S2 L3.3: Cardiomyopathy Flashcards
This is a form of heart failure that is dependent on the etiology.
Cardiomyopathy
This disease of heart muscles that result from a myriad of insults such as: (3)
○ Genetic defects
○ Cardiac myocyte injury
○ Infiltration of myocardial tissues
Heart chambers “get huge” or “balloon out”
Dilated Cardiomyopathy
Muscles of the heart/Myocardium become thick; reducing the chamber size of the ventricles
Hypertrophic Cardiomyopathy
Looks normal but the problem is in the function, not its structure
Muscles are stiff, unable to relax, dilate, and contract
Restrictive Cardiomyopathy
Common causes of Dilated Cardiomyopathy
Ischemia and HTN
Statement 1: In dilated cardiomypathy, there is enlargement of one or both of the ventricles and systolic dysfunction
Statement 2: Uncommon for chamber enlargement to precede signs and symptoms of congestive heart failure
a. TF
b. FT
c. TT
d. FF
a. TF
Not uncommon
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Common in Africa but also manifests in the developed world
b. Peripartum CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Patients may develop a DCM with CHF in the face of recurrent or persistent tachycardias
c. Tachycardia-induced CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
The most common secondary CM
Closely resembles idiopathic DCM
d. Alcoholic CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Arises as dilated cardiomyopathy with depressed ventricular function not explained by the extent of coronary artery obstructions or ischemic damage
e. Ischemic CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Arises with left ventricular hypertrophy with features of cardiac failure related to systolic or diastolic dysfunction
i. Hypertensive CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Most common among middle-aged women (Appears to be related to catecholamine release)
a. Takotsubo CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Most common association is with atrial fibrillation or supraventricular tachycardia (SVT)
c. Tachycardia-induced CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Includes a wide variety of causes, including endocrine abnormalities, glycogen storage disease, deficiencies (such as hypokalemia), and nutritional disorders
h. Metabolic CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Cardiac dysfunction as a consequence of myocarditis
g. Inflammatory CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Manifests between the last month of pregnancy and 6 months postpartum
Etiology is unclear
b. Peripartum CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Linked to ongoing excessive alcohol consumption
Dose-related and responsive to cessation of alcohol exposure
d. Alcoholic CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Provoked by a stressful or emotional situation
Fully reversible with supportive care in most cases
○ As long as intervened properly
○ Gets better spontaneously
a. Takotsubo CM
Specific Dilated CM
a. Takotsubo CM
b. Peripartum CM
c. Tachycardia-induced CM
d. Alcoholic CM
e. Ischemic CM
f. Valvular CM
g. Inflammatory CM
h. Metabolic CM
i. Hypertensive CM
Provoked by a stressful or emotional situation
Fully reversible with supportive care in most cases
○ As long as intervened properly
○ Gets better spontaneously
i. Hypertensive CM
Includes connective tissue disorders and infiltrative diseases such as sarcoidosis and leukemia
General Systemic Disease
Includes Duchenne, Becker-type, and myotonic dystrophies
Muscular Dystrophies
Includes Friedreich ataxia, Noonan syndrome, and lentiginosis
Neuromuscular Disorders
Includes reactions to alcohol, catecholamines, anthracyclines, irradiation, and others
Sensitivity & Toxic Reactions
This CM is one of the more common conditions that PTs will encounter and handle since it is more commonly seen in athletes
Hypertrophic Cardiomyopathy
Usual cause in athletes who die suddenly on the playground they do not die from a heart failure but typically from ??
electrical arrhythmia, ventricular tachycardia or ventricular fibrillation
Hypertrophic CM
Statement 1: Caused by a multitude of mutations in genes encoding proteins of the cardiac sarcomere
Statment 2: May be responsible for heart failure–related disability at virtually any age
a. TF
b. FT
c. TT
d. FF
c. TT
T/F: A big percentage goes to HCM for the causes of sudden cardiac death in young competitive athletes
True
This CM is not really common and occurs with lower frequency in the developed world
Restrictive and Infiltrative CM
Increase in stiffness of the ventricular walls brought about by inflammation, which causes heart failure because of impaired diastolic filling of the ventricle
Restrictive and Infiltrative CM
T/F: If the impaired diastolic filling goes to systolic dysfunction, death is imminent
True
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Amyloidosis
Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Scleroderma
Non-Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Familial cardiomyopathy
Non-Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Pseudoxanthoma elasticum
Non-Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Gaucher disease
Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Fatty infiltration
Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Idiopathic cardiomyopathy
Non-Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Hurler disease
Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Hypertrophic
cardiomyopathy
Non-Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Diabetic cardiomyopathy
Non-Infiltrative
Causes of Restrictive Cardiomyopathy
Non-inflitrative or Infiltrative?
Sarcoidosis
Infiltrative
Name the 3 Storage Diseases
- Hemochromatosis
- Fabry Disease
- Glycogen Storage Disease
Progressive fibrofatty replacement of the right, and to some degree left, ventricular myocardium
Arryhythmogenic Right Ventricular Dysplasia
Arrythmogenic Right Ventricular Dysplasia
Statement 1: Right side that gets affected. The RV muscle is replaced with fat; fat is contractile resulting to right ventricular failure
Statement 2: Clinical manifestations usually develop during the first
decade
a. TF
b. FT
c. TT
d. FF
d. FF
1: Fat is not contractile
2: Second Decade
Symptomatology
PTs would just identify:
● CHF, left sided
● Fatigue
● Weakness
● Systemic emboli
● Pulmonary emboli
Dilated
Symptomatology
PTs would just identify:
● Dyspnea
● Fatigue
● Right sided CHF
● Signs and symptoms of systemic disease
Restrictive
Symptomatology
PTs would just identify:
● Dyspnea
● Angina
● Fatigue
● Syncopex
● palpitations
Hypertrophic
