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cardiovascular system > Cardiomyopathy, Myocarditis & Pericarditis > Flashcards

Cardiomyopathy, Myocarditis & Pericarditis Flashcards

1
Q

What is cardiomyopathy?

A

Refers to diseases of the heart muscle

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2
Q

What are different kinds of cardiomyopathy?

A

Hypertrophic

Dilated

Restricted

Myocarditis

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3
Q

What are different kinds of pericardial diseases?

A

Pericarditis

Effusion

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4
Q

What is dilated cardiomyopathy?

A

Condition in which the heart becomes enlarged and cannot pump blood effectively

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5
Q

What is a condition where the heart becomes enlarged and cannot pump blood effectively?

A

Dilated cariomyopathy

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6
Q

How many chambers are usually affected in dilated cardiomyopathy?

A

Can be only one chamber but most often all the chambers are affected

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7
Q

Speak about the reversibility of dilated cardiomyopathy?

A

Most causes are progressive/irreversible but some are reversible

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8
Q

What is the incidence of dilated cardiomyopathy?

A

5-8/100000

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9
Q

What is not uncommon in chambers for dilated cardiomyopathy?

A

Thrombosis

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10
Q

Is dilated cardiomyopathy a primary or secondary condition?

A

Can be primary or as the end result of almost any pathological insult to the myocardium

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11
Q

What is the aetiology of dilated myocardium?

A

Genetic

Inflammatory

Toxic

Injury

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12
Q

What are examples of genetic causes of dilated myocardium?

A

SCN5A gene

Muscular dystrophy

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13
Q

What is muscular dystrophy?

A

Group of muscle diseases that results in the weakening and breakdown of skeletal muscles over time

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14
Q

What are examples of inflammatory causes of dilated myocardium?

A

Infectious

Autoimmune

Postpartum (following childbirth)

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15
Q

What does postpartum mean?

A

Following childbirth

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16
Q

What are examples of toxic causes of dilated myocardium?

A

Drugs

Exogenous chemicals

Postpartum

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17
Q

What are exogenous chemicals?

A

Ones that originate from outside organism

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18
Q

What are examples of injury causes of dilated myocardium?

A

Cell loss

Scar replacement

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19
Q

What are some symptoms of dilated myocardium?

A

Progressive

Slow onset

Dyspnoea

Fatigue

Orthopnoea

Paroxysmal nocturnal dyspnoea (PND)

Ankle swelling

Weight gain

Cough

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20
Q

What does PND stand for?

A

Paroxysmal nocturnal dyspnoea

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21
Q

What is paroxysmal nocturnal dyspnoea (PND)?

A

Attack of severe shortness of breath and coughing that generally occurs at night

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22
Q

What is an attack of severe shortness of breath and coughing that generally occurs at night called?

A

Paroxysmal nocturnal dyspnoea (PND)

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23
Q

What is often seen in the past medical history for dilated myocardium?

A

Systemic illness

Travel

Hypertension

Vascular disease

Thyroid

Neuromuscular disease

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24
Q

What does the examination for dilated myocardium often show?

