Module 4 Logbooks - Dilated Cardiomyopathy

Front 1

Module 4 - logbook 9: definition cardiomyopathy

Back 1

Ventricular chamber enlargement and contractile dysfunction with normal left ventricular wall thickness. Diagnosis of exclusion

Front 2

Module 4 - logbook 9: epidemiology

Back 2

20-60 year old, men > women. Black > white. 2/10,000 - almost 1/2 genetic

Front 3

Module 4 - logbook 9: risk factors

Back 3

Heart disease, recreational drug use, alcohol and co-morbidities (HIV/SLE)

Front 4

Module 4 - logbook 9: common presentation

Back 4

Symptomless - heart failure, stroke from thromboembolism, arrhythmias, and sudden cardiac death.

Congestive heart failure: dyspnoea, weakness, fatigue, oedema, raised JVP, pulmonary congestion, cardiomegaly, loud third and/or fourth heart sound

Front 5

Module 4 - logbook 9: investigations

Back 5

Echocardiogram, CXR (cardiomegaly) and ECG

Front 6

Module 4 - logbook 9: pathophysiology

Back 6

Heart failure > left ventricular remodeling, which manifests as increases in left ventricular end-diastolic +end-systolic volumes, wall thinning, and change in chamber geometry to a more spherical shape - usually associated with a continuous decline in ejection fraction

Front 7

Module 4 - logbook 9: prognosis

Back 7

Five-year survival for patients with dilated cardiomyopathy is about 30%. Mitral regurgitation or diastolic dysfunction is associated with a worse prognosis. Arrhythmias can be a cause of sudden death

Front 8

Module 4 - logbook 9: management

Back 8

Lifestyle - especially alcohol

Medication: diuretics, ACE, beta blocker and maybe spironolactone.

Prevention/treatment of arrhythmias

Anticoagulation if required

Surgery: transplant

Front 9

Module 4 - logbook 9: drugs - ASPIRIN

Back 9

Antiplatelet - Acetyl donor to COX rendering it inactive which reduces thromboxane A2

Front 10

Module 4 - logbook 9: drugs - OMEPRAZOLE

Back 10

PPI. Reduces gastric acid secrection by inhibiting H+K+ ATPase enzyme system.

Front 11

Module 4 - logbook 9: drugs - INSULIN

Back 11

Promotes glucose and amino acid uptake into muscle and adipose tissues. Stimulates glycogen, inhibits gluconeogenesis.

Front 12

Module 4 - logbook 9: drugs - ATORVASTATIN

Back 12

Hypercholesterolemia - enzyme inhibitor HMG coA reductase, reducing quantity of mevalinic acid, a precursor of cholesterol

Front 13

Module 4 - logbook 9: drugs - FUROSEMIDE

Back 13

Loop diuretic - Inhibits water reabsorption in nephron by acting on sodium potassium chloride cotransporter

Front 14

Module 4 - logbook 7: aetiology

Back 14

Genetic, inflammatory, toxic (alcohol), metabolic

Front 15

Module 4 - logbook 9: drugs - WARFARIN

Back 15

Vitamin K antagonist, precursor of clotting facotrs

Front 16

Module 4 - logbook 9: Shock

Back 16

Types: Cardiac, hypovolemic (fluid) and distributive (vasodilation) (septic, anaphylactic and neurogenic)

Cardiac shock (failure of pump action of heart)- high JVP. Give ionotropes such as dopamine.

Front 17

Module 4 - logbook 9: Cardiomyopathies

Back 17

Cardiomyopathy = heart muscle is structurally and functional abnormal

Hypertrophic : LVH (can't relax)

Dilated : enlargement and contractile dysfunction (can't contract)

Restrictive: rigid but not thickened - caused by amyloidosis