Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory system 2017 > Cardiomyopathy, myocarditis and pericarditis > Flashcards

Cardiomyopathy, myocarditis and pericarditis Flashcards

1
Q

What is cardiomyopathy?

A

group of diseases of the myocardium which affects the mechanic or electrical function of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kinds of cardiomyopathy affect the mechanic function of the heart?

A 
Hypertrophic
Arrhythmogenic 
Right ventricular
Dilated
Restrictive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What kinds of cardiomyopathy affect the electrical function of the heart?

A

Conduction system disease

Ion channelopathies e.g. long QT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe dilated cardiomyopathy

A

Dilated left ventricle (poorly contracts)
All chambers can be dilated though
Can result from myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause dilated cardiomyopathy?

A

Genetic and familial DCM: SCN5A, MD
Inflammatory/infectious
Toxic - alcohol
Injury/cell loss/scarring - sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What gene is responsible for familial dilated cardiomyopathy?

A

SCN5A - autosomal dominant inheritance

Muscular dystrophy can also cause it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the symptoms of DCM?

A 
Dyspnoea
Fatigue
Orthopnoea
PND
Ankle oedema, weight gain from fluid
Cough
Embolism from mural thrombi
Arrhythmias
Signs of biventricular heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What should you make sure to check during a history for suspected DCM?

A

PMH - systemic illness, travel, vascular disease

FH - familial? MD?

SH- alcohol, job

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What would be seen on examination on those with DCM?

A 
Poor superficial perfusion
Thready pulse, irregular if in AF
SOB at rest
Narrow pulse pressure
Elevated JVP pressure
Displaced apex
S3 and S4
Pulmonary oedema
Pleural effusion
Ankle oedema
Sacral oedema
Ascites
Hepatomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What investigations would be carried out on those with suspected DCM?

A 
CXR - cardiac enlargement 
ECG - LBBB
Cardiac imaging - CMRI, angiogram
BNP
ECHO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What general treatments are given to those with DCM?

A 
Correct anaemia - iron tablets
Remove exacerbating drugs
Correct endocrine disturbance (thyroid)
Reduce salt and fluid intake
Weight management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What treatments are given to those with DCM?

A 
BP - ACEIs, ARBs, diuretics
Beta blockers
Spironolactone
Anticoagulants
ICD if patients have later stage HF
Heart transplant if severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe restrictive cardiomyopathy

A

Rigid myocardium restricts ventricular filling, features similar to constrictive pericarditis. Can see gross bi-atrial dilation in an attempt to counteract this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common cause of restrictive cardiomyopathy?

A

Amyloidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List some causes of restrictive cardiomyopathy

A

Non infiltrative - familial, diabetes
Infiltrative - amyloidosis, sarcoid
Storage - haematochromatosis, Fabry dis.
Endomyocardial - fibrosis, carcinoid, toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe some investigations for RCM?

A 
ECG - LBBB, other defects
CXR
BNP
Bloods
Autoantibodies for sclerotic disease
Amyloid - non-cardiac biopsy
Fabry - low a-galactosidase A activity
ECHO
Biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you diagnosis RCM?

A

Cardiac catheterization

Endomyocardial biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What test would confirm Fabry disease being the cause of RCM?

A

Fabry - low a-galactosidase A activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What test would confirm amyloidosis being the cause of RCM?

A

Amyloid - non-cardiac biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you treat RCM?

A 
NO DIURETICS
Beta blockers and ACEIs
Anticoagulants as required
Treatments for iron overload
ICD
Cardiac transplants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe hypertrophic cardiomyopathy

A

Marked ventricular hypertrophy in the absence of abnormal loading conditions such as hypertension and valvular disease. Leads to loss of compliance which impairs diastolic filling, reducing stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are most cases of hypertrophic cardiomyopathy caused by?

A

Autosomal dominant mutations in genes encoding sarcomeric proteins e.g. troponin I and beta myosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common cause of sudden cardiac death in young people?

A

Hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What can result from septal hypertrophy due to hypertrophic cardiomyopathy and mitral valve defect?

A

Let ventricular outflow tract obstruction (LVOT)

