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Y4 - Medicine - Cardiology > Dilated Cardiomyopathy > Flashcards

Dilated Cardiomyopathy Flashcards

1
Q

ESSENCE

A

Cardiomyopathy characterised by cardiac chamber dilation and systolic dysfunction

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2
Q

EPIDEMIOLOGY

What is most common kind of cardiomyopathy

A

Dilated cardiomyopathy (90%)

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3
Q

AETIOLOGY

Causes

A
  • Stress
    • Takutsubo cardiomyopathy (broken heart syndrome)
  • Toxins
    • Alcohol
    • Cocaine
    • Cobalt
    • Duxorubicin
  • Infectious
    • Coxsacki B viral myocarditis
    • Chagas disease
  • Hereditary
    • Muscular dystrophies
    • Familial
  • Sarcoidosis
  • Haemochromatosis
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4
Q

AETIOLOGY

Infectious causes

A

Coxsacki B viral myocarditis

Chagas disease

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5
Q

PATHOGENESIS

A

Dilated cardiac chambers causes decreased contractility and decreased ejection fraction leading to systolic dysfunction

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6
Q

PROGNOSIS

Death

A

50% within 2 years from heart failure or arrhythmia

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7
Q

CLINICAL FEATURES

Symptoms

A
  • Progressive heart failure
    • Dyspnoea on exertion
    • Orthopnea
    • Paroxysmal nocturnal dyspnea
    • Fatigue
    • Pulmonary oedema
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8
Q

CLINICAL FEATURES

Signs

A
  • Cardiac
    • S3 sound
    • Systolic regurgitant murmur
  • Ascites
  • Jugular venous distension
  • Pulmonary rales
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9
Q

INVESTIGATIONS

Imaging

A
  • Radiography - all patients
  • ECHO - all patients, assess ejection fraction
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10
Q

Radiography findings

A
  • Heart looks like balloon
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11
Q

ECHO findings

A
  • Dilated ventricles
  • Reduced ejection fraction
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12
Q

INVESTIGATIONS

Studies

A

ECG

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13
Q

ECG findings

A
  • May have bundle branch block
  • May have widened QRS complex
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14
Q

INVESTIGATIONS

Making diagnosis

A

Based on clinical presentation and ECHO

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15
Q

MANAGEMENT

Approach

A
  • Drugs that lover mortality
    • Angiotensin converting enzyme inhibitors or angiotensin receptor blockers
    • B-blockers
    • Spironolactone or eplernone
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16
Q

MANAGEMENT

Conservative options

A

Cessation of alcohol

17
Q

MANAGEMENT

Medical options

A
  • Indication - for all patients
    • ACE inhibitors
    • B blockers
    • Spironolactone
18
Q

Most used beta blockers to reduce mortality

A
  • Metoprolol
  • Carvedilol
  • Bisoprolol
19
Q

MANAGEMENT

Surgical options

A
  • Automatic implantable cardioverter/defibrillator (AICD)
  • Biventricular pacemaker
  • Heart transplant
20
Q

Indication for AICD

A

Ejection fraction <35%

21
Q

Indication for biventricular pacemaker

A

QRS > 120ms

22
Q

Indication for heart transplant

A

Only definitive treatment

23
Q

COMPLICATIONS

A
  • Heart failure
  • Thromboembolism

Y4 - Medicine - Cardiology (24 decks)

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