Week 2-Cardiomyopathies Flashcards
PART 1
PART 1
Cardiomyopathy is a disorder within the cardiac _________ themselves which results in abnormal cellular and hence cardiac performance. This typically leads to ________ decline in cardiac function. Patients with cardiomyopathy are often candidates for __________.
- myocytes
- irreversible
- transplantation
What is the most powerful risk stratifier for cardiomyopathy?
LVEF
What are the (3) most common types of cardiomyopathies?
- Dilated Cardiomyopathy (enlarged ventricles)
- Hypertrophic Cariomyopathy (thick, stiffened walls)
- Restrictive Cardiomyopathy (stiffened walls)
What is the most common form of cardiomyopathy?
Dilated Cardiomyopathy
Describe the anatomy of Dilated Cardiomyopathy.
- Increased heart weight
- 1 or more chambers dilated
- Thinned walls
Dilated Cardiomyopathy has impaired ________ function and reduced ___ with cardiac enlargement. _________ is common.
- systolic function and reduced EF
- fibrosis
What are some causes of Dilated Cardiomyopathy?
- Genetic mutations
- Viral infections (HIV)
- Toxins
- Metabolic disorders
- Myocarditis
What are the S/Sx of Dilated Cardiomyopathy?
Symptoms
- Fatigue
- Dyspnea on exertion, SOB, cough
- Orthopnea, Paroxysmal nocturnal dyspnea
- Increasing edema/weight/abdominal girth
Signs
- Tachypnea
- Tachycardia
- Hyper/Hypotension
Other Pertinent Findings of Dilated Cardiomyopathy:
- Signs of ________
- _______________
- __________ edema
- Enlarged ______
- Ascites or peripheral edema
- hypoxia (cyanosis, clubbing)
- jugular venous distension (JVD)
- pulmonary edema (crackles/wheezing)
- liver (hepatomegaly)
What does nonpharmacologic management of Dilated Cardiomyopathy include? Why?
- sodium diet restricted to 2g/day
- fluid restriction
-Helps to minimize blood volume and thus minimize workload on the heart.
________ Cardiomyopathy is the single most common cause of death in apparently healthy young people.
Hypertrophic Cardiomyopathy
Describe the anatomy of Hypertrophic Cardiomyopathy.
-thick LV wall with non-dilated cavity
- In Hypertrophic Cardiomyopathy, the resulting cardiac hypertrophy is out of proportion to the ____________ load.
- Hypertrophic Cardiomyopathy is associated with one or more of __ gene defects which can cause defects in sarcomeric proteins.
- hemodynamic
- 9
Is Hypertrophic Cardiomyopathy a genetic disorder?
Yes
Describe how Hypertrophic Cardiomyopathy occurs.
- Normal BP perceived as excessive by defective myocytes.
- Hypertrophy occurs as a compensatory mechanism.
- Ultimately leads to heart decompensation (decreased functional capacity) and fails
Dilated Cardiomyopathy:
- Majority of cases are ___________.
- First clinical manifestation is often ___________.
- asymptomatic
- sudden death
What are the (2) types of Hypertrophic Cardiomyopathy?
Obstructive HCM
-Septal/LV wall stiffens, obstructing blood flow.
Nonobstructive HCM
-LV wall stiffens, reducing LVEDV and SV. Blood flow not blocked.
What are the S/Sx of HCM?
- Chest pain (esp with exertion)
- SOB (esp with exertion)
- Fatigue
- Arrhythmias
- Dizziness/Lightheadedness
- Fainting
- Swelling in ankles, feet, legs, abdomen, and veins in the neck
What are some long terms complications of HCM?
- A.fib
- Dysrhythmias
- HF
- Hx of MIs
What are some treatment options for HCM?
- Alcohol septal ablation
- Implantable cardioverter defibrillator (ICD)
- Heart transplants
What type of cardiomyopathy is rare and is characterized by restricted diastolic filling, loss of compliance, and idiopathic fibrosis?
Restrictive Cardiomyopathy
Restrictive Cardiomyopathy:
- Systolic function is ________
- EDV is ___________
- ESVs and EFs is ________
- SV is _________
- Filling pressures are very _____
- normal
- diminished (chambers cannot expand)
- normal
- diminished
- high
What are the symptoms of Restrictive Cardioyopathy?
- Dyspnea
- Abdominal swelling
- Ankle edema
- Fatigue
What are some causes of Restrictive Cardiomyopathy?
- Scleroderma
- Amyloidosis
- Sarcoidosis (fibrotic scarring secondary to myocardial infiltrates)
- Diabetes
- Hemochromatosis (excessive deposition of iron)
- Chemotherapeutic agents
- Radiation
