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Cardiovascular System > Cardiomyopathy, Myocarditis and Pericarditis > Flashcards

Cardiomyopathy, Myocarditis and Pericarditis Flashcards

1
Q

Dilated cardiomyopathy

A

Dilation of the heart chambers

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2
Q

Aetiology of dilated cardiomyopathy

A

Genetic and familial DCM
Inflammatory, infectious, autoimmune, postpartum
Toxic - drugs, exogenous chemicals, endocrine
Injury, cell loss, scar replacement

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3
Q

Dilated cardiomyopathy often results in

A

Thrombosis in chambers

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4
Q

Causes of dilated cardiomyopathy that are reversible to some degree

A 
Alcohol
Endocrine
Tropical disease
Post partum
Haemaochromatosis
Sarcoid
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5
Q

Symptoms of dilated cardiomyopathy

A 
Dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea
Fatigue
Ankle swelling
Weight gain of fluid overload
Cough
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6
Q

Examination findings of dilated cardiomyopathy

A 
Poor superficial perfusion
Shortness of breath at rest
Narrow pulse pressure
JVP elevated
Pulmonary oedema 
Ankle oedema
Displaced apex
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7
Q

Investigation of dilated cardiomyopathy

A 
ECG
Chest x-ray
N terminal pro Brain Natriuetic Peptide
Echo
Bloods - FBC, U+E
Coronary angiogram
CMRI
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8
Q

General measures in treatment for dilated cardiomyopathy

A 
Correct anaemia and any endocrine disturbance
Reduce fluid and salt intake
Advise on managing weight
Remove exacerbating drugs
Heart failure nurse referral
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9
Q

More specific measures in treatment of dilated cardiomyopathy

A 
Diuretics
Beta blockers
Anticoagulants
ACE inhibitor
ARB
Sprionolactone
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10
Q

Prognosis of dilated cardiomyopathy

A

Generally poor and often influenced by the causes where known

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11
Q

Restrictive and infiltrative cardiomyopathy

A

Inability to fill well a ventricle whose wall has reduced compliance

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12
Q

Aetiology of restrictive and infiltrative cardiomyopathy

A

Non-infiltrative - familial, diabetic, scleroderma
Infiltrative - amyloid, sarcoid
Storage diseases - haemaochromatosis
Endomyocardial - fibrosis, radiation, carcinoid, drugs

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13
Q

Investigation of restrictive and infiltrative cardiomyopathy

A 
ECG
Chest x-ray
N terminal pro Brain Natriuetic Peptide
Bloods - FBC, U+E
Echo
CMRI
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14
Q

Specific measures for treatment of restrictive and infiltrative cardiomyopathy

A 
Limited diuretics use
Beta blockers
Limited ACE inhibitor use
Anticoagulants
Cardiac transplant
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15
Q

Prognosis of restrictive and infiltrative cardiomyopathy

A

Poor unless reversible

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16
Q

Features of dilated cardiomyopathy

A

Ventricular function is impaired

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17
Q

Features of restrictive and infiltrative cardiomyopathy

A

Impaired filling, myocyte relaxation and potentially systolic function

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18
Q

Hypertrophic cardiomyopathy

A

Portion of heart becomes thickened

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19
Q

Features of hypertrophic cardiomyopathy

A

Impaired myocyte relaxation and abnormal systolic function

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20
Q

Gene defect in hypertrophic cardiomyopathy

A

Sarcomere - autosomal dominant but variable expression and incomplete penetrance

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21
Q

Pathology of hypertrophic cardiomyopathy

A

Myocyte hypertrophy and disarray - can be generalised, septal or apical
Impaired relaxation so restrictive
Small vessel narrowing - ischaemia, fibrosis, arrhythmias

22
Q

Symptoms of hypertrophic cardiomyopathy

A 
Asymptomatic
Fatigue
Dyspnoea
Anginas like chest pain
Exertional pre syncope
Syncope
Breathlessness
Palpitations
23
Q

