Ch 24 Flashcards
What is cardiomyopathy?
A series of progressive events in the cardiac muscle that results in impaired cardiac output; ‘disease of the heart muscle’ classified based on structural and functional abnormalities.
What is dilated cardiomyopathy (DCM)?
The most common form of cardiomyopathy characterized by significant dilation and thinning of the ventricles with systolic dysfunction.
What are the characteristics of dilated cardiomyopathy (DCM)?
Significant dilation and thinning of the ventricles, no hypertrophy, elevated volumes, and decreased ejection fraction (EF).
What is hypertrophic cardiomyopathy (HCM)?
A genetic disorder and leading cause of sudden death in adolescents and young adults, particularly athletes. Heart is thickened from blood not reaching the heart muscle.
What are the characteristics of hypertrophic cardiomyopathy (HCM)?
Increased heart muscle size and mass (increased thickness from scarring/fibrosis), especially along the septum, but can involve other areas of the heart. Heart is thickened from blood not reaching the heart muscle.
What is restrictive/constrictive cardiomyopathy (RCM)?
The least common type of cardiomyopathy characterized by diastolic dysfunction due to rigid ventricular walls. It becomes stiffened, not thickened.
What causes diastolic dysfunction in restrictive/constrictive cardiomyopathy (RCM)?
Rigid ventricular walls that impair diastolic filling and ventricular stretch.
What is unclassified cardiomyopathy?
Cardiomyopathy that does not fit into one of the above categories, such as Takotsubo.
What is the major electrolyte involved with cardiomyopathy?
Sodium
Sodium plays a critical role in heart function and electrolyte balance. Decreased stroke volume stimulates SNS and RAAS, resulting in increased systemic vascular resistance and increased sodium and fluid retention (from aldosterone)
What condition often leads to heart failure?
Cardiomyopathy
Cardiomyopathy refers to diseases of the heart muscle that can affect its size, shape, and thickness.
What develops in part from fluid overload?
Heart failure
Fluid overload can increase pressure in the heart and lungs, contributing to heart failure symptoms.
Fluid overload is often associated with elevated _______ intake.
sodium
High sodium intake can lead to increased fluid retention in the body.
What is a significant risk factor for hypertrophic cardiomyopathy?
Family History
A genetic predisposition is crucial for understanding this condition.
How does older age affect the risk of cardiomyopathy?
Increases the risk of structural heart changes
Name three pre-existing conditions that contribute to cardiomyopathy.
- Coronary artery disease (CAD)
- Hypertension (HTN)
- Myocardial infarction (MI)
What lifestyle factors are considered modifiable risks for cardiomyopathy?
- Smoking
- Alcohol use
- Illicit drug use
- Obesity
List some other conditions that can increase the risk of cardiomyopathy.
- Diabetes mellitus (DM)
- Infections
- Stress
- Pregnancy
What are the modifiable and non-modifiable risk factors for cardiomyopathy?
Modifiable: Smoking, alcohol abuse, illicit drug use, diabetes mellitus, obesity, infections, chronic stress
Non-modifiable: Family history, older age, pre-existing heart conditions
What is the significance of family history in cardiomyopathy?
A significant risk factor, particularly for hypertrophic cardiomyopathy, as it is often inherited.
What is pulsus paradoxus?
An exaggerated drop (>10 mmHg) in systolic blood pressure during inspiration.
In which conditions is pulsus paradoxus commonly observed?
- Severe cardiomyopathy
- Pericardial effusion leading to tamponade
- Other restrictive cardiac conditions
What are common symptoms to document in a medical history assessment for cardiomyopathy?
- Orthopnea
- Paroxysmal Nocturnal Dyspnea (PND)
- Chest Pain or Discomfort
- Fatigue
- Syncope
- Swelling (Edema)
What does orthopnea indicate?
Difficulty breathing when lying flat, indicating fluid buildup in the lungs due to heart failure.
What are key physical assessment components for cardiomyopathy?
- Weight Changes
- Blood Pressure Abnormalities
- Heart Sounds
- Jugular Venous Distention (JVD)