A

Poor superficial perfusion

Thready pulse

Shortness of breath at rest

Displaced apex

Pulmonary oedema

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25
What investigations are done for cardiomyopathy?
Repeated ECG Chest X-ray Basic bloods Echocardiogram Cardiac MRI Coronary angiogram Sometimes biopsy
26
What are general measures for the treatment of dilated cardiomyopathy?
Correct anaemia Remove exacerbating drugs (such as NSAIDs) Correct any endocrine disturbance Advice on fluid and salt intake (reduce it) Advice on managing weight to identify fluid overload
27
What are specific measures for the treatment of dilated cardiomyopathy?
ACEI, ATII blockers, diuretics Beta blockers Spironolactone Anticoagulants as required Cardiac transplant
28
What is the prognosis for dilated cardiomyopathy like?
Generally poor and often influenced by the causes where known
29
What is restrictive and infiltrative cardiomyopathy?
Form of cardiomyopathy where the walls of the heart are rigid (but not thickened) causing the heart to be restricted from stretching and filling with blood properly
30
What is a form of cardiomyopathy where the walls are rigid (but not thickened) causing the heart to be restricted from stretching and filling with blood properly?
Restricted and infiltrative cardiomyopathy
31
What kind of process is relaxation of the ventricular walls?
Active process that needs functioning intact myocytes
32
What is the aetiology of restricted cardiomyopathy?
Non-infiltrative Infiltrative Storage diseases Endomyocardial
33
What are examples of non-infiltrative causes of restricted cardiomyopathy?
Familial Scleroderma Diabetic Pseudoxanthoma elasticum
34
What are examples of infiltrative causes of restricted cardiomyopathy?
Amyloid Sarcoid
35
What are examples of storage disease causes of restricted cardiomyopathy?
Haemachromatosis Fabry disease
36
What are endomyocardial causes of restricted cardiomyopathy?
Fibrosis Carcinoid Radiation Drug effects
37
What investigations are done for restricted cardiomyopathy?
Repeated ECG Chest X-ray Basic bloods Auto antibodies for sclerotic CT diseases Echocardiogram Chest MRI Biopsy more helpful but still has high false negatives
38
What are some specific measures for the treatment of restrictive cardiomyopathy?
Limited diuretic use as low folling pressures will cause problems Beta blockers Limited ACEI use Anticoagulants as required Cardiac transplant
39
What is the prognosis of restricted cardiomyopathy?
Poor unless it is reversible
40
What is hypertrophic cardiomyopathy?
A disease in which the heart muscle (myocardium) becomes abnormally thick (hypertrophied), making it harder for the heart to pump blood
41
What is a disease where the heart muscle (myocardium) becomes abnormally thick, making it harder for the heart to pump blood?
Hypertrophic cardiomyopathy
42
What is the prevalence of hypertrophic cardiomyopathy?
1/500
43
What is hypertrophic cardiomyopathy often due to?
Genetics
44
What gene defect most commonly causes hypertrophic cardiomyopathy?
Sarcomere gene defect which is autosomal dominant
45
What is the pathology of hypertrophic cardiomypathy?
Myocyte hypertrophy and disarray Generalised or segmental wall thickness Impaired relaxation so behaves in a restrictive manner
46
What is septal hypertrophy often to do with?
Mitral valve defect leading to left ventricular outflow tract obstruction
47
What are symptoms of hypertrophic cardiomyopathy?
Asymptomatic for many Fatigue Dyspnoea Anginal like chest pain Exertional pre-syncope Syncope related to arrhythmias of LVOT obstruction
48
What does LVOT obstruction mean?
Left ventricular outflow tract obstruction
49
What are examination findings for hypertophic cardiomyopathy?
Can be none Notched pulse pattern Irregular pulse Double impulse over apex JVP can be raised in very restrictive filling
50
What investigations are done for hypertrophic cardiomyopathy?
ECG Echocardiogram Chest MRI
51
What are general measures for hypertrophic cardiomyopathy?
Avoid heavy exercise Avoid dehydration Explore family history Consider genetic testing
52
What are specific measures for hypertrophic cardiomyopathy?
Drugs to try and enhance relaxation (beta blockers, verapamil, disopyrimide) Anticoagulate if in atiral fibrillation If obstructive form then surgical or alcohol septal ablation
53
What is myocarditis?
Acute or chronic inflammation of the myocardium
54
What is acute or chronic inflammation of the myocardium called?
Myocarditis
55
What is myocarditis often in association with?
