Malozzi- Cardiomyopathies Flashcards
disease of the heart muscle
cardiomyopathy
2 main types of cardiomyopathy (clinically)
ischemic
nonischemic
most common type of cardiomyopathy
ischemic cardiomyopathy
presents w/:
exercise intolerance
dyspnea on exertion
fluid retention
sob when lying down
increased HR
cardiomyopathy
most patients with this cardiomyopathy present with acute MI or longstanding coronary atherosclerosis
ischemic cardiomyopathy
L coronary a. system (w/ stenosis)
R coronary a. system (w/ stenosis)
the degree of coronary artery disease has to match degree of cardiac _______ to label it ischemic cardiomyopathy
dysfunction
if EF is 20% and LAD occlusion is 30% (not restricting blood flow), yes you have CAD, but it is not what
not the cause of cardiac dysfunction
3 main causes of dilated cardiomyopathy
genetic, acquired, mixed
inflammatory process affecting myocardium and weakening pump function
myocarditis
patient presents w/ flu-like sx’s and acute HF
Myocarditis
most common cause of myocarditis
coxsackie B virus
this often leads to thin RV due to dilatation (was told this in lab)
myocarditis
pt presents w/ HF over a few days/wks
acute myocarditis
pt presents w/ fever, myalgia, upper respiratory sx’s and chest pain and dyspnea
acute myocarditis
Rx acute myocarditis
supportive (virus)
HF treatment
rapidly progressive form of myocarditis accompanied by ventricular arrhythmias
Giant Cell myocarditis
occurs in people <40 yrs
treatment doesn’t help
giant cell myocarditis
best thing to do for patient w/ giant cell myocarditis
heart transplant
3 main causes of toxic cardiomyopathy
long term alcohol use
long term cocaine use
cancer therapy
what can cause tachycardia-induced cardiomyopathy
AFib or PVC’s (any SVT’s); LV dysfunction
to Rx tachycardia-induced cardiomyopathy
get pt. back to sinus rhythm and control HR
cardiomyopathy caused by anatomic myocardial abnormality due to arrest of embryogenesis of ventricular myocardium
LV non-compaction cardiomyopathy
this causes increase in wall thickness and decrease in LV function
LV non-compaction cardiomyopathy
LV non-compaction cardiomyopathy
pathologic hallmark of LV non-compaction cardiomyopathy
deep trabeculations in LV
Takotsubo (stress cardiomyopathy)
Takotsubo (stress cardiomyopathy)
most common cause of sudden death in young people/athletes
hypertrophic cardiomyopathy
presents w/ unexplained LV wall thickness
hypertrophic cardiomyopathy
caused by mutations in myosin heavy chain (AD)
hypertrophic cardiomyopathy
hypertrophic cardiomyopathy
ventricular septal thickness
hypertrophic cardiomyopathy
hypertrophic cardiomyopathy
ventricular arrhythmias can lead to what 2 things
syncope
sudden death
left ventricular hypertrophy causes impaired diastolic filling and _____ LVEDP
increases LVEDP
an increase in LVEDP and mitral regurgitation can cause what symptom
dyspnea
how does mitral regurgitation and elevated LVEDP cause dyspnea
elevated pulmonary venous pressure in lungs
dynamic LV outflow obstruction leads to failure to increase CO w/ exertion leading to
syncope
increased LVEDP and increased wall thickness makes it more difficult to supply what with blood
endocardium
what increases hypertrophic cardiomyopathy murmur
standing/valsalva
what increases aortic stenosis murmur
squatting
these drugs function to slow everything down, increase diastolic filling and reduce obstruction
beta blockers
best Rx for LV outflow obstruction (hypertrophic cardiomyopathy)
beta blockers
low preload
low afterload
tachycardia
seen in what
worsening LVOT obstruction
2 main causes of restrictive cardiomyopathy
amyloidosis
sarcoidosis
what happens in restrictive cardiomyopathy to ventricle (and during diastole)
becomes stiff and can’t fill fully during diastole
cause of restrictive cardiomyopathy due to deposition of beta pleated sheets made of misfolded proteins deposited into myocardium
Amyloidosis
what is the paradoxical finding of amyloidosis restrictive cardiomyopathy
echo shows LVH
EKG doesn’t show LVH; we see lowww voltage
restrictive cardiomyopathy: amyloidosis
deals with myocardium; increased wall thickness
restrictive cardiomyopathy
deals with external factors; normal wall thickness
constrictive pericarditis
pregnant patient who suddenly develops HF symptoms (sob, lower extremity edema) with no identifiable cause
peripartum cardiomyopathy
to Rx peripartum cardiomyopathy
HF drugs (NOT ACEIs/ARBs)
_______correlates with EF in peripartum cardiomyopathy
survival
