Cardiomyopathy & Myocarditis

Question 1

What is acute myocarditis?

Answer 1

Acute inflammation of the cardiac muscle that is usually viral in etiology.
• May be focal or diffuse• Often seen in relatively young adults and children
• 50% have preceding respiratory or GI symptoms

Question 2

common presentation of acute myocarditis

Answer 2

– Fever
– CP w/ ECG changes
– Arrhythmia
– Heart failure

Question 3

complications of myocarditis

Answer 3

Low ejection fraction and heart failure have high mortality but some recover and others develop a chronic dilated cardiomyopathy

Question 4

etiology of dilated cardiomyopathies

Answer 4

Usually idiopathic Genetic
Viral
Ischemic
Other

Question 5

presentation

Answer 5

Heart failure with a large silent heart with impaired systolic function

Question 6

CXR in dilated cardiomyopathies

Answer 6

Enlarged Heart

Congested Lung fields

Question 7

What are the clinical manifestation of dilated cardiomyopathies?

Answer 7

• HF
• Arrhythmia
• Thromboemolism

Question 8

Effect of angiotensin binding to AT1

Answer 8

Vasoconstriction
Increased aldosterone release Sodium Retention
Fibrosis
Increased Sympathetic Activity Hypertrophy

Question 9

Tx of dilated cardiomyopathies

Answer 9

TREATMENT OF HEART FAILURE
ANTICOAGULATION
ANTI-ARRHYTHMIC AGENTS
ANTI-INFLAMMATORY / IMMUNO-SUPPRESSIVE

Question 10

do you see diastolic or systolic dysfunction in HYPERTROPHIC CARDIOMYOPATHY WITHOUT AORTIC OUTFLOW OBSTRUCTION?

Answer 10

Diastolic dysfunction due to impaired diastolic relaxation & increased stiffness

Question 11

What is the usual Sx seen w/ HYPERTROPHIC CARDIOMYOPATHY WITHOUT AORTIC OUTFLOW OBSTRUCTION?

Answer 11

Dyspnea on exertion

Question 12

What causes increased pulmonary venous & capillary pressures in hypertrophic cardiomyopathy w/out aortic outflow obstruction?

Answer 12

Elevated LV diastolic pressure

Question 13

HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHy

Answer 13

Asymmetric myocardial hypertrophy
Diastolic dysfunction
Enhanced systolic dysfunction
Dynamic left ventricular outflow obstruction

Question 14

Pt w/ hypertrophic obstructive cardiomyopathy have a Propensity for what?

Answer 14

syncope & sudden death

Question 15

What is seen w/ hypertrophic obstructive cardiomyopathy ?

Answer 15

Systolic Anterior Motion of Mitral Valve

Question 16

what are the clinical manifestations of hypertrophic obstructive cardiomyopathies?

Answer 16

DYSPNEA
ANGINA
Hypertrophic LV
SUDDEN DEATH
Variable: Asymptomatic to severe symptoms

Question 17

hypertrophic obstructive cardiomyopathy Tx

Answer 17

• Avoidcompetitivesportsandotherextreme exertion
• Decreasecontractility–Betablockers/Verapamil
• SurgicalmyomectomyorAlcoholablation
• AutomaticImplantableCardiacDefibrillator

Question 18

RESTRICTIVE CARDIOMYOPATHY most common infiltrative

Answer 18

amyloidosis, sarcoidosis

Question 19

Ventricular filling in restrictive cardiomyopathy

Answer 19

Impaired ventricular filling due to stiff (noncompliant) ventricles

Question 20

T or F: Systolic function often normal

and ventricles usually not dilated ins restrictive cardiomyopathy

Answer 20

True

Question 21

How are sarcomeres added in concentric hypertrophy?

Answer 21

in parallel

Question 22

How are sarcomeres added in eccentric hypertrophy?

Answer 22

in series