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MRCP Cardiology > Diseases of Heart Muscle > Flashcards

Diseases of Heart Muscle Flashcards

1
Q

Name at least 3 causes of MYOCARDITIS

A

idiopathic (50%)
Viral
bacterial
Spirochaetes
Protozoa
Drugs
Toxins (cocaine/lithium)
Immune reaction (SLE, sarcoid, kawasaki)

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2
Q

Give examples of viruses which could cause myocarditis

A

Enteroviruses
Adenoviruses
EBV
CMV
Influenza
Hepatitis
Mumps
Polio
HIV
HSV

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3
Q

What bacteria can cause myocarditis?

A

Staph
Strep
Clostridia
Diphtheria
TB
Meningococcus
Mycoplasma

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4
Q

What drugs can be responsible for myocarditis?

A

Cyclophosphamide
Chloramphenicol
Methyldopa

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5
Q

ECG findings in myocarditis

A

ST changes
TWI
Atrial arrhythmias
Transient AV block
QT prolongation

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6
Q

What bloods should you order if querying myocarditis?

A

Troponin
CRP
Viral serology

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7
Q

Treatment of myocarditis

A

Supportive management
Tx underlying cause (e.g. Abx if bacterial infection)
Tx arryhthmias/ HF as normal
NSAIDs for pain

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8
Q

Dilated cardiomyopathy is associated with…

A

Alcohol
Hypertension
Chemotherapy
Haemochromatosis
Viral infections
Autoimmune conditions
Peri/Postpartum
Thyrotoxicosis
Congenital (X-Linked)

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9
Q

Symptoms of dilated cardiomyopathy

A

SOB
Fatigue
Pulmonary Oedema
RV failure
Emboli
AF
VT

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10
Q

Signs of cardiomyopathy on examination

A

high HR
raised JVP
low BP
displaced apex beat
S3 gallop
MR/TR
pleural effusion
oedema
jaundice
hepatomegaly
ascites

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11
Q

Dilated cardiomyopathy findings on CXR

A

Cardiomegaly
pulmonary oedema

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12
Q

Dilated cardiomyopathy findings on ECG

A

tachycardia
non-specific T wave changes
Poor R wave progression

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13
Q

Dilated cardiomyopathy findings on ECHO

A

globally dilated heart
hypokinetic
low EF%
MR/TR
Left mural thrombus

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14
Q

Treatment of dilated cardiomyopathy

A

Bed rest
Diuretics for HF symptoms
Beta blockers
ACEi
anticoagulation
Biventricular pacing/ICD
Transplant (prognosis 40% in 2 years)

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15
Q

Definition of Hypertrophic cardiomyopathy

A

Left ventricular outflow tract obstruction due to asymmetrical hypertrophy of heart septum
=> often leads to sudden cardiac death

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16
Q

How is hypertrophic cardiomyopathy inherited

A

Autosomal dominant
(but 50% are sporadic mutations)

17
Q

Genes affected in hypertrophic cardiomyopathy

A

Beta-myosin
Alpha-Tropomyosin
Troponin T

18
Q

Symptoms of hypertrophic cardiomyopathy

A

note some patients may be asymptomatic and present with sudden cardiac death

Angina/chest pain
SOB
Palpitations
Syncope
CCF

19
Q

Signs of hypertrophic cardiomyopathy

A

Jerky pulse
raised JVP
double apex beat
systolic thrill, lower left sternal edge
harsh ejection systolic murmur

20
Q

ECG changes in hypertrophic cardiomyopathy

A

LVH
TWI
q waves in inferior/lateral leads
AF, WPW
Ectopics
VT

21
Q

Findings on ECHO in hypertrophic cardiomyopathy

A

Asymmetrical septal hypertrophy
Small LV cavity
Hypercontractile posterior wall

22
Q

Treatment for hypertrophic cardiomyopathy

A

Beta blockers/verapamil for symptoms
Aim to REDUCE ventricular contractility
Amiodarone if arryhthmias
Anticoagulation if AF/emboli
Surgery - septal myomectomy (if severe symptoms)
Consider ICD

23
Q

Causes of restrictive cardiomyopathy

A

idiopathic
amyloidosis
haemochromatosis
sarcoid
scleroderma
fibrosis

24
Q

How do patients present with restrictive cardiomyopathy

A

Similar to constrictive pericarditis
RV failure
- raised JVP
- hepatomegaly
- oedema
- ascites

25
Q

What investigations can be used to diagnose restrictive cardiomyopathy

A

ECHO
MRI
Cardiac catheterisation

26
Q

What is the name given to a benign cardiac tumour?

A

Cardiac myxoma

27
Q

Females are two times as likely as males to develop cardiac myxoma. TRUE/FALSE

A

TRUE
2:1 females to males

28
Q

How are cardiac myxomas usually inherited?

A

Sporadic
Familial - “Carney Complex”(cardiac/cutaneous myxomas)

29
Q

Presentation of cardiac myxoma

A

Fever
Weight loss
clubbing
Raised CRP
Systemic emboli
LA obstruction
AF

30
Q

What sound may be audible on examination of a patient with cardiac myxoma?

A

Tumour “plop”

31
Q

How is cardiac myxoma managed?

A

Excision

MRCP Cardiology (10 decks)

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