Flashcards in cardiomyopathies Deck (17):
What are causes of dilated cardiomyopathies?
ABCCCD: alcoholism, beri beric, chronic cocaine, coxsackie, Chagas disease doxorubicin toxicity. also hemochromatosis and pregnancy
What are the findings in dilated cardiomyopathy?
dilation of all four chambers of the heart.
heart failure, S3, dilated heart on echo, balloon appearance on CXR. eccentric hypertrophy- sarcomeres added in series.
Treatment of dilated cardiomyopathies
mostly supportive, maybe a heart transplant (may also try BBs, ACE-Is, diuretics, digoxin)
What is the main problem with a dilated cardiomyopathy?
this is a systolic problem
What is a hypertrophic cardiomyopathy?
disorganized ventricular hypertrophy of the heart that causes problems with filling. often septum is particularly hypertrophied. there may be fibrosis.
What are some causes of hypertrophic cardiomyopathy?
usually autosomal dominant defects with the sarcomere proteins. may rarely be caused by friedrich's ataxia.
Findings in hypertrophic cardiomyopathy
disorganized hypertrophic tissues, leading cause of sudden death in young athletes. may hear an S4.
patients may have decr. cardiac output, syncope with exercise (subaortic hypertrophy ofo
What is the main problem with hypertrophic cardiomyopathy?
this is a filling problem (diastolic issue)
What are the major causes of restrictive cardiomyopathy?
amyloidosis, sarcoidosis, endocardial fibroelastosis (thick fibroelastic tissue in the endocardium of young kids), Loffler syndrome (endomyocardial fibrosis with a prominent eosinophilic infiltrate), and hemochromatosis
What is the main problem with restrictive cardiomyopathy?
this is a also filling/diastolic issue
Findings of restrictive cardiomyopathy?
low voltage EKG in spite of thick myocardium.
What interventions decrease mortality in CHF?
ACE-I, BBs (except in acute decompensated), ARBs, and spironolactone. hydralazine with nitrates helps in select patients.
What are the classic findings in CHF lung biopsy?
hemosiderin laden macrophages.
What are some signs of right heart failure?
nutmeg liver/hepatomegaly: incr. central venous pressure casues incr. resistance to portal flow. rarelym leads to cardiac cirrhosis.
may also see peripheral edema and jugular venous distention
What are the types of acute pericarditis?
fibrinous (dressler syndrome, uremia, radiation), serous (viral pericarditis or SLE/RA), suppurative/purulent: usually d/t pneumococcus or streptococcus but now rare
presents with pain aggravated by inspiration and relieved by sitting up, friction rub, widespread ST seg elevation and/or PR depression
What are the findings of syphilitic heart disease?
teritiary syphilis disrupts the vasa vasorum of the aorta and causes atrophy of the vessel wall and dilation of the aorta and valve ring. this manifests as calcification of the aortic root and ascending arch aorta. leads to a tree bark appearance. can cause an aneurysm of the ascending aorta or aortic arch and aortic insufficiency.