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Cardiovascular > Cardiomyopathy, Myocarditis and Pericarditis > Flashcards

Cardiomyopathy, Myocarditis and Pericarditis Flashcards

1
Q

What is cardiomyopathy?

A

A group of diseases that affect the heart muscle

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2
Q

What is dilated cardiomyopathy?

A

A condition in which the heart becomes enlarged and cannot pump blood effectively

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3
Q

What are the possible causes of secondary dilated cardiomyopathy?

A 
Genetic 
Inflammatory 
Toxic drugs
Exogenous chemicals 
Infections 
Autoimmune reactions 
Muscular dystrophy 
Injury 
Ischaemia 
Valvular causes 
Alcohol abuse 
Cocaine use
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4
Q

Essentially what can cause dilated cardiomyopathy?

A

Almost any pathological insult to the myocardium

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5
Q

How many chambers of the heart does dilated cardiomyopathy affect?

A

Can be one but more often all chambers are dilated and functionally impaired

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6
Q

What is the incidence rate of dilated cardiomyopathy?

A

5-8 per 100,000 per year

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7
Q

What are the symptoms of dilated cardiomyopathy?

A 
Progressive, slow onset:
Dyspnoea 
Fatigue 
Orthopnoea 
PND 
Weight gain  
Cough
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8
Q

On examination what would be noticed on a patient with dilated cardiomyopathy?

A 
Thready pulse 
SOB 
Narrow pulse pressure 
JVP elevated 
Displaced apex 
MR murmur 
Pulmonary oedema 
Pleural effusion 
Ankle and sacral oedema
Ascites 
Hepatomegaly
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9
Q

What examination should be done for dilated cardiomyopathy?

A 
Repeated ECG 
CXR 
FBC
U+E
Echo 
CMRI 
Coronary angiogram 
N termial pro brain natriuetic peptide
Sometimes biopsy
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10
Q

How is dilated cardiomyopathy treated?

A 
Correct anaemia 
Remove exacerbating drugs 
Reduce fluid and salt intake 
Manage weight to identify fluid overload 
HF nurse referral 
Medication
Cardiac transplant 
LVAD
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11
Q

What is the medication for dilated cardiomyopathy?

A 
ACE inhibitors 
ATII blockers 
Diuretics 
Beta blockers 
Sprinolactone 
Anticoagulants
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12
Q

What is the prognosis like for dilated cardiomyopathy?

A

Generally poor and often influenced by the cause where known

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13
Q

What is restrictive and infiltrative cardiomyopathy?

A

A condition where the heart walls are rigid so the heart is restricted form stretching and filling with blood properly

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14
Q

What can cause restrictive cardiomyopathy?

A 
Amyloidosis 
Sarcoidosis 
Endocardial fibroelastosis 
Loffler endocarditis 
Haemochrimatosis 
Radiation
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15
Q

What is the investigation for restrictive cardiomyopathy?

A 
Repeated ECG 
CXR 
N termial pro Brain Natriuetic Peptide
FBC 
U+E
Auto antibodies for sclerotic CT disease 
Echo 
CMRI 
Biopsy
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16
Q

What should you be looking out for in bloods for restrictive cardiomyopathy?

A

Sarcoid and haemachromatosis

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17
Q

What are the treatment options for restrictive cardiomyopathy?

A 
Limited diuretic use 
Beta blockers 
Limited ACEI use 
Anticoagulants 
Cardiac transplant 
Treat underlying disease
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18
Q

What is hypertrophic cardiomyopathy?

A

When the heart muscles are enlarged there is impaired relaxationso not enough blood gets into the ventricles

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19
Q

What is the prevalence of hypertrophic cardiomyopathy\?

A

1 in 500

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20
Q

What are the different types of hypertrophic cardiomyopathy?

A

Apical
Septal
Generalised

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21
Q

What can happen in septal hypertrophy?

A

It can cause defects in the mitral valve with leads to left ventricular outflow tract obstruction

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22
Q

What are the symptoms of hypertrophic cardiomyopathy?

A 
Asymptomatic 
Fatigue 
Dyspnoea 
Anginal like chest pain 
Syncope on exertion 
Palpitations
23
Q

What are the examination finding of hypertrophic cardiomyopathy?