Pericarditis
56
What is the prevalence of myocarditis?
8-10/100000
57
What is the most common cause of myocarditis?
Viral
58
What can myocarditis impair?
Myocardial function Conduction Generate arrhythmia
59
What can be said about the cause of myocarditis?
Long list, often not found dispite investigations
60
What is the pathology of myocarditis?
Infiltration of inlammatory cells into the myocardial layers Causing reduced function and heart block as conduction system is involved, and arrhythmia
61
What are symptoms of myocarditis?
Heart failure Fatigue May not have fever Signs of heart failure
62
What investigations are done for myocarditis?
ECG usually abnormal Biomarkers often elevated Echocardiogram Chest MRI can see oedema Biopsy
63
What are general measures for myocarditis?
Supportive treatment of heart failure and support for brady and tachy arrhythmias Immunotherapy if biopsy suggests specific diagnosis Stop possible drugs or toxic agent exposure
64
What is the prognosis for myocarditis?
30% recover fully 20% mortality at 1 year 55% mortality by 4 years At 11 years those till alive are 90% transplant free
65
What is the pericardium?
Reflected lining over the epicardium, inner portion of the exterior sac around the heart and proximal great vessels
66
What are examples of pericardial diseases?
Pericarditis Pericardial effusion Constructive pericarditis
67
What is pericarditis?
Inflammation of the pericardial layers with or without myocardial involvement
68
What is inflammation of the pericardial layers with or without myocardial involvement called?
Pericarditis
69
What are key causes of pericarditis?
Bacteria Post myocardial infarction Perforation Dissection of proximal aorta Neoplasia
70
What is a perforation?
Small hole
71
What are symptoms of pericarditis?
Chest pain with pleuritic and postual features (sitting forward usually improves it and lying back makes it worse) Fever
72
What are signs of pericarditis?
Raised temperature Look for JVP as if an effusion is present then it will be raised Low blood pressure Muffled heart sounds
73
What investigations are done for pericarditis?
ECG ECHO Blood tests
74
What could blood tests for pericarditis reveal?
Troponin raised if myocardial involvement
75
What are general measures for pericarditis?
Viral is conversative Idiopathic gets colchicine and limited use of NSAIDs Bacterial must be drained even if small effusion If large effusion is present then drain
76
What is pericardial effusion?
Accumulation of fluid in the pericardial cavity
77
What is an accumulation of fluid in the pericardial cavity called?
Pericardial effusion
78
What may a pericardial effusion be related to?
Forces involved in blood circulation
79
What are some symptoms of pericardial effusion?
Overt (plainly apparent) Fatigue Shortness of breath Dizzy with low blood pressure Occasionally chest pain
80
What are signs of pericardial effusion?
Overt Pulsus paradoxus JVP raised Low blood pressure Maybe or maybe not muffled heart sound Pulmonary oedema is very rare
81
What does overt mean?
Obvious
82
What is pulsus paradoxus?
Abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration
83
What is an abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration called?
Pulsus paradoxus
84
What investigations are done for pericardial effusion?
Urgent echocardiogram Chest X-ray (can show large cardiac shadow) Blood tests
85
What is the treatment of pericardial effusion?
Drainage Persistent effusion needs surgical pericardial window to allow flow to abnomen
86
What is constructive pericarditis?
Thickened, fibrotic pericardium limiting the hearts ability to function normally
87
What is a thickened, fibrotic pericardium limiting the hearts ability to function normally called?
Constructive pericarditis
88
What are some of the causes of constructive pericarditis?
Idiopathic Radiation Post-surgery Autoimmune Renal failure Sarcoid
89
What are some symptoms for constructive pericarditis?
Fatigue Shortness of breath Cough Signs of right heart failure with oedema High JVP Jaundice Hepatomegaly Atrial fibrillation Pleural effusion
90
What investigations are done for constructive pericarditis?
Echocardiogram
91
What is the treatment of constructive pericarditis?
Careful and limited diuretics Pericardectomy
92
What is a pericardectomy?
Surgical removal of a portion or all of the pericardium
93
What is surgical removal of a portion or all of the pericardium called?
Pericardectomy

cardiovascular system (41 decks)

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