cardiomyopathy and specific heart disease Flashcards

Question

what is the commonest cardiomyopathy and commonest cause of heart failure?

Answer 1

Genetic and familial DCM: SCN5A gene, muscular dystrophy Inflammatory, infectious, autoimmune, postpartum Toxic; drugs, exogenous chemicals, endocrine Injury, cell loss, scar replacement

Answer 2

``` heart failure cardiac arrhythmias conduction defects thromboembolism sudden death ```

Answer 3

- dyspnoea - fatigue - peripheral oedema - orthopnoea - paroxysmal nocturnal dsypnoea - weight gain - cough

Answer 4

thready pulse irregular pulse if in AF narrow pule pressure poor superficial perfusion diplaced apex beat S3 and S4 MR murmur pulmonary oedema pleural effusion SOB at rest ``` ankle oedema sacral oedema ascites hepatomegaly JVP elevated ```

Answer 5

- ECG- noting LBBB - echocardiogram - cardiac MRI - coronary angiogram - sometimes biopsy - CXR - basic bloods FBC and U & E - N terminal pro Brain Natiuretic peptide

Answer 6

dilatation of the left and/or right ventricle

Answer 7

generalised cardiac enlargement

Answer 8

identifying other aetiologies of LV systolic dysfunction (e. MI) or abdominal myocardial fibrosis

Answer 9

exclude coronary artery disease

Answer 10

``` treat heart failure with; spiranolactone oral nitrates ACE-i Beta Blockers Digoxin warfarin ``` corrct anaemia correct endocrine disturbance reuce fluid and salt intake cardiac transplant

Answer 11

excessive alcohol consumption can lead to thiamine deficiency, direct toxicity and the adulaterations of alcohol causes effects it presents similarly to dilated cardiomyopathy

Answer 12

avoid heavy exercise | avoid dehydration

Answer 13

amyloid sarcoid

Answer 14

``` familial forms of HCM sclerodoma diabetes pseudoxanthoma elasticum ```

Answer 15

haemachromatosis | Fabry disease

Answer 16

fibrosis carcinoid radiation drug effects

Answer 17

inability to fill the ventricles as they have reduced compliance. This leads to atrial dilatation as they gave to work harder and atrial fibrillation.

Answer 18

- repeated ECG (noting LBBB and other conduction defects) - ECHO - cardiac MRI - biopsy sometimes useful for amyloid and sarcoid - CXR - N termial pro Brain Natriuretic Peptide - Basic bloods, U and E and look out for sarcoid and haemochromatosis - autoantibodies for sclerotic CT diseases - low plasma alpha galactoside A activity for Fabry

Answer 19

- anticoagulants if AF - limited diuretic as low filling pressures cause problems - Beta blockers - limited ACEi - ICD or CRT-D/P implant rare as prognosis is so low - cardiac transplant

Answer 20

acute or chronic inflammation of the myocardium

Answer 21

myocardial function impairment conduction impairment- heart block generate arrhthmia

Answer 22

``` viral - common bacterial fungal and parasitic - uncommon toxins eg. cocoaine hypersensitivity autoimmune activation ```

Answer 23

``` assymptomatic heart failure fatigue SOB chets pain in a 1/4 patients fever ```

Answer 24

tachycardia soft heart sounds prominent third heart sound pericardial rub

Answer 25

enlarged and hypertrophied heart and dilated cardiomyopathy

Answer 26

ECG ECHO cardiac MRI biopsy ``` troponin raised but unlike in MI it doesnt fall viral dna pcr autoantibodies strep antibodies lyme B burgdorferi HIV ```

Answer 27

- treatment of heart failure - treatment of brady/tachy arrhythmias - immunotherapy - stop possible drugs bringing about inflammation

Answer 28

inflammation of the pericardial layers (with or without the myocardium)

Answer 29

``` viral bacterial post MI perforation dissection of proximal aorta neoplasia autoimmune response ```

Answer 30

chest pain: relieved by sitting forward execerbated by movement, repsiration and lying down fever

Answer 31

``` pericardial rub fever raised JVP (if effusion causinf haemodynamic effects) low BP muffled heart sounds ```

Answer 32

ECG- ST segment raised and concave and PR dependent echo troponin (raised if myocardium involved) CXR

Answer 33

conservative

Answer 34

colchicine | limited use of NSAIDS

Answer 35

drain pericardial effusion | antimicrobials after

Answer 36

haemodynamically significanr pericardial effusion

Answer 37

often same as pericrditis

Answer 38

fatigue SOB dizzy with low BP occasionally chest pain

Answer 39

``` pulsus paradoxus JVP raised low BP rub muffled HS ```

Answer 40

an abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration

Answer 41

echo | CXR

Answer 42

drainage | underlying cause

Answer 43

``` idopathic radiation post surgery autoimmune renal failure sarcoid. ```

Answer 44

impaired filling although myocardium is normal

Answer 45

fatigue SOB cough

Answer 46

``` RHF with oedema ascites high JVP jaundice hepatomegaly AF TR pleural effusion pericardial knock ```

Answer 47

echo right heart catheter to differentiate from RCM ECG CXR

Answer 48

limited diuretic | pericardectomy