25
What are the symptoms of hypertrophic cardiomyopathy?
Fatigue Dyspnoea Anginal like chest pain Exertional pre-syncope or syncope related to arrhythmias or LVOT
26
What complications are associated with hypertrophic cardiomyopathy?
``` Sudden death Atrial and ventricular arrhythmias Thromboembolism Infective endocarditis Heart failure ```
27
Describe the clinical signs of hypertrophic cardiomyopathy
``` Jerky carotid pulse Pansysolic murmur from mitral regurgitation Ejection systolic murmur - LVOT Notched pulse pattern Double impulse over apex LVOT murmur increased with valsalva Decreased LVOT when squatting Raised JVP ```
28
What assessments will be carried out for hypertrophic cardiomyopathy?
ECG - patterns of LVH ECHO - LVH CMRI - VH and fibrosis Genetic testing for sarcomeric protein mutations
29
How do you treat hypertrophic cardiomyopathy?
``` Beta blockers + verapamil - reduce HR Amiodarone - anti-arrhythmic Anticoagulants Surgical resection/ septal ablation ICD ```
30
What general advice do you give to those with hypertrophic cardiomyopathy?
Avoid heavy exercise Avoid dehydration Encourage family to be tested Regular follow ups to reappraise progress
31
Describe myocarditis
Inflammation of myocardium, which can impact on myocardial function, conduction (heart block) and generate arrhythmias Late stages appears like DCM
32
List some causes of myocarditis
``` Infection - Coxsackie virus, diphtheria, RF Radiation Injury Lyme disease? HIV ```
33
What is the most common cause of myocarditis?
Coxsackie infection
34
List the symptoms of myocarditis
``` Fever Varying degrees of biventricular failure Cardiac arrhythmias and pericarditis Fatigue SOB Heart block? ```
35
Describe some investigations for myocarditis
``` ECG - ST changes ECHO CMRI - cardiac enlargement, oedema Viral DNA PCR Autoantibodies HIV Lyme B burgdorferi ```
36
How do you diagnose myocarditis?
Demonstrate increased serum viral titres and inflammation on cardiac biopsy (though these are rarely performed)
37
How do you treat myocarditis?
Treat HF and arrhythmia Immunotherapy Stop possible drug/toxic agent exposure Bed rest
38
How much fluid is found in the pericardium normally?
50ml
39
What is pericarditis?
Inflammation of the pericardial layers with to without myocardial involvement
40
What causes pericarditis?
``` Infection - Coxsackie B, echovirus, HIV Tuberculosis Fungal infections Perforation/trauma Dissection of proximal aorta Neoplasia (breast, lung, leukaemia) Ureamia AI rheumatic disease ```
41
Describe symptoms of pericarditis
``` Lasts 1-2 weeks normally Sharp retrosternal chest pain Pleuritic features - pericardial rub Postural changes - sitting forward improves, lying back makes it worse Pain worse on inspiration Pain radiates to neck and shoulders Fever (infection) ```
42
What are the clinical signs of pericarditis?
``` Fever Pericardial rub Raised JVP Low BP Muffled heart sounds + increased JVP suggest effusion No effusion = bacterial infection ```
43
What investigations are used for pericarditis?
ECG - ST elevation (saddle shaped) ECHO Troponin increased if myocardium involved
44
How do you treat pericarditis?
Antimicrobials, NSAIDs Drain large effusions/bacterial infected Systemic corticosteroids if resistant
45
Why cant NSAIDs be used for pericarditis if an MI has happened a few days prior?
Increased risk of myocardial rupture
46
What are some complications of pericarditis?
Pericardial effusion Chronic pericarditis (>6 months) Tamponade
47
What can cause pericardial effusions?
pericarditis | hypothyroidism
48
What is pericardial tamponade?
Medical emergency, large amount go pericardial fluid restricts diastolic filling and causes a marked reduction in cardiac output
49
What are some symptoms of pericardial tamponade?
Fatigue SOB Dizzy with low BP Occasionally chest pain
50
What are some clinical signs of pericardial tamponade?
``` Pulsus paradoxus Raised JVP Low BP Pericardial rub Muffled HS Pulmonary oedema Tachycardia KUSSMAULS SIGN ```
51
What is Kussmaul's sign?
Elevated JVP which paradoxically increases with inspiration (sign of pericardial tamponade) Seen in pericarditis
52
What investigations are used for pericardial tamponade?
CXR - large heart shadow, globular heart ECG ECHO - echo free space around heart
53
How do you treat pericardial tamponade?
Emergency pericardiocentesis Fluid analysed for neoplastic cells, infection If recurs, excise pericardial "window"
54
Describe constrictive pericarditis
Heart becomes encased with fibrotic pericardial sac, preventing adequate diastolic filling of ventricles
55
What causes constrictive pericarditis?
``` Intrapericardial haemorrhage in surgery Radiation AI RF Sarcoid disease ```
56
What are the clinical signs of constrictive pericarditis?
``` Jugular venous distension Oedema Hepatomegaly Ascites Kussmauls sign Atrial fibrillation Pericardial knock ```
57
What are the symptoms of constrictive pericarditis?
``` Fatigue SOB Cough Jaundice VERY similar to right HF and restrictive cardiomyopathy ```
58
What investigations are used for constrictive pericarditis?
CXR - normal heart, pericardial calcification CT/MRI - pericardial thickening/calcification ECHO - diff from restrictive cardiomyopathy
59
How do you treat constrictive pericarditis?
Careful/limited diuretics | Surgical removal of pericardium

Respiratory system 2017 (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions