block

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6
Q

Associations:

Myocarditis + no improvement for weeks

A

Giant cell myocarditis

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7
Q

Giant cell myocarditis:
- Cause
- Diagnosis
- Treatment
- Prognosis
- Tx candidacy?

A

Cause: Autoimmune
Diagnosis: cath and biopsy
Treatment: Steroids
Prognosis: Poor
Tx candidacy: Can recur in transplanted heart

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8
Q

Associations:

Myocarditis + rub + pleuritic chest pain + abnormal ECG (diffuse ST segment changes)

A

Myopericarditis

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9
Q

Associations:

Myocarditis + LV aneurysm and clot + Latin america

A

Chagas disease

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10
Q

Chagas disease:
Causative agent
Diagnosis
Prognosis

A

Causative agent: Trypanosome cruzi
Diagnosis: ELISA test
Test: Benznidazole, Nifurtimox
Prognosis: Depends on HF symptomatology

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11
Q

How do you differentiate MIS-C from Kawaski disease?

A

MISC: More likely to be in hispanic or black individuals, more likely to have abdominal pain

MISC platelets are low, KD platelets are high

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12
Q

What nutritional deficiency is associated with DCM?

A

Thiamine deficiency

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13
Q

How does DCM appear on pathology?

A

Myocardial hypertrophy with interstitial fibrosis

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14
Q

Where the the LGE located in DCM?

A

Midwall (septum)

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15
Q

Medical treatment of DCM: Asymptomatic and symptomatic

A

Asymptomatic: ACEi +/- BB
Symptomatic: GDMT

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16
Q

Associations:

DCM + difficulty walking + elevated CK

A

Duchenne muscular dystrophy

17
Q

Duchenne muscular dystrophy:

Etiology and inheritance

A

Dystrophin mutation (DMD)- located in the cell membrane

X-linked (hence why saw only males)

18
Q

What medication has been found to slow disease progression in Duchennes MD?

19
Q

Associations:

DCM + muscle weakness + low ANC + elevated 3-methylglutaconic level

A

Barth’s syndrome

20
Q

Barth’s syndrome:

Etiology
Inheritance

A

Etiology: Tefazzin defect (TAZ gene_
X-linked inheritance

21
Q

Associations:

DCM + predominantly right sided disease

A

Arrythmogenic RV cardiomyopathy

22
Q

Arrythmogenic RV cardiomyopathy:

Cause:
Pathology:
Inheritance
Treatment

A

Cause: Issue with Desmosomes
Pathology: Fibro-fatty deposits in RV and RVOT
Inheritance: Autosomal dominant
Treatment: GDMT, activity restriction

23
Q

What kind of proteins are most commonly involved in HCM?

A

Sarcomere - MYPC1, MYH7

24
Q

Describe the classic HCM cath tracing

A

Gradient as you pull from the LV apex to the base followed by a spike and dome aortic tracing

25
Describe the pathology findings of HCM
Muscle fiber disarray
26
Where is the LGE in HCM?
At the junctions between the RV and LV
27
Most common arrhythmia in HCM
A fib and other atrial arrythmias (but VT is most deadly)
28
What are the only factors found to reduce the risk of SCD in patients with HCM
ICD and exercise restriction
29
How do you differentiate HCM from an athletes heart?
HCM: Will have increased mass to volume ration (athletes hear will have a normal ration) Thickness decreases when an athlete deconditions HCM may have LGE but athletes heart does not
30
What is the inheritance pattern of friederichs ataxia?
Autosomal recessive
31
Clinical findings in Pompe disease
Severe HCM, hypotonia, big tongue, big liver
32
Pompe disease - Etiology - Diagnosis - Treatment - Alternative diagnosis
Etiology: Alpha glucosidase deficiency, lysosomal storage disease Diagnosis: Low alpha glucosidase Treatment: Enzyme replacement therapy Alternative: If alpha glucosidase is normal, may be Dannon syndrome
33
Hurler disease: - Findings - Etiology - Diagnosis - Related syndromes
Findings: Coarse facial features, developmental delay, hepatosplenomegaly and corneal clouding - ETiology: Mucopolysaccharide 1. alpha-l-iduronidase deficiencyt. Cannot break down GAG. - Diagnosis: urinary GAG levels - Related: If more mild, no corneal clouding -> Hunters
34
What mitral spectral doppler tracing will you find in restrictive CM?
Augmented E wave, increased E:A ratio
35
Differing exam findings in RCM vs. constrictive pericarditis
RCM: S3, loud S2 (2/2 increased PVR) Constrictive pericarditis: loud "knock" - high pitched
36
Differing cath findings in RCM vs. constrictive pericarditis
RCM: LVEDP > RVEDP, increased PVR Constrictive pericarditis: LVEDP = RVEDP, square root sign on the LV tracing