Cardiomyopathy & Myocarditis Flashcards
What is acute myocarditis?
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
common presentation of acute myocarditis
– Fever
– CP w/ ECG changes
– Arrhythmia
– Heart failure
complications of myocarditis
Low ejection fraction and heart failure have high mortality but some recover and others develop a chronic dilated cardiomyopathy
etiology of dilated cardiomyopathies
Usually idiopathic Genetic
Viral
Ischemic
Other
presentation
Heart failure with a large silent heart with impaired systolic function
CXR in dilated cardiomyopathies
Enlarged Heart
Congested Lung fields
What are the clinical manifestation of dilated cardiomyopathies?
- HF
- Arrhythmia
- Thromboemolism
Effect of angiotensin binding to AT1
Vasoconstriction
Increased aldosterone release Sodium Retention
Fibrosis
Increased Sympathetic Activity Hypertrophy
Tx of dilated cardiomyopathies
TREATMENT OF HEART FAILURE
ANTICOAGULATION
ANTI-ARRHYTHMIC AGENTS
ANTI-INFLAMMATORY / IMMUNO-SUPPRESSIVE
do you see diastolic or systolic dysfunction in HYPERTROPHIC CARDIOMYOPATHY WITHOUT AORTIC OUTFLOW OBSTRUCTION?
Diastolic dysfunction due to impaired diastolic relaxation & increased stiffness
What is the usual Sx seen w/ HYPERTROPHIC CARDIOMYOPATHY WITHOUT AORTIC OUTFLOW OBSTRUCTION?
Dyspnea on exertion
What causes increased pulmonary venous & capillary pressures in hypertrophic cardiomyopathy w/out aortic outflow obstruction?
Elevated LV diastolic pressure
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHy
Asymmetric myocardial hypertrophy
Diastolic dysfunction
Enhanced systolic dysfunction
Dynamic left ventricular outflow obstruction
Pt w/ hypertrophic obstructive cardiomyopathy have a Propensity for what?
syncope & sudden death
What is seen w/ hypertrophic obstructive cardiomyopathy ?
Systolic Anterior Motion of Mitral Valve
what are the clinical manifestations of hypertrophic obstructive cardiomyopathies?
DYSPNEA ANGINA Hypertrophic LV SUDDEN DEATH Variable: Asymptomatic to severe symptoms
hypertrophic obstructive cardiomyopathy Tx
- Avoidcompetitivesportsandotherextreme exertion
- Decreasecontractility–Betablockers/Verapamil
- SurgicalmyomectomyorAlcoholablation
- AutomaticImplantableCardiacDefibrillator
RESTRICTIVE CARDIOMYOPATHY most common infiltrative
amyloidosis, sarcoidosis
Ventricular filling in restrictive cardiomyopathy
Impaired ventricular filling due to stiff (noncompliant) ventricles
T or F: Systolic function often normal
and ventricles usually not dilated ins restrictive cardiomyopathy
True
How are sarcomeres added in concentric hypertrophy?
in parallel
How are sarcomeres added in eccentric hypertrophy?
in series
