Cardiomyopathies and sutff Flashcards Preview

Med School: Semester 2 > Cardiomyopathies and sutff > Flashcards

Flashcards in Cardiomyopathies and sutff Deck (33):
1

What is the ventricular morphology of dilated cardiomyopathy?

Dilated LV with little hypertrophy

2

What is the ventricular morphology of arrhythmogenic RVCM?

dilated RV with sections of missing muscle.

3

What is the ventricular morphology of HCM?

Marked hypertrophy.

4

What is the ventricular morphology of RCM?

fibrotic/infiltrated myocardium

5

What are the symptoms of DCM?

Fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea

6

What are the symptoms of ARVCM?

R heart failure
Palpatations
Syncope
Sudden death

7

What are the symptoms of HCM?

Exertional dyspnea
Angina
Syncope
A-Fib, V-Fib
CHF
Sudden Death (1.5%)

8

What are the symptoms of RCM?

Dyspnea
Fatigue

9

What presents in the physical exam for DCM?

pulmonary rales
s3
functional regurge
possible RV failure signs

10

What presents in the physical exam for ARVCM?

rhythm disturbances (ventricular arrhythmias)

11

What presents in the physical exam for HCM?

S4
Outflow obstruction: systolic murmur and mitral regurgitation

12

What presents in the physical exam for RCM?

Signs of RV failure
JVD
Hepatomegaly
Peripheral edema

13

What is the pathophysiology of DCM?

imparied systolic contraction

mural thrombi is common

14

What is the pathophysiology of ARVCM?

nothing.

15

What is the pathophysiology of HCM?

impaired diastolic relaxation

LV systolic function vigorous with dynamic obstruction of mitral valve during mid-to-late systole

16

What is the pathophysiology of RCM?

"stiff" LV
impaired diastolic relaxation
normal systolic function

17

What is the cardiac size for DCM?

Dilated/enlarged

18

What is the cardiac size for HCM?

normal or dilated

19

What is the cardiac size for RCM?

usually normal

20

What does the echo show for DCM?

dilated, poorly contractile LV

21

What does the echo show for HCM?

LV hypertrophy more pronounced in septum (acquired) or concentric (genetic)

Systolic anterior movement of MV with mitral regurge

22

What does the echo show for RCM?

Usually normal systolic contraction

Speckled appearance in infiltrative disorders

23

What does the histology show for DCM?

Interstitial fibrosis

replacement fibrosis

24

What does the histology show for ARVCM?

myocyte atrophy

fibrosis

fatty tissue

25

What does the histology show for HCM?

increased diameter of myocytes

abnormal arteries

myofiber disarray

26

What does the histology show for RCM?

interstitial fibrosis

27

What is the pathogenesis for DCM?

-often in 30s and 40s
-genetic, usually autosomal dominant
-in kids with DCM, often mitochondrial gene mutations
-infectious: coxsackie, adenovirus, parvovirus, HIV
-iron overload
-child birth

28

What is the pathogenesis for ARVCM?

-autosomal dominant with variable penetrance
-defective desmosomes > detachment of myocytes at intercalated discs > myocyte death and fibrosis
-disease occurs in bursts

29

What is the pathogenesis for HCM?

-heart thickening usually happens in kids
-autosomal dominant mutation of sarcomeric genes (B-myosin heavy chain, myosin binding protein C, Troponin T)
**Troponin T is important**

30

What is the pathogenesis for RCM?

-genetics, involving Troponin I and desmin genes
-amyloidosis
-endomyocardial fibrosis
-Loeffler endomyocarditis: hypereosinophilia due to release of granulocytes

31

What is the treatment for ARVCM?

none (80% dies of arrhythmias, 20% die of CHF)

32

What is the treatment for HCM?

-implanted automatic defibrillator
-negative inotropic agents
-myocardial reduction with surgery or alcohol

33

What is the treatment for RCM?

Can be treated with platelet derived growth factor