Cardiomyopathy - Restrictive and Infiltrative Flashcards
What does restrictive CM affect?
The filling capacity as it affects the myocyte relaxation ability
Systolic function may or may not be impaired
Aetiology of non infiltrative RCM?
Hypertrophic cardiomyopathy
Can be familial
Scleroderma
Diabetic pseduo-xanthoma elasticum
Aetiology of infiltrative RCM?
Amyloidosis
Sarcoidosis
Other aetiologies?
Haemochromatosis Fabry disease Fibrosis Carcinoid Radiation Drug effects
Pathology of RCM? What is happening?
Ventricles doesn’t fill as the wall has reduced compliance
Relaxation of ventricular wall is an active process and needs functioning healthy myocytes - if these are damaged compliance is losy
What investigations can be done?
ECG CxR Bloods/BNP Echos Cardiac MRI
What is the ECG looking for?
Left bundle branch block
What BNP a mark of?
Heart failure
What else is looked for in bloods?
FBC
Us and Es
Sarcoidosis and haemochromatosis
Autoantibosies for sclerotic CT diseases
If amyloidosis is suspected as a cause - what investigation can be done?
Non cardiac biopsy
If fabry’s is suspected as a cause - what investigation can be done?
Low plasma alpha galactosidease A activity will show if its fabrys
Treatment of RCM?
Treat the underlying cause if it is reversible Limited diuretic use Beta blockers with ACEIs Anticoagulants as needed ICDs/Pacemakers Transplants
Why is diuretic use kept to a minimum?
Low filling pressures can cause problems
