Cardiomypathy

Question 1

Symptoms of cardiomyopathies

Answer 1

Dilated: fatigue, dyspniae, pulmonary oedema symptoms, RVF symptoms, Emboli, AF, VT

Hypertrophic-Sudden death can be first sign of HCM, angina, dyspnoa, palpitation, syncope, CCF,

Restrictive-like constrictive pericarditis -These are mainly of right heart failure with raised JVP (, peripheral effusion, orthopnea, hypertension, bloating, ascites, hepatosplenomegaly)

Question 2

Signs of cardiomyopathy

Answer 2

Dilated-pulse high, JVP high, Low BP, displaced apex, s3 gallop, mitrial/tricuspid regurg, pleural effusion, jaundice, hepatomegaly, ascites

Hypertrophic-sudden death. Jerky pulse. double apex beat, systolic thrill at left sternal edge, ejection systolic murmur

Restrictive-raised JVP, hepatomegaly, oedema, ascites, quiet heart sounds, S3,

Question 3

test for cardiomypathy

Answer 3

Dilated-Bloods-BNP high (low Na is worse prognosis for CCF)
CXR-cardiomegaly, pulm oedema
ECG-tachycardia, poor R wave progression
Echo-dilated hypokinetic heart

Hypertrophic-ECG-LVH, progressie T wave inversion, deep q waves,
AF, WPW, WT
Echo-asymetrical septal hypertrophy, small LV, MITRIAL REGURG

Restrictive-diagnose with cardiac catheterisation
CXR-small heart

Question 4

Management and features of HOCM

Answer 4

Leading cause of sudden cardiac death in young athletes
Usually due to a mutation in the gene encoding β-myosin heavy chain protein
Common cause of sudden death
Echo findings include MR, systolic anterior motion (SAM) of the anterior mitral valve and asymmetric septal hypertrophy

Question 5

Management of dilated cardiomyopathy

Answer 5

idiopathic: the most common cause, then genetic, alcohol
duchennes
general-(mixed genetic/other)

dilated heart leading to predominately systolic dysfunction- all 4 dilated tho

classic findings of heart failure
systolic murmur: stretching of the valves may result in mitral and tricuspid regurgitation
S3

ECHO to diagnose–
HF sx- furosemid, stand up etc

Question 6

Management of Restictive cardiomyopathy

Answer 6

Mixed genetic
Classic causes include
amyloidosis
post-radiotherapy
Loeffler’s endocarditis

Question 7

Takutsubo (everything)

Answer 7

Acquired cardiomyopathy

Stress’-induced cardiomyopathy e.g. patient just found out family member dies then develops chest pain and features of heart failure
Transient, apical ballooning of the myocardium
Treatment is supportive