week 4 systemic diseases Flashcards
Diabetes
high blood sugar can damage coronaries, causing heart attack and stroke
ECHO
early stage - normal echo except decr strain
Int stage - Incr LV wall thickness and big LA with grade 1-2 diastolic dysf
Late stage - LV wall thickness and LA even bigger with grade 2-3 diastolic dysf
*look for big walls and diastolic dysf (also MAC and Ao sclerosis)
Chagas cardiomyopathy
Chagas Cardiomyopathy is dilated cardiomyopathy that forms 20-30 years post Chagas infection
Chagas is caused by a tropical parasite and spread by the feces of “kissing bugs” that bit you near your mouth while you are sleeping (Latin America and southern states)
ECHO
- cardiomyopathy and heart failure (don’t know why Chagas causes this)
Ankylosing spondylitis
autoimmune inflammatory disease of the spine that causes vertebrae to fuse together
many patients also have costochondritis which makes them difficult to scan (painful)
causes inflammation of Ao
ECHO
- assess Asc Ao (Ao dilation? AI?)
Rheumatoid Arthritis
autoimmune disease that causes inflammation of joints (unknown cause)
Increased risk of atherosclerosis, MI, stroke, A-fib, HT, heart failure
ECHO
- non specific - assess everything (EF…)
Scleroderma
Systemic scleroderma
autoimmune disease of CT that causes thickening and tightening of skin
lung involvement
ECHO
- Pulm HT and Right heart failure
Lupus
Systemic Lupus Erythematosus
autoimmune disease that affect joints, skin, kidneys, blood, brain, heart, lungs
ECHO
* Assess everything
- pericarditis
- myocarditis
- valve thickening
- can affect systolic and diastolic function
Friedriche’s Ataxia
inherited neuromuscular disease that causes difficulty walking and speaking, loss of feeling in limbs (later loss of hearing and vision)
scan patient in wheelchair
most patients will have heart involvement
ECHO
- dilated cardiomyopathy
- symmetrical hypertrophic cardiomyopathy
- arrhythmias
Duchenne muscular dystrophy
inherited neuromuscular disease, most severe form of muscular dystrophy. Life expectancy 30 yrs with heart/lung transplant
All patients have cardiac involvement
ECHO
* dilated cardiomyopathy (bc degeneration of cardiomyocytes) - common cause of death
Marfans
or req just says “tall”
genetic CT disease
ppl are tall and thin, highly flexible
weak CT so at risk for dissection of all arteries
ECHO
* Ao dilation/dissection
- MVP
Ehlers-Danlos
inherited CT disease
joint hypermobility and skin involvement (soft and easily bruised skin)
ECHO
* Ao dilation/dissection
- MVP
- Arrythmias
Loeys - Dietz
inherited CT disease
Ao aneurysm syndrome – often happens at a young age, high risk of aortic dissection
ppl have
- wide eyes, cleft palate, wide uvula
- Arterial /Ao aneurysms and arterial tortuosity
ECHO
* Assess Asc Ao
What are generally looking for on an echo for
neuromuscular diseases
vs CT diseases
neuromuscular diseases - dilated cardiomyopathy
CT diseases - Asc Ao to rule out dilation, dissection, aneurysm
HIV
Associated with pericardial effusions* and pericarditis
*pericardial effusions are very dangerous for patient with HIV
ECHO
*pericardial effusion and pericarditis
- myocarditis
- LV dysf
- pulm HT
- endocarditis (if IVDU)
Cocaine and drug use
drug that stimulates sympathetic NS = incr HR, BP and contractility (incr oxygen demand) but vasoconstriction (decr oxygen supply)
= ischemia or MI
ECHO
*everything
- RWMAs
- Ao dissection
- LVH and diastolic dysf
- dilated cardiomyopathy
- heart failure
COVID 19
primarily a respiratory disease, but can affect the cardiac system
the virus can enter cardiac cells and cause direct injury, which can cause myocarditis
ECHO
* myocarditis (RWMAs and decr. EF)
Alcohol: acute and chronic
acute - “Holiday Heart Syndrome” = A-fib induced by binge alcohol consumption
chronic - dilated cardiomyopathy and heart failure
