Cardiomyopathy, Myocarditis and Pericarditis

Question 1

What is impaired in those with dilated cardiomyopathy?

Answer 1

Ventricular function

Question 2

What are some of the causes of dilated cardiomyopathy?

Answer 2

Genetics
Injury
Inflammatory
Toxic- response to chemicals/drugs

Question 3

What are some of the treatable factors which can be causes of dilated cardiomyopathy?

Answer 3

Alcohol, endocrine, tropical disease, post partum, haemaochromatosis, sarcoid

Question 4

Describe the symptoms which may be experienced by those with dilated cardiomyopathy.

Answer 4

Progressive, slow onset.

Dyspnoea, fatigue, orthopnoea, PND, ankle swelling, weight gain of fluid overload, cough.

Question 5

What might you see upon examination of someone with dilated cardiomyopathy?

Answer 5

Poor superficial perfusion
Thready pulse,
SOB at rest
JVP elevated+/- TR waves
Displaced apex
S3 and S4, MR murmur often
Pulmonary oedema,
Pleural effusions
Ankle oedema

Question 6

Name two investigations which must be carried out in the basic evaluation of dilated cardiomyopathy.

Answer 6

Repeated ECG
CXR

Question 7

Which other investigations can be carried out to help with the diagnosis of dilated cardiomyopathy?

Answer 7

Basic bloods
ECHO
CMRI
Coronary angiogram

Question 8

What are some of the general measures for those with dilated myocardiopathy?

Answer 8

Correct anaemia
Remove exacerbating drugs eg NSAIDs
Correct any endocrine disturbance
Advise on fluid and salt intake, reduce it
Advise on managing weight to identify fluid overload
HF nurse referral

Question 9

What are some of the more specific measures for those with dilated myocardiopathy?

Answer 9

ACEI, ATII blockers, diuretics, Sac/Val
Beta blockers
Spironolactone
Anticoagulants as required
SCD risk assessment with ICD or CRT-D/P implant
Cardiac transplant