Myocarditis and Cardiomyopathy

Question 1

what is myocarditis?

who is mostly affected?

what are the most common infectious causes?

Answer 1

inflammation of myocardium with myocyte necrosis and degeneration

kids 1-10 y/o

1. mostly- cocksackie virus B
2. trypanosoma cruzi (chagas)
3. Borrelia burgdorferi
4. Corneybacterium diptheriae

Question 2

what are the non-infectious causes of myocarditis?

Answer 2

acute rheumatic fever

doxorubicin

SLE

Question 3

if infectious endocarditis is suspected, a bipsy is done, what do you find?

Answer 3

focal myocyte necrosis with lymphocyte infiltration

Question 4

what are the clinical findings in myocarditis?

Answer 4

• fever
• chest pain
• arrhytmia
• CHF signs

Question 5

what labs can we find in myocarditis?

Answer 5

increased troponins and CK-MB

imp. it is not due to infarction

Question 6

what is cardiomyopathy?

what are the causes of death due to a cardiomyopathy?

what are the 3 types of cardiomyopathy?

Answer 6

group of non-inflammatory diseases taht involve the myocardium and produce myocardial infarction.

arrhythmia or cardiac heart failure

dilated, hypertrophic and restrictive

Question 7

what characterizes dilated cardiomyopathy?

what can cause dilated or congestive cardiomyopathy?

Answer 7

4 chamber dilation resulting in systolic failure leading to CHF

1. alcholol toxicity
2. myocarditis by cocksackie B
3. post-partum

Question 8

if you have congestive (dilated) cardiomyopathy, what clinical findings will you find?

clinical findings could lead to what?

Answer 8

global enlargement of the heart- cardiomegaly

poor contractility

progressive left or right heart failure

bundle branch block and atrial ventricular arrhytmias

Question 9

what is the most common cardiomyopathy?

Answer 9

congestive cardiomyopathy

Question 10

hypertrophy cardiomyopathy has 2 forms? what are they? how do they happen?

these pts die from what?

Answer 10

1. familial- in young individuals by mutation of beta myosin heavy chain
2. sporadic - in elderly (not very imp)

arrhytmias by CHF

Question 11

what happens in hypertrophic cardiomyopathy?

Answer 11

obstruction of blood flow below aortic valve because mitral valve is drawn against the hypertrophied septum when blood exits the left ventricle

the aberrant myofibers and conduction system in the interventricular septum cause conduction disturbances manifesting as arrhytmias

Question 12

what will you find grossly in hypertrophic cardiomyopathy?

Answer 12

asymmetrical cardiac hypertrophy, mostly in IVS

Question 13

what will you find histologically in hypertrophic cardiomyopathy?

Answer 13

microfiber hypertrophy and muscle fibers are un-arranged

Question 14

which cardiomyopathy is the leading cause of sudden death in young athletes?

Answer 14

hypertrophic cardiomyopathy

Question 15

what characterizes restrictive cardiomyopathy?

what causes it?

Answer 15

restricted ventricular filling

• pompe’s (storing glycogen)
• amyloidosis
• hemochromatosis
• endocardial fibroelastosis in children (thick elastic tissue in endocardium

Question 16

what symptoms is the most prominent in restrictive cardiomyopathy?

Answer 16

arrhythmias

Question 17

what is this?

Answer 17

endocardial fibroelastosis found in restrictive cardiomyopathy

Question 18

what is this?

Answer 18

pompe’s disease related to restrictive cardiomyopathy

Question 19

what is this?

Answer 19

amyloidosis related to restrictive cardiomyopathy

Question 20

what is this?

Answer 20

hemochromatosis related to restrictive cardiomyopathy