Heart muscle diseases Flashcards
what is the possible aetiology of dilated cardiomyopathy?
often idiopathic
alcohol, endocrine disorders, genetic (gene mutations), inflammation, infection, trauma
what are the possible signs of dilated cardiomyopathy?
same as heart failure: raised JVP murmur (MR) peripheral/sacral/pulmonary oedema pleural effusion peripheral cyanosis hepatomegaly displaced apex beat
what are some possible symptoms of dilated cardiomyopathy?
same as heart failure: SoB/orthopnea/PND chest pain exertional fatigue cough ankle swelling
what are possible investigations for dilated cardiomyopathy?
bloods (FBC, U&E, CRP, BNP) ECG CXR echo MRI (ideally) CT angiogram
what are the non-pharmacological treatments of dilated cardiomyopathy?
weight loss
exercise
diet
salt and water intake
what are the pharmacological treatment options for dilated cardiomyopathy?
erythropoietin if anaemic
treat underlying cause (endocrine, alcoholism etc)
ACEi/ARB, beta blockers, spironolactone
Anticoagulants
What is the aetiology if restrictive and infiltrative cardiomyopathy?
Half the time due to other diseases, otherwise unknown
What investigations should be done for restrictive/infiltrative cardiomyopathy?
Bloods (FBC, CRP, U&E) ECG CXR Echo MRI ideally
What are the treatments for restrictive cardiomyopathy?
Limited
Anticoagulants
Heart transplant
What is the aetiology of hypertrophic cardiomyopathy?
Can be caused by diseases causing hypertrophy, genetic abnormalities, or idiopathic
What is the pathology of hypertrophic cardiomyopathy?
Disarray of myocytes, impaired relaxation on diastole
What are the signs of hypertrophic cardiomyopathy?
Can be none
May be raised JVP, irregular pulse, double apex beat
What are the symptoms of hypertrophic cardiomyopathy?
Can cause sudden cardiac death
Can have no symptoms
Fatigue, SoB (on exertion), palpitations
Left ventricular outflow obstruction
What are the non-pharmacological and pharmacological measures for hypertrophic cardiomyopathy?
Nonpharmacology:
Light exercise, avoid dehydration, genetic testing
Pharmacology: drugs to aid relaxation (beta blockers, vasodilating CCB’s)
internal defibrillator
Anticoagulants
What investigations can be done for hypertrophic cardiomyopathy?
Bloods
ECG
Echo
MRI
What can be some causes of myocarditis?
Virus Bacteria Toxins Autoimmune Inflammation
What are some symptoms of myocarditis?
Heart failure symptoms
SoB
Chest pain
Fatigue
What are some investigations for myocarditis?
Bloods (biomarkers, troponin)
ECG
Echo
MRI
What is the difference between troponin levels with MI and with myocarditis?
MI - troponin levels rise then fall
Myocarditis - troponin levels stay high
What treatment options are available for myocarditis?
Supportive treatment, relieve symptoms
Treat underlying cause
Immunotherapy
What is PR depression on an ECG specific for?
Pericarditis
What is pericarditis and what is it caused by?
Inflammation of only pericardium
Can be bacterial, viral, post MI, cancer, dissection
What are symptoms of pericarditis?
Fever
Specific pericardial pain
What are some signs of pericarditis?
Potentially raised JVP
Pericardial rub
Low blood pressure
Muffled heart sounds
What investigations should be done for pericarditis?
ECG
Bloods (troponin)
Echo
What is the treatment of pericarditis?
Viral - conservative treatment
Bacterial - antibiotics, but high mortality
Idiopathic - colchicine + NSAIDs
Drain if necessary
What are some signs and symptoms of pericardial effusion?
Often same as pericarditis:
Fatigue, SoB, cough, raised JVP, low BP
What are the investigations of pericardial effusion?
ECG
Echo
What are some signs of constrictive pericarditis?
Cough
SoB
Right heart failure
What are some investigations for constrictive pericarditis?
Cardiac catheter
Echo
What are possible causes of constrictive pericarditis?
It’s rare, normally idiopathic
Post surgery, radiation, autoimmune
