Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
31 Cards in this Set
- Front
- Back
|
heart disease from an abnormality in the myocardium
|
Cardiomyopathy
|
|
|
Cardiomyopathy results in what four things?
|
Changes in wall thickness
Changes in chamber size Mechanical dysfunction Electrical dysfunction |
|
|
Almost exclusively genetic (autosomal dominant)
Usually asymmetric septal hypertrophy, though apical variant exists (particularly among Asians) Causes small left ventricular volume leading to ↓cardiac output |
Hypertrophic Cardiomyopathy
|
|
|
What are the signs and symptoms of hypertrophic cardiomyopathy?
|
Usually asymptomatic
Dyspnea is most common presenting complaint Angina Syncope Ventricular Arrhythmias |
|
|
What is noticed in the physical examination of hypertrophic cardiomyopathy?
|
Left ventricular lift
Loud S4 gallop Systolic ejection murmur Increases in intensity with decreased LV filling (standing) Decreased in intensity with increased LV filling (squatting) |
|
|
What is seen in the EKG studies and echocardiogram with hypertrophic cardiomyopathy?
|
ECG: LVH, large septal Q waves, nonspecific ST/T-wave abnormalities
ECHO, NUC, CARD MRI, Cath: LVH, septal hypertrophy, diastolic dysfunction |
|
|
What is the Tx for hypertrophic cardiomyopathy?
|
Septal ablation
AICD Prevent heart failure: β-Blockers, ACE-I, and/or CCB |
|
|
Most common type of cardiomyopathy
Usually idiopathic, up to 30% have genetic cause |
Dilated cardiomyopathy
|
|
|
What is the hallmark of dilated cardiomyopathy?
|
Hallmark: dilation of both ventricles & reduced contractile function
|
|
|
Who is the most likely patient with a dilated cardiomyopathy?
|
black males as most likely patient
|
|
|
What are the signs and symptoms of dilated cardiomyopathy?
|
Dyspnea is most common presenting complaint
Poor exercise tolerance Heart failure Fatigue Palpitations Presyncope or Syncope |
|
|
What is seen in the physical exam with dilated cardiomyopathy?
|
Tachycardia
Tachypnea JVD Pulmonary rales Ascites, hepatomegaly *** Looks like heart failure |
|
|
What is seen in the EKG, Echo and Chest X-Ray in dilated cardiomyopathy?
|
ECG: nonspecific ST/T wave abnormalities, ectopy
Chest X-Ray: heart failure signs (enlarged cardiac silhouette, pulmonary vascular congestion, pleural effusions) ECHO, NUC, Cath: LV dilation and dysfxn with low EF |
|
|
What is the Tx for dilated cardiomyopathy?
|
Treat for CHF: ACE-I, β-Blockers, Ald Antag, Diuretics, Digoxin
AICD, Bi-V Pacing/CRT |
|
|
Rare: 1-5% of cardiomyopathies
|
Restrictive cardiomyopathy
|
|
|
What are the causes of restrictive cardiomyopathy?
|
Amyloidosis (most common)
Hemochromotosis Sarcoidosis Radiation exposure |
|
|
Abnormal myocardial stiffness results in…
|
Increased diastolic filling pressure leading to
Decreased cardiac output leading to Heart Failure |
|
|
What are the signs and Sx of restrictive cardiomyopathy?
|
Chest pain
Palpitations Congestive heart failure |
|
|
What is seen in the physical exam with restrictive cardiomyopathy?
|
Congestive heart failure
|
|
|
What is done with lab/imaging studies in restrictive cardiomyopathy?
|
Rule in/out amyloidosis or hemochromatosis
Chest X-Ray: enlarged silhouette ECHO: restrictive diastolic filling pattern is diagnostic |
|
|
How do you Tx restrictive cardiomyopathy?
|
Decrease preload with loop diuretics
Treat arrhythmias Treat any underlying identifiable cause if it exists |
|
|
new onset heart failure with preceding viral syndrome
|
Myocarditis
|
|
|
What is the usual viral cause of myocarditis?
|
Usually Coxsackievirus B is the culprit but MANY viral causes
|
|
|
What are the signs and Sx of myocarditis?
|
Usually asymptomatic
If sx present, think heart failure sx |
|
|
What is seen in the physical exam of myocarditis?
|
Fever (if caught during viral illness)
Tachycardia Fluid overload (think CHF!!) Systolic murmurs (MR and TR) S3 and S4 gallops |
|
|
What is seen with the lab and imaging studies with myocarditis?
|
↑ESR, ↑Cardiac enzymes (esp Troponin T or I and CK-MB)
ECG: nonspecific ST/T-wave abnormalities; ectopy, atrial arrhythmias, AV conduction delay, IVCD (e.g. LBBB) Chest X-Ray: maybe CHF findings ECHO, NUC: LV enlarged, reduced global function, +/- mural thrombi |
|
|
How do you Tx myocarditis?
|
Pain relief with narcotics
Abx if bacterial cause Treat CHF Avoid NSAIDS and steroids Careful: some will go on to develop DCM!!! Serial ECHO to monitor |
|
|
Looks like dilated cardiomyopathy
Resolves with abstinence in most |
Alcoholic Cardiomyopathy
|
|
|
Resembles dilated cardiomyopathy
CD4 count < 100 |
HIV Cardiomyopathy
|
|
|
May be dilated or hypertrophic
Results after prolonged untreated hypertension |
Hypertensive Cardiomyopathy
|
|
|
AKA “Broken Heart Syndrome”
Can look EXACTLY like STEMI Caused by catacholamine surge after traumatic event More common in patients with h/o pulmonary disease |
Takotsubo’s Cardiomyopathy
|
