Cardiomyopathy & Myocarditis Flashcards Preview

CVPR: CV Unit I > Cardiomyopathy & Myocarditis > Flashcards

Flashcards in Cardiomyopathy & Myocarditis Deck (16):
1

Clinical presentation of acute myocarditis

-often w/in 2 wks of URI/flu-like symptoms
-+ preicarditis=chest pain
-S3 heart sound
-pulmonary contestion
-peripheral edema
-w/cardiac dilation --> mitral/tricuspid insufficiency murmurs
-non-specific ECG changes
-Echo=global ventricular dysfunction --> dx

2

Outcomes of acute myocarditis

-can lead to cardiac dilation --> valvular insufficiency/regurgitation
-dilated cardiomyopathy may be acute (and resolve) or chronic
-adults --> present w/HF w/or w/out cardiogenic shock
-arrhythmias w/palpitations or syncope --> sudden death

3

Anatomic classes of cardiomyopathies (3)

-dilated cardiomyopathy (most common)
-hypertrophic cardiomyopathy
-restrictive cardiomyopathy

4

Features of dilated cardiomyopathy (causes, clinical present)

-causes: ischemic (CAD) & nonischemic (viral, familial)
-clinical manifestations: HFrEF w/ dilated ventricles, arrhythmia, thromboembolism

5

Causes of hypertrophic obstructive cardiomyopathy

-strong genetic component

6

Epidemiology of hypertrophic obstructive cardiomyopathy

-autosomal dominant inheritance

7

Anatomic features of hypertrophic obstructive cardiomyopathy

-LV=hypertrophy, but no dilation
-muscle fibers/collagen matrix = disorganized, esp. @ septum
-septal thick + hyperdynamic contraction --> aortic outflow tract obstructuion

8

Hemodynamic features of hypertrophic obstructive cardiomyopathy

-less compliant ventricles --> reduced filling
--predominant diastolic dysfunction --> lower EDV --> lower SV

9

Clinical features of hypertrophic obstructive cardiomyopathy

-eccentric hypertrophy of ventricle w/out dilation
-normal or enhanced systolic fxn
-predominant diastolic dysfunction (decreased ventricular filling/EDV)

10

Treatment of hypertrophic obstructive cardiomyopathy

-decrease contractility: beta/calcium channel blockers
-surgical resection
-avoid extreme exertion
-ventricular pacing

