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cardiovascular system > Cardiomyopathy, MYocarditis and Pericarditis > Flashcards

Cardiomyopathy, MYocarditis and Pericarditis Flashcards

1
Q

what are the causes of dilated cardiomyopathy

A 
genetic
inflammatory 
toxic
injury 
pregnancy
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2
Q

how is the function of the heart impaired in dilated cardiomyopathy

A

its a systolic dysfunction
decrease in ejection fraction
cant pump blood as efficiently

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3
Q

what is the general prognosis for dilated cardiomyopathy

A

most cases are progressive and irreversible

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4
Q

what are the clinical signs of dilated cardiomyopathy

A 
poor superficial perfusion
thready pulse
SOB @ rest
narrow pulse pressure
oedema - ankle, pul, sacral
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5
Q

what is the best investigation to diagnose dilated cardiomyopathy

A

echo

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6
Q

can an ECG be used to detect dilated cardiomyopathy?

A

yes but findings will be unspecific, ECG will just show there is abnormality

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7
Q

what investigations besides ECG and echo could you carry out for dilated cardiomyopathy

A

CXR
BNP lvls-elevated in muscle stretching
cardiac MRI
basic bloods

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8
Q

what is the treatment for dilated cardiomyopathy

A 
ACEI
ARB
diuretics 
anticoagulants ( if A-fib develops)
lifestyle advice 
possible heart transplant
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9
Q

what function of the heart does restrictive cardiomyopathy affect

A

ventricles can’t relax properly therefore filling capacity is reducded

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10
Q

what are the causes of restrictive cardiomyopathy

A

non-infiltrative-familial
infiltrative- amyloid, sarcoid
storage disease- haemachromotosis
fibrosis- radiation, idiopathic

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11
Q

what percent of restrictive carrdiomyopathy cases are idiopathic

A

50%

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12
Q

what investigations would be done fro restrictive cardiomyopathy, what would they show

A

CXR- pulmonary congestion with normal heart size
ECG- will sow abnormality but this is non specific
echo-increased ventricular thickness possible biatrial enlargement

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13
Q

what specific tests could be done to look for known cases of restrictive cardiomyopathy

A

bloods to check for sarcoid or haemachromotosis

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14
Q

would a biopsy be useful in restrictive cardiomyopathy

A

yes- can detect amyloid

no- high false negative rate

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15
Q

what is the prognosis of restrictive cardiomyopathy

A

unless reversible diagnosis is poor as fibrosis has little specific treatment

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16
Q

what is the treatment for restrictive cardiomyopathy

A 
diuretics (limited use)
Beta blockers 
ACEI
anticoagulants 
possible heart transplant
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17
Q

how does hypertrophic cardiomyopathy affect the function of the heart

A

causes impaired relaxation as heart muscle is thickened and this makes it harder to pump

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18
Q

what is the cause of hypertrophic cardiomyopathy

A

genetic- autosomal dominant transmission in genes coding for myofibrils

19
Q

what are the symptoms of hypertrophic cardiomyopthy

A 
often asymptomatic 
exertion SOB
chest pain 
syncope
fatigue 
family history of SCD
20
Q

what are the clinical findings in hypertrophic cardiomyopathy

A

left ventricular outflow obstruction, this causes a steep rising jerky pulse

21
Q

what investigations would you do for hypertrophic cardiomyopathy

A 
ECG
Echo-LV wall thickness
CXR-can be normal 
CMRI
Genetic test
22
Q

how would you treat hypertrophic cardiomyopathy

A

drugs to enhance relaxation: beta blockers, verapamil(CCB) and disopyrimide(treats arrhythmias)

ICD if at risk

23
Q

when would septal ablation be recommended in hypertrophic cardiomyopathy

A

if medication does not relieve symptoms

24
Q

what is myocarditis

A

inflammation of theheart muscle

25
Q

what is the consequence of myocarditis

A

can impair the function and conduction of the heart

26
Q

what is the cause of myocarditis

A 
infective organism:
viral 
bacterial
protozoal 
autoimmune
27
Q

what are the symptoms of myocarditis

A 
recent viral illness
fatigue
dyspnoea
chest pain
 arrhythmias as a result of infla.
resting tachycardia
28
Q

what investigations could be done for myocarditis and what would they show

A

ECG-abnormal
CXR-cardiac enlarge, venous congestion
echo- wall motion abnormalities
viral DNA PCR

29
Q

what is the treatment for myocarditis

A

supportive with treatment of HF and arrhythmias

Immunotherpay if biopsy or other Ix point to a specific diagnosis

30
Q

what is the prognosis of myocarditis

A

30% recover

50% mortality @ 4yr

31
Q

what is pericarditis

A

inflammation of the pericardial layers

32
Q

who is most likely to get pericarditis in the UK

A

males aged 20-50

33
Q

what are the main causes of pericarditis

A

viral
idiopathic
pathogenic infection

34
Q

what are important causes of pericarditis to detect

A 
bacterial 
post MI
dissection of proximal aorta
neoplasia 
perforation
35
Q

what are the symptoms of pericarditis

A

chest pain that is worse lying down
fever
breathlessness (consider effusion)
pericardial rub

36
Q

what investigations would you do for pericarditis

A

ECG- widespread ST changes

echo- can distinguish from MI

37
Q

what is the treatment for pericarditis in most cases

A

NSAIDS to reduce inflammation

colchicine to reduce inflammation by killing certain cells

38
Q

what is the treatment for bacterial pericarditis

A

drain effusion and give antimicrobials

39
Q

what is constrictive pericarditis

A

thickening and fibrosis of the pericardium causing cardiac compression and impaired diastolic filling

40
Q

what are the causes of constrictive pericarditis

A 
radiation
infective 
post surgical 
autoimmune 
renal failure
41
Q

what are most cases of constrictive pericarditis in the uk caused by

A

they are idiopathic

42
Q

what are the symptoms of constrictive pericarditis

A

fatigue
SOB
cough

43
Q

what is the treatment for constrictive pericarditis

A

careful use of diuretics
treatment of any underlying condition
pericardectomy

cardiovascular system (34 decks)

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