Cardiomyopathy, Myocarditis and Pericarditis Flashcards
What is cardiomyopathy?
A group of diseases that affect the heart muscle
What is dilated cardiomyopathy?
A condition in which the heart becomes enlarged and cannot pump blood effectively
What are the possible causes of secondary dilated cardiomyopathy?
Genetic Inflammatory Toxic drugs Exogenous chemicals Infections Autoimmune reactions Muscular dystrophy Injury Ischaemia Valvular causes Alcohol abuse Cocaine use
Essentially what can cause dilated cardiomyopathy?
Almost any pathological insult to the myocardium
How many chambers of the heart does dilated cardiomyopathy affect?
Can be one but more often all chambers are dilated and functionally impaired
What is the incidence rate of dilated cardiomyopathy?
5-8 per 100,000 per year
What are the symptoms of dilated cardiomyopathy?
Progressive, slow onset: Dyspnoea Fatigue Orthopnoea PND Weight gain Cough
On examination what would be noticed on a patient with dilated cardiomyopathy?
Thready pulse SOB Narrow pulse pressure JVP elevated Displaced apex MR murmur Pulmonary oedema Pleural effusion Ankle and sacral oedema Ascites Hepatomegaly
What examination should be done for dilated cardiomyopathy?
Repeated ECG CXR FBC U+E Echo CMRI Coronary angiogram N termial pro brain natriuetic peptide Sometimes biopsy
How is dilated cardiomyopathy treated?
Correct anaemia Remove exacerbating drugs Reduce fluid and salt intake Manage weight to identify fluid overload HF nurse referral Medication Cardiac transplant LVAD
What is the medication for dilated cardiomyopathy?
ACE inhibitors ATII blockers Diuretics Beta blockers Sprinolactone Anticoagulants
What is the prognosis like for dilated cardiomyopathy?
Generally poor and often influenced by the cause where known
What is restrictive and infiltrative cardiomyopathy?
A condition where the heart walls are rigid so the heart is restricted form stretching and filling with blood properly
What can cause restrictive cardiomyopathy?
Amyloidosis Sarcoidosis Endocardial fibroelastosis Loffler endocarditis Haemochrimatosis Radiation
What is the investigation for restrictive cardiomyopathy?
Repeated ECG CXR N termial pro Brain Natriuetic Peptide FBC U+E Auto antibodies for sclerotic CT disease Echo CMRI Biopsy
What should you be looking out for in bloods for restrictive cardiomyopathy?
Sarcoid and haemachromatosis
What are the treatment options for restrictive cardiomyopathy?
Limited diuretic use Beta blockers Limited ACEI use Anticoagulants Cardiac transplant Treat underlying disease
What is hypertrophic cardiomyopathy?
When the heart muscles are enlarged there is impaired relaxationso not enough blood gets into the ventricles
What is the prevalence of hypertrophic cardiomyopathy\?
1 in 500
What are the different types of hypertrophic cardiomyopathy?
Apical
Septal
Generalised
What can happen in septal hypertrophy?
It can cause defects in the mitral valve with leads to left ventricular outflow tract obstruction
What are the symptoms of hypertrophic cardiomyopathy?
Asymptomatic Fatigue Dyspnoea Anginal like chest pain Syncope on exertion Palpitations
What are the examination finding of hypertrophic cardiomyopathy?
None Notched pulse pattern Irregular pulse if in AF or ectopy Double impulse over apex Thrills Murmurs Raised JVP
How does the LVOT murmur change in hypertrophic cardiomyopathy?
Increase with valsalve manoeuvre
Decrease with squatting
