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CVS > Heart Muscle Diseases > Flashcards

Heart Muscle Diseases Flashcards

1
Q

What happens during dilated cardiomyopathy ?

A

Heart becomes dilated

- all four chambers can be affected but left ventricle is most affected

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2
Q

Is diastole or systole affected with dilated cardiomyopathy?

A

systole

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3
Q

What is the difference between primary and secondary dilated cardiomyopathy?

A

primary - no previous condition which could have caused the dilation

secondary - another condition had caused the dilation

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4
Q

Name some secondary causes for dilated cardiomyopathy

A

Genetics
autoimmune, inflammatory or infectious disease
toxic exposure: drugs, chemicals
injury: cell loss

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5
Q

Is the risk of thrombosis increased or decreased with dilated cardiomyopathy

A

increased as the blood flow is more stagnant as the blood is not being pumped effectively out of the heart

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6
Q

What secondary conditions can be treated to decrease the extent of dilation of the heart?

A
  • post pregnancy
  • sarcoid
  • endocrine
  • alcohol intake
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7
Q

Is the onset of symptoms slow or fast with dilated cardiomyopathy?

A

slow (can take months)

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8
Q

What symptoms do people with dilated cardiomyopathy have?

A
  • fatigue
  • orthopnoea - SOB when lying
  • ankle swelling
  • fluid overload
  • cough
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9
Q

What clinical signs may be seen with dilated cardiomyopathy?

8 signs

A 
Peripheral cyanosis 
Severe SOB 
Displaced apex beat 
Elevated JVP
MR murmur 
Pulmonary oedema 
Sacral oedema 
Enlarged liver
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10
Q

What investigations would be done for dilated cardiomyopathy?

A 
CXR - Pulmonary oedema 
Bloods - FBC, U+Es
Regular ECG 
Echo 
Coronary angiogram 
CMRI
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11
Q

What 4 drugs should be given as treatment?

A

B blockers - decrease contractibility of the heart
ACEI - decrease BP
Anticoagulants - blood thinner to reduce risk of thrombosis
Spironolactone - a steroid drug which promotes sodium excretion

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12
Q

What drug makes dilated cardiomyopathy worse?

A

NSAIDS

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13
Q

What other treatment/management should be done to treat the dilated heart?

A
  • manage body weight
  • watch diet (fluid and salt intake)
  • nurse referral
  • correct anaemia (if present)
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14
Q

What occurs during Restrictive and infiltration cardiomyopathy ?

A

Filling process of the heart is abnormal

Heart chambers are not compliant and don’t stretch as they should so pre load is reduced.

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15
Q

Is Restrictive and infiltration cardiomyopathy common or uncommon?

A

uncommon

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16
Q

Name some infiltrative and and non-infiltrative causes for restrictive cardiomyopathy

A

Non infiltrative = Familiar, scleroderma, diabetic

Infiltrative = Amyloid, sarcoid

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17
Q

What investigations should be done for restrictive cardiomyopathy?

A 
Repeated ECG 
Bloods - FBC, U+Es 
CXR 
Echo 
CMRI
Sclerotic – auto antibodies detection 
Biopsy
18
Q

what drugs should not be used in restrictive cardiomyopathy ? and why?

A

ACEI
B blockers
Diuretics

they would reduce the BP which would increase the problem of low cardiac output

19
Q

Which drug should be given during restrictive cardiomyopathy ?

A

Anticoagulant

20
Q

Is prognosis better or worse than dilated cardiomyopathy?

A

worse

21
Q

Is hypertrophic cardiomyopathy common or uncommon?

A

very common

22
Q

In hypertrophy are the myocytes organised or unorganised?

A

unorganised (not lined up properly )

- reduces contractibility efficiency

23
Q

Is diastole or systole affected during restrictive cardiopathy?

A

diastole

24
Q

Is diastole or systole affected during hypertrophy cardiopathy?

A

diastole as the walls have been thickened so less blood can fill up the heart chamber

25
Q

Does hypertrophic heart disease run in families?

A

yes

26
Q

What differences would be seen if the apex OR septal was hypertrophied?

A

APEX - function not affected as much

SEPTAL - valves can be affected and led to left ventricle outflow track (LVOT) obstruction

27
Q

Can coronary arteries be affected during hypertrophy?

A

yes which can lead to ischaemia and infarction

28
Q

What symptoms can a patient with hypertrophy have?

A
  • mostly asymptomatic
  • fatigue, angina like chest pain, pre syncope (on excretion)
  • If no obstruction and have hypertrophy (abnormal myoctyes can cause AF which is a common reason for people to be syncope even when there is no obstruction)
  • Irregular pulse
  • Notched pulse pattern
  • Double impulse of apex
29
Q

What investigations would be done for hypertrophy?

A 
ECG 
Echo 
ETT 
CMRI 
MRI

have to assess sudden cardiac death risk as the patient mat require a ICD (implantable cardioverter-defibrillator)

30
Q

Is myocarditis common or uncommon?

A

very rare

31
Q

What are five causes of myocarditis?

A
  • Viral
  • Bacteria
  • Toxins
  • Medications
  • Fungi
32
Q

What four things happen if the myocarditis if left a long period of time without treatment?

A
  • inflammatory response
  • lose of functional myocytes
  • results in heart failure
  • 3rd degree heart block and tachycardia
33
Q

What symptoms would someone with myocarditis have?

A
  • fever
  • flu like symptoms
  • last a couple of weeks
  • signs of heart failure
34
Q

What investigations would be done for myocarditis

A
  • ECG
  • Echo
  • Bloods (biomarkers - troponin)
  • Viral DNA PCR
  • Strep and auto antibodies
  • HIV test
  • CMRI
35
Q

What is the treatment for myocarditis ?

A
  • ACEI, B blockers, diuretics
  • Immunotherapy
  • Treat heart failure
36
Q

What % fully recover from myocarditis?

A

30%

37
Q

What % die within the 1st year?

A

20%

38
Q

What are the symptoms of pericarditis ?

A
  • Short course (1-2 weeks)
  • chest pain on inspiration
  • postural (sitting forward makes it better)
  • fever
39
Q

What three investigations should be done for pericarditis?

A
  • Troponin - may not show MI but may be a secondary cause
  • ECG - ST elevation, PR depression
  • Echo
40
Q

What are the clinical signs of pericarditis?

5 signs

A
  • pyrexic
  • low BP
  • raised JVP
  • patient will be sitting forward
  • muffled heart sounds (like walking on snow)

CVS (20 decks)

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