Term
| pathology Dilated Cardiomyopathy |
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Definition
1. Heart is enlarged and weakened
2. Cannot pump efficiently
3. Systolic dysfunction (right or left ventricle)
4. Most common Non-ischemic Cardiomyopathy |
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Term
| etiology Dilated Cardiomyopathy |
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Definition
-genetics
-viral/immune
-alcohol toxicity
-idiopathic |
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Term
| presentation Dilated Cardiomyopathy |
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Definition
-Men >women
-Age 20-60
-May be asymptomatic
-Eventually may show signs of HF
-vague chest pain, syncope in some cases |
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Term
| physical findings Dilated Cardiomyopathy |
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Definition
-Crackles (pulm edema)
-elevated JVD
-narrowed pulse pressure
-S3 S4
-systolic Murmurs |
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Term
| diagnosis Dilated Cardiomyopathy |
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Definition
-CXR - enlarged heart, possible pleural effusion
-ECG -sinnus tach, A-fib, Ventricular arrhythmias, atrial enlargement
-LBB w/ RAD (right axis deviation)
-Echocardiogram- enlarged ventricle, normal to thin walls
-Dec EF
-Cardiac cath
-Coronary aniography |
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Term
| management Dilated Cardiomyopathy |
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Definition
-Standard HF Tx
-Salt restriction
-ACE-I
-Diuretics
-Anticoagulant
-Some require pacemaker |
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Term
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Definition
-Can cause Hypertrophic Cardiomyopathy
- |
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Term
| What are 2 causes of Myocarditis |
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Definition
-Hard to Dx
-1' acute viral infection or post-viral autoimmune
-2' Myocardial inflammation from specific pathogen (bacteria, fungi, protozoan, chemicals), also Lupus |
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Term
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Definition
-Major cause 2' DCM
-Alcohol cessation early can stop progression
-Toxic effects, nutritional eficiencies, cobalt additives |
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Term
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Definition
-Inflammatory cellular infiltrate
-Virus enter, immune response, virus enters cardiac myocyte and replicates, immune cells ingest them
-leads to cell death/dysfucntion
-Direct toxicity AND autoimmune damage |
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Term
|
Definition
-HF, Chest pain, arrhythmias, or vague (fatigue, dyspnea, pain)after acute viral infection
-Murmurs, Gallops
-May see elevated CK/troponin |
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Term
| Clinical manifestations of myocarditis |
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Definition
Sub-clinical to SCD
-New onset arrhythmias
-Amyloid like syndrome
-LV dysfunction = Dyspnea |
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Term
| Labs/Tests of Myocarditis |
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Definition
-Trop may be elevated
- viral serology (poor correlation b/c so prevalent)
-ECG- can be nonspecific or MI appearing
Eg) Conduction delays,AV block, AVT/VT
-Echo- rule out other causes HF |
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Term
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Definition
-Controversial, supportive
-Standard HF regimen
-Mechanical support if fails, balloon pump, heart pump, to buy time
-Look for Giant cell or sarcoidosis |
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Term
|
Definition
-Chemotherapy
-Adromyocin or anthracyclines (Doxorubicin or Daunorubicin) |
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Term
| Pathology Medication associated DCM |
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Definition
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Term
| Role genetics Hypertrophic Cardiomyopathy |
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Definition
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Term
| Pathology Hypertrophic Cardiomyopathy |
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Definition
-Stiff, hypertrophied ventricle
-Elevated diastolic filling pressure
-Pressure inc further w/ inc HR and contractility or dec LV filling |
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Term
| Presentation of Hypertrophic CM |
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Definition
-Dyspnea on exertion
-Chest pain
-Syncope after exertion or valsalva
-palpitations, arrhythmias
-Cardiac failure
-Sudden Cardiac Death SCD |
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Term
|
Definition
-Echocardiogram mainly*
-Also clinical dx and fam hx |
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Term
|
Definition
-Asymptomatic pts usually don't need tx, controversial
-All pts avoid strenuous exercise
-Symptomatic pts - Beta Blocker initially
-2' Ca2+ block (verapamil) if don't respond
-Diuretics if fluid retention
-Sx- Myomectomy (excise part of septum) for severe dz, high success
-Pacemaker ?? |
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Term
| Left ventricular outflow obstruction Hypertrophic CM |
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Definition
| pts may have dynamic outflow obstruction due to asymmetric hypertrophy of interventricular septum |
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Term
| Genetic form Restrictive CM |
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Definition
-the heart muscle is stiff and cannot fully relax after each contraction.
-Impaired muscle relaxation causes blood to back up in the atria and lungs, which reduces the amount of blood in the ventricles. |
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Term
| Acquired restrictive cardiomyopathy |
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Definition
-Infiltrative
-Chemotherapy or radiation induced
-Carcinoid syndrome
-Idiopathic
-Hemochromatosis
-Amyloidosis
-Sarcoidosis |
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Term
| Presentation Restrictive CM |
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Definition
-Elevated filling pressure = dyspnea and exercise intolerance
-right sided S&S |
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Term
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Definition
-Echo - thickened myocardium, possible systolic dysfunction, Inc. right atrium and Left Ventricle size, bright myocardium w/ amyloidosis
-ECG- low voltages, conduction abnormalities, arrhythmias, Afib
-Endomyocardial biopsy |
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Term
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Definition
Tx underlying Disorder
-Hemochromatosis -phlebotomy, deferoxamine
-Sarcoidosis - glucocorticoids
-Amyloidosis- no tx
-Digoxin if systolic dysfunction
Use diuretics and vasodilators cautiously |
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Term
| Most common cause myocarditis |
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Definition
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