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
what is the consequence of myocarditis
can impair the function and conduction of the heart
26
what is the cause of myocarditis
``` infective organism: viral bacterial protozoal autoimmune ```
27
what are the symptoms of myocarditis
``` recent viral illness fatigue dyspnoea chest pain arrhythmias as a result of infla. resting tachycardia ```
28
what investigations could be done for myocarditis and what would they show
ECG-abnormal CXR-cardiac enlarge, venous congestion echo- wall motion abnormalities viral DNA PCR
29
what is the treatment for myocarditis
supportive with treatment of HF and arrhythmias | Immunotherpay if biopsy or other Ix point to a specific diagnosis
30
what is the prognosis of myocarditis
30% recover | 50% mortality @ 4yr
31
what is pericarditis
inflammation of the pericardial layers
32
who is most likely to get pericarditis in the UK
males aged 20-50
33
what are the main causes of pericarditis
viral idiopathic pathogenic infection
34
what are important causes of pericarditis to detect
``` bacterial post MI dissection of proximal aorta neoplasia perforation ```
35
what are the symptoms of pericarditis
chest pain that is worse lying down fever breathlessness (consider effusion) pericardial rub
36
what investigations would you do for pericarditis
ECG- widespread ST changes | echo- can distinguish from MI
37
what is the treatment for pericarditis in most cases
NSAIDS to reduce inflammation | colchicine to reduce inflammation by killing certain cells
38
what is the treatment for bacterial pericarditis
drain effusion and give antimicrobials
39
what is constrictive pericarditis
thickening and fibrosis of the pericardium causing cardiac compression and impaired diastolic filling
40
what are the causes of constrictive pericarditis
``` radiation infective post surgical autoimmune renal failure ```
41
what are most cases of constrictive pericarditis in the uk caused by
they are idiopathic
42
what are the symptoms of constrictive pericarditis
fatigue SOB cough
43
what is the treatment for constrictive pericarditis
careful use of diuretics treatment of any underlying condition pericardectomy