Myocardial Disease

Question 1

what is myocarditis

Answer 1

inflammation of the myocardium

Question 2

what causes myocarditis

Answer 2

50% are idiopathic
viral - coxackie, parvovirus B19
bacterial - TB
immune - SLE, GCA, sarcoidosis

Question 3

symptoms of myocarditis

Answer 3

flu like prodrome – sore throat, fever, myalgia

SOB, chest pain, palpitations

Question 4

signs of myocarditis

Answer 4

tachycardia
S4 gallop rhythm
soft S1

Question 5

ECG changes in myocarditis

Answer 5

ST elevation or depression
T wave inversion
AV block

Question 6

blood results in myocarditis

Answer 6

+Ve Troponin

raised ESR, CRP

Question 7

Tx myocarditis

Answer 7

supportive

treat underlying cause

Question 8

what is the most common cardiomyopathy

Answer 8

dilated cardiomyopathy

Question 9

causes of dilated cardiomyopathy

Answer 9

majority are idiopathic 
familial 
IHD/HTN
viral 
alcohol / drug abuse

Question 10

features of dilated cardiomyopathy

Answer 10

dilated chambers
tachycardia, hypotension
S3, mitral / tricuspid regurgitation
increased JVP

Question 11

appearance of heart in dilated cardiomyopathy on CXR

Answer 11

balloon heart

Question 12

management of dilated cardiomyopathy

Answer 12

as for HF

• ACEI + beta blockers
• loop diuretics

Question 13

what is the inheritance of hypertrophic obstructive cariomyopathy

Answer 13

autosomal dominant

Question 14

leading cause of sudden death in young, healthy patients

Answer 14

hypertrophic obstructive cardiomyopathy

Question 15

signs and symptoms of hypertrophic obstructive cardiomyopathy

Answer 15

SOB, syncope, palpitations - typically following exercise 
jerky pulse
double apex beat
ejection systolic murmur
ECG -LVH, deep Q waves

Question 16

management options of hypertrophic obstructive myopathy

Answer 16

Amiodarone
Beta blocker
- symptomatic relief

Cardioverter defibrillator
Dual chamber pacemaker
- for arrhythmias / high risk of sudden cardiac death

Question 17

what is takotsubo cardiomyopathy

Answer 17

stress cardiomyopathy - aka ‘broken heart syndrome’

• transient left ventricular dysfunction: “ballooning of heart”
• ‘octopus heart’ appearance
• ST elevation that resolves

Question 18

what is an atrial myxoma

Answer 18

most common primary cardiac tumour

Question 19

signs and symptoms of atrial myxoma

Answer 19

SOB, fatigue, weight loss, clubbing, fatigue

murmur: mid diastolic plop