Restrictive/infiltrative CM

Question 1

Amyloid

Answer 1

biatrial enlargement
low voltage EKG (despite hypertrophy on echo)
Dx: RHC with ventricular biopsy
No ACEi in HFpEF or infiltrative CM

Question 2

Sarcoid

Answer 2

AAM
high PVC burden
1st deg AVB
dx with Cardiac MR or FDG PET (morphology, function, perfusion, viability, blood flow, tissue characterization

Question 3

Acute systolic HF (2wks to 3 months)

Answer 3

with new arrythmias, 2nd 3rd deg avb, dilated LV, failure to respond to usual care NEEDS biospy r/o sarcoid or giant cell or other myocarditis, Lyme, Chagas

Question 4

Giant cell

Answer 4

few to weeks with new HF, arrythmia, heart block
T cells, histocytes, eos, myocyte necrosis
a/w autoimmune conditions