Cardiomyopathy/obstructive sleep apnea (exam 2) Flashcards
Describe what dilated cardiomyopathy is, the dysfunction it causes, ejection fraction and ventricle size
Heart becomes weakened/chambers become enlarged so can’t pump enough blood to body
Dysfunction: primarily systolic
EF: <30%
Ventricle size: Enlarged
Note: ejection fraction may improve over time with appropriate treatment
Describe what hypertrophic cardiomyopathy is, the dysfunction it causes, ejection fraction and ventricle size
Hypertrophy (thickening) of the left ventricle
Dysfunction: primarily diastolic
EF: >60% (high percentage/low volume)
Ventricle size: left ventricle and septum thickened, but volume decreased
Describe what restrictive cardiomyopathy is, the dysfunction it causes, ejection faction, and ventricle size
Changes in and weakening of the heart muscle, which causes the heart to fill poorly, squeeze poorly, or both
Dysfunction: Diastolic and systolic
EF: decreased 25-50%
Ventricle size: Left ventricular internal dimension decreased
Signs and sxs of dilated cardiomyopathy? Risks to be aware of?
- Non-specific ischemic chest pain
- Syncope (arrhythmias, emboli)
- Symptoms of heart failure (DOE or at rest, PND, orthopnea, peripheral edema)
- Risks: Ventricular tachyarrhythmias and sudden death
Physical exam findings of dilated cardiomyopathy?
- Cardiomegaly (PMI shift, LV lift)
- Signs of left-sided HF (rales, wheezes)
- Signs of right-sided HF (edema, hepatojugular reflex)
Signs and sxs of hypertrophic cardiomyopathy? Risks to be aware of?
- Dyspnea on exertion
- Chest pain
- Syncope while exercising (especially be aware of for athletes)
- Risks: ventricular tachyarrhythmias and a-fib; sudden death in athletes
Physical exam findings for hypertrophic cardiomyopathy?
- Prominent left ventricular impulse
- S4 gallup
- Murmur along left sternal border (decrease on inspiration and increase on expiration; increase when go from squatting to standing and with valsalva)
Physical exam findings for restrictive cardiomyopathy?
- May be normal
- May see signs of left sided HF
- May see A-fib
What is systolic dysfunction? Which cardiomyopathy does this primarily apply to?
- Systolic dysfunction is the inability of the heart to contract strongly enough to supply blood to the periphery.
- Primary abnormality with dilated cardiomyopathy
What is diastolic dysfunction? Which cardiomyopathy does this primarily apply to?
- Abnormal relaxation of the myocardium and reduced filling of the ventricle
- Hypertrophic or restrictive cardiomyopathy
Tx for dilated cardiomyopathy
- Eval etiology
- Treat underlying disease
- Treat HF
- Treat arrhythmias and conduction disturbances
- Prevent thromboembolic complications
First line tx for hypertrophic cardiomyopathy
- Beta blockers initially (slow heart, allow for better ventricular filling)
- Treat for HF
- Rate control and anticoagulation if a-fib occurs
- Anti-arrhytmics or implantable defibrillators (EF 30% or less) because of risk for sudden death
Tx for restrictive cardiomyopathy
- Treat for HF
- Treat for arrhythmias
Which type of cardiomyopathy is most common?
Dilated
What is the common pathway the cardiomyopathies all lead to?
Heart failure
