Flashcards in Acute Myocarditis Deck (16):
What is the typical etiology of acute myocarditis?
Viral etiology usually associated with epidemics
The majority of indiv. with acute myocarditis present with:
– Chest pain with ECG changes
– Heart failure
Note: 50% have preceding respiratory or GI symptoms
With regards to heart physiology, what does acute myocarditis cause?
Low ejection fraction (~20%) and heart failure --> (high mortality) --> can further develop a chronic dilated cardiomyopathy
--> Heart failure with a large silent heart with impaired systolic function
Clinical manifestations of Dilated cardiomyopathy
1. Heart failure
What can Arrhythmia from Dilated cardiomyopathy result in?
What can thromboembolism from Dilated cardiomyopathy result in?
Activation of AT1 receptors by angiotensin II can result in?
Increased aldosterone release
Increased Sympathetic Activity
What would you expect BNP levels to be in patients with CHF?
Super elevated compared to pts w/o CHF
Treatment of Cardiomyopathy
TREATMENT OF HEART FAILURE
ANTI-INFLAMMATORY / IMMUNO-SUPPRESSIVE
Treatment of heart failure from dilated cardiomyopathy
Diuretics, ACE Inhibitors, Beta blockers, Aldosterone antagonists, Vasodilators, Inotropes, LVads, Transplant
HYPERTROPHIC CARDIOMYOPATHY WITHOUT AORTIC OUTFLOW OBSTRUCTION
- what is it?
- What is a typical symptom?
•Diastolic dysfunction due to impaired diastolic relaxation & increased stiffness
•`Elevated LV diastolic pressure causes increased pulmonary venous & capillary pressures
•Dyspnea on exertion usual symptom
HYPERTROPHIC / OBSTRUCTIVE CARDIOMYOPATHY
- what is it?
- what can it result in?
•Asymmetric myocardial hypertrophy -->
Possibly . . . Mitral valve leaflet can obstruct aortic opening during systole
(systolic anterior motion of mitral valve)
•Enhanced systolic dysfunction
•Dynamic left ventricular outflow obstruction
•Propensity for syncope & sudden death
Vasodilator (pick one) increases/decreases ventricular volume, and (pick one) increases/decreases outflow obstruction
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY
- clinical manifestations
- what are they caused by
Variable: Asymptomatic to severe symptoms
- cause by Increased LV filling pressure
- Hypertrophic LV
- Increased systolic LV pressure
3. SUDDEN DEATH
- (Frequent cause of sudden death in athletes)
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY TREATMENT
Avoid competitive sports and other extreme exertion
•Decrease contractility – Beta blockers/Verapamil
•Surgical myomectomy or Alcohol ablation
•Automatic Implantable Cardiac Defibrillator if they had a syncope event!!! or else they can die O.O