A 
None 
Notched pulse pattern 
Irregular pulse if in AF or ectopy 
Double impulse over apex 
Thrills
Murmurs 
Raised JVP
24
Q

How does the LVOT murmur change in hypertrophic cardiomyopathy?

A

Increase with valsalve manoeuvre

Decrease with squatting

25
Q

What is the investigation for hypertrophic cardiomyopathy?

A

ECG
Echo
CMRI
Risk stratification for sudden cardiac death

26
Q

What general methods should be taken for someone with hypertrophic cardiomyopathy?

A

Avoid heavy exercise
Avoid dehydration
Consider genetic testing
Regular follow ups

27
Q

What specific measures should be taken with hypertrophic cardiomyopathy?

A

Drugs
Anticoagulants if in AF
Surgical or alcohol septal ablation
ICD

28
Q

What drugs are used in hypertrophic cardiomyopathy?

A

Beta blockers
Verapamil
Disopyrimide

29
Q

What is myocarditis?

A

Acute or chronic inflammation of the myocardium

30
Q

What does myocarditis do?

A

Impair myocardial function, conduction and generate arrhythmias

31
Q

What is the prevalence of myocarditis?

A

8-10 per 100,000

32
Q

What are the symptoms of Myocarditis?

A

Heart failure
Fatigue
SOB
Chest pain

33
Q

What is the investigation of Myocarditis?

A 
ECG 
Biomarkers 
Echo 
CMRI 
Biopsy 
Viral DNA PCR
Auto antibodies 
Step antibodies
34
Q

What is the treatment of Myocarditis?

A

Treat heart failure
Treat brady and tachy arrhythmias
Immunotherapy
Stop possible drugs or toxic agent exposure

35
Q

What is pericarditis?

A

Inflammation of the pericardial layers with or without myocardial involvement

36
Q

What are the main causes of pericarditis?

A

Viral

Idiopathic

37
Q

What are the symptoms of pericarditis?

A 
Chest pain with pleuritic and postural features 
Fever 
Pericardial rub 
Raised JVP 
Hypotension 
Muffled heart sounds
38
Q

How does the chest pain change in pericarditis?

A

Improves when sitting forward

Gets worse when lying back

39
Q

What investigations are done for pericarditis?

40
Q

What is the treatment for viral pericarditis?

A

Conservative treatment

41
Q

What is the treatment for idiopathic pericarditis?

A

Colchicine

Limited use of NSAIDs

42
Q

What is the treatment for bacterial pericarditis?

A

Always drain effusion

43
Q

What are the symptoms of pericardial effusion?

A 
Fatigue 
SOB 
Dizziness 
Hypotension 
Chest pain
44
Q

what are the signs of a pericardial effusion?

A 
Pluses paradoxus 
Raised JVP 
Pericardial rub 
Muffled heart sounds 
Pulmonary oedema
45
Q

What is the investigation for pericardial effusion?

A

Urgent echo

CXR

46
Q

What is the treatment of pericardial effusion?

47
Q

What is the treatment of a persistent pericardial effusion?

A

Surgical window made to allow flow to abdomen

48
Q

What is constrictive pericarditis?

A

A thickened fibrotic pericardium reducing the hearts ability to function

49
Q

What are the causes of constrictive pericarditis?

A 
Idiopathic 
Radiation 
Post surgery 
Autoimmune 
Renal failure 
Sarcoidosis
50
Q

What are the symptoms of constrictive pericarditis?

A

Fatigue
SOB
Cough

51
Q

What are the signs of constrictive pericarditis?

A 
Right heart failure 
Oedema 
Ascites 
High JVP 
Jaundice 
Hepatomegaly 
AF 
Tricuspid regurgitation 
Pleural effusion 
Pericardial knock
52
Q

What is the investigation of constrictive pericarditis?

A

Echo and right heart catheter to differentiate from restrictive cardiomyopathy

53
Q

What is the treatment for constrictive pericarditis?

A

Careful and limited diuretics

Pericardectomy

Cardiovascular (34 decks)

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