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28 Cards in this Set
- Front
- Back
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What is cardiomyopathy?
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Heart disease resulting form a PRIMARY abnormality in the myocardium
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What are three kinds of cardiomyopathy?
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1. dilated cardiomyopathy
2. hypertropic cardiomyopathy 3. restrictive cardiomyopathy |
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What is the most common cardiomyopathy?
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Dilated cardiomyopathy
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Describe the characterisitcs of dilated cardiomyopathy:
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1. enlarged heart with 4 chamber dilitation
2. left ventricle may be hypertrophied 3. progressive systolic (conctractile) dysfuction |
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What can the Coxsackie B virus produce?
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Dilated cardiomyopathy
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What are six known causes of dilated cardiomyopathy?
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1. post myocarditis (caused by Coxsackie B)
2. alcohol - long term heavy consumption 3. toxins other than alcohol like DOXORUBICIN (a chemotherapy agent) 4. peripartum cardiomyopathy (develops late in pregnancy or after delivery) 5. Idiopathic genetic causes 6. iron overload |
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What is hypertrophic cardiomyopathy and what exactly is its cause?
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Marked Left ventricular hypertrophy along with even greater hypertrophy of the septum caused by an autosomal dominant defect in genes encoding SARCOMERE proteins especially in the myosin heavy chain.
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Describe the appearance of the septum of hypertrophic cardiomyopathy:
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It is so enlarged, much more than the walls, that is becomes banana shaped and bulges into the left ventricle. It is so large that during systole the mitral valve leaflets contact the ventricular septum.
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Is systole and or diastole functional in hypertrophic cardiomyopathy?
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No, systole is impeded since the left ventricle is too squished. Also, there is abnormal diastolic filling since the ventricle can't relax enough to except blood.
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Histologically what does hypertrophic cardiomyopathy look like?
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Disorganized myofibrals which disarranged myocytes. Also, there is lots of connective tissue between myocytes and blood vessels are narrowd by fibrous growth.
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What does hypertrophic cardiomyopathy lead to?
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Diastolic CHF (decreased myocardial compliance and stroke volume)
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What seven characterisitics are seen in hypertrophic cardiomyopathy?
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1. systolic ejection murmur that increases in loudness during maneuvers that decrease preload (squatting to standing)
2. anginal pain 3. dyspnea 4. syncope 5. arrhythmias 6. mural thrombi with embolic complications 7. sudden death (ex. athlete drops dead) |
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What does hypertrophic cardiomyopathy produce a systolic ejection murmur that increases in loudness when you stand up from a squatting position?
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Maneuvers that affect the degree of LV outflow (obstruction) cause a change in murmur intensity. An increase in intensity is due to enhanced obstruction when moving upward.
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What is restrictive cardiomyopathy?
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A diastolic dysfunction caused by something impeding the walls of the heart. Systolic function is unaffected.
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What are the pathologic findings in a patient with restrictive cardiomyopathy? (2)
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1. ventricles cavity is normal in size and caliber
2. myocardium is firm impeding expansion of left ventricle cavity. |
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Six causes of restrictive cardiomyopathy:
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1. radiation fibrosis
2. amyloidosis - resulting from a pathologic proteinaceous substance deposited in myocardium 3. sarcoidosis - chronic granulomatous disease causing stiffness 4. metastatic tumor 5. inborn errors of metabolism 6. idopathic |
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What is the protein that is deposited in familial restrictive cardiomyopathy?
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Transthyretin
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What kind of heart failure does restrictive cardiomyopathy cause?
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Diastolic CHF
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What is myocarditis?
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An inflammatory process resulting in myocardial injury as is not a result of coronary atherosclerosis
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What five categories of infections can cause myocarditis?
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1. virus - Enterovirus Coxsakie A and B, influenza, HIV
2. Bacteria - Borrelia (Lyme disease), Corynebacterium diphtheriae (produces cardiac toxins) 3. Parasites - trypanasoma cruzi (Chagas disease), trichinosis, toxoplasmosis 4. immune mediated - rheumatic fever, lupus 5. Unknown mechanisms of sarcoidosis and giant cell myocarditis |
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What is the appearance of heart with myocarditis?
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It can appear normal but also flabby with mottled myocardium
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What are the symptoms of myocarditis? 5
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1. asymptomatic
2. fever 3. fatigue 4. acute CHF 5. arrhythmias, sudden death |
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What is cardiac tamponade?
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A pericardial effusion (fluid accumulation in pericardial sac) that is so large it compresses atria and ventricles.
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What is pericarditis?
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Inflammation of the pericardium often as a response to a cardiac, throacic, or systemic process.
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What is the most common cause of pericarditis?
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Coxsackievirus A and B
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What three autoimmune reactions can cause pericarditis?
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Rheumatic fever, lupus, Dressler syndrome
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Is pericarditis ever asymptomatic? How can it be picked up on examination? EKG?
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Yes, it can be asympomatic. You may be able to pick up a pericardial friction rub and diffuse s-t segment elevations in all leads.
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What is constrictive pericarditis?
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When pericardial space is obliterated by dense scar tissue formed through the healing process. (seen in TB)
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