Non Ischaemic Cardiomyopathies

Question 1

What is HCM?

Answer 1

• Hypertrophic cardiomyopathy

- Condition causing increases wall thickness not explained solely by loading conditions

Question 2

What is the pathophysiology of HCM?

Answer 2

• Loss of architecture
• Myocyte hypertrophy
• Fibrosis = chamber stiffness, outflow tract abnormalities, mitral valve abnormalities, arrhythmias

Question 3

What is the clinical presentation of HCM?

Answer 3

• No symptoms - genetics
• Sudden death - young, athletes, arrhythmia
• Dyspnoea
• Angina
• Syncope

Question 4

What is seen on ECG in HCM?

Answer 4

• Sinus rhythm
• AF
• ST segments
• T wave inversion

Question 5

What is seen on echo in HCM?

Answer 5

• Diastolic dysfunction
• LA dilation
• Tissue doppler
• Outflow obstruction

Question 6

What is the risk stratification for SCD?

Answer 6

1. Family history
2. Syncope
3. NVST
4. BP responses to exercise
5. Septum > 30

2/3 = worry

Question 7

What is alcohol septal ablation?

Answer 7

Go into LAD > find septal branch > blow balloon into it + inject alcohol which destroys myocardium > blocking off CA

Used for LVOT

Question 8

What are the causes of dilated cardiomyopathy?

Answer 8

• Idiopathic
• Genetic
• Infective
• Toxins
• Neuromuscular diseases
• Storage disorders

Question 9

What is an LVAD?

Answer 9

Left ventricle assist device

Question 10

What is arrhythmogenic RV cardiomyopathy?

Answer 10

• Characterised by fibro-fatty infiltration, ventricular dilation + hyper-trabeculation
• Presents with arrhythmia/SCD
• ECG = T wave inversion, Epsilon wave
• Echo = RV dilation + aneurysms, RV hypertrabeculation

Question 11

What is restrictive cardiomyopathy?

Answer 11

Characterised by normal cardiac size, reduced systolic + diastolic function + bi-atrial dilation