Norton - cardiomyopathy Flashcards
Three clinical, functional, pathologic patterns
Dilated
Hypertrophic
Restrictive
dilated cardiomyopathy has what type of dysfunction
contractile - systolic
Majority of cases of DCM
idiopathic
Insults causing DCM
Coxsackie B Enterovirus Alcohol Doxo (adriamycin) - chemo Pregnancy Genetic Unknown
Two things NOT seen in dilated cardiomyopathy
Valvular alterations
Coronary artery obstructions
DCM - morphology
heavy heart
large, flabby
all chambers dilated
mural thrombi
Hypertrophic cardiomyopathy has which type of dysfunction
diastolic filling
Classic HCM
asymmetrical septal hypertrophy
presses into the left chamber
HCM is most prominent in _____ area
subaortic
what hypertrophies in HCM
endocardium - LV outflow tract and anterior mitral leaflet
Microscopic morphology of HCM
Myocytes are
- hypertrophied
- disarrayed bundles
Fibrosis
is the chamber larger or smaller in HCM?
smaller
SV and compliance in HCM
reduced
impaired diastolic filling of LV,, hypertrophied LV
Major complication of HCM
sudden death (athletes)
clinical sx - HCM
Exertional dyspnea
Anginal pain
Exertional dyspnea due to
dec CO
Inc Pulmonary venous pressure
Anginal pain due to
focal myocardial ischemia
what plays a primary role in development of myocardial injury
Inflammatory process
1 cause of myocarditis
viruses (Cox A,B)
Microscopic morphology - Myocarditis
Infiltrate of mononuclear cells
focal necrosis
Florid myocarditis
MNC, PMNs, toxoplasma pseudocyst
fluid accumulates slowly, less than 500ml
Globular enlargement
fluid accumulates rapidly, greater than 500ml
Cardiac tamponade
fibrinous pericarditis develops a
loud pericardial friction rub
