L33 Flashcards
What is cardiomyopathy
Dysfxn of myocardium
5 types of cardiomyopathies
- Dilated
- Hypertrophic
- Restrictive
What does dilated CM look like
Dilated LA & LV
Thickness can be normal - cavity larger
Dilation causes
Is dilated CM systolic or diastolic pathology
Systolic
Dilated means don’t get the same contraction
Causes of dilated CM
Genetics Post-myocarditis Alcohol Pregnancy Hemochromatosis (iron overload)
What disease results from dilated CM?
CHF
What drug could give you dilated CM
Doxorubicin (chemo)
2ary findings/concerns/patho for dilated CM
- Tricuspid and mitral regurg due to ventricular dilation
2. Thrombi
What histo changes do you see with arrhythmogenic RV CM?
Fibrofatty
What genetic mutation is common for hypertrophic CM
B myosin heavy chain
Is hypertrophic CM a disease of systole or diastole
Diastole - duh, hypertrophic ventricle so doesn’t relax - doesn’t fill correctly
What does hypertrophic CM look like?
Thick LV
Dilated LA
+/- outflow obstruction
Treat hypertrophic CM
BBs
Ca CBs
Hypertrophic CM histo
Myofiber disarray
3 causes of restrictive CM
Idiopathic
Amyloid
Endocardial fibrosis
What does restrictive CM look like?
Ventricles normal
Both atrial dilated
Is restricted CM a disease of systole or diastole
Stiff ventricle - no change in size of gross appearance
Restricted motion - can’t relax fully - impaired filling
DIASTOLIC problem
What are the 3 types of amyloid that could cause restrictive CM
AL - light chain amyloids
AA
AS - transthyretin
What do you see grossly with amyloid restrictive CM
Waxy lining of endocardium (inner most layer)
Esp at atrium
Can you ID cardiac amyloid histo?
GO LOOK IT UP
Test Q
Normal or reduced EF & CO for dilated, hypertrophy and restrictive CM
ALL low CO = CM
Dialted = low EF
Hyper & restrictive = normal EF
What is Loffler endocarditis? What CM can it cause?
Eosinophil infiltrate –> thrombosis –> scar –> restricted CM
Treat Loffler endocarditis restricted CM
Steroids
Most common cause of myocarditis
VIRAL
- Cox B
- Adeno
What pts get viral myocarditis? What does the heart look like?
Kids and teens
Flabby, DILATED heart w/ T cell infiltrate on histo
Aka LYMPHOCYTE infiltrate
Pathogensis for viral myocarditis - what type of CM can result (treat)
Viral infection - virus particles attach to heart receptors Infection cleared Immune attacks viral particles on heart Recover totally - or DILATED CM Treat like dilated CM - ACE I - BBs
What does HST myocarditis look like on histo?
EOSINOPHILIC infiltrate
- 2 lobes, bright RED granules
What should you look for on histo for giant cell myocarditis
Giant cell = macrophage w/ multiple nuclei