Examination findings of hypertrophic cardiomyopathy

A 
Notched pulse pattern
Irregular pulse if in AF
Double impulse over apex
Thrills 
Murmurs
JVP raised
24
Q

Investigation of hypertrophic cardiomyopathy

A

ECG
Echo
CMRI
Risk stratification for SCD

25
Q

General measures for hypertrophic cardiomyopathy

A

Avoid heavy exercise and dehydration
Consider genetic testing
Follow up

26
Q

Specific measures for hypertrophic cardiomyopathy

A 
Beta blockers
Verapamil - CCB
Disopryrimide 
Anticoagulant
Surgical or alcohol septal ablation
ICD if required
27
Q

Myocarditis

A

Acute or chronic inflammation of the myocardium

28
Q

Features of myocarditis

A

Can impair myocardial function, conduction and generate arrhythmia

29
Q

Aetiology of myocarditis

A

Viral, bacterial, fungal or parasitic infection
Toxins
Hypersensitivity
Autoimmune activation

30
Q

Pathology of myocarditis

A

Infiltration of inflammatory cells into the myocardial layers

31
Q

Symptoms of myocarditis

A

Heart failure
Fatigue
Shortness of breath
Cerebral palsy

32
Q

Investigation of myocarditis

A 
ECG - abnormal
Biomarkers elevated
Echo
CMRI - oedema
Viral DNA pCR
Auto antibodies
33
Q

General measures of myocarditis

A

Support for brady and tachy arrhythmias
Treatment of heart failure
Immunotherapy if specific diagnosis identified
Stop possible drugs or toxic agent exposure

34
Q

Pericarditis

A

Inflammation of the pericardial layers with or without myocardial involvement

35
Q

Aetiology of pericarditis

A 
Idiopathic
Viral or bacterial infection
Autoimmune
Trauma
Congenital
Neoplastic disease
36
Q

Symptoms of pericarditis

A

Pleuritic chest pain

Fever

37
Q

Signs of pericarditis

A 
Raised temperature
Raised JVP
Muffled heart sounds
Pericardial rub
Very unwell
38
Q

Investigation of pericarditis

A

ECG - ST elevation and PR depression
Echo
Troponin if myocardial involvement

39
Q

General measures of pericarditis

A

Viral - let it pass
Idiopathic - colchicine and NSAIDs (anti-inflammatory)
Bacterial - antimicrobials
Effusion - drain

40
Q

Pericardial effusion may be

A

Cardiac tamponade

41
Q

Aetiology of pericardial effusion

A

Viral or bacterial infection
Neoplastic disease
Autoimmune
Trauma

42
Q

Symptoms of pericardial effusion

A

Fatigue
Shortness of breath
Dizzy
Chest pain

43
Q

Signs of pericardial effusion

A 
Pulsus paradoxus
JVP raised
Low blood pressure
Pericardial rub
Muffled heart sounds
Pulmonary oedema
44
Q

Investigations of pericardial effusion

A

Echo - key
Chest x-ray - large cardiac shadow
ECG - alteration of QRS complex

45
Q

Treatment of pericardial effusion

A

Drainage
Send for MCS, neoplastic cells, protein and LDH
Persistent effusion - surgical pericardial window to allow flow to abdomen

46
Q

Constrictive pericarditis

A

Chronic inflammation of pericardium causing thickening, fibrosis and muscle tightening

47
Q

Aetiology of constrictive pericarditis

A 
Idiopathic
Radiation
Post surgery
Autoimmune
Renal failure
Sarcoid
48
Q

Pathology of constrictive pericarditis

A

Impaired filling

49
Q

Symptoms of constrictive pericarditis

A

Fatigue
Shortness of breath
Cough

50
Q

Signs of constrictive pericarditis

A 
Oedema
High JVP
Jaundice
AF
Pleural effusion
Tricuspid regurgitation
51
Q

Investigation of constrictive pericarditis

A

Echo

Right heart Cath

52
Q

Treatment of constrictive pericarditis

A

Limited diuretics

Pericardiectomy

Cardiovascular System (27 decks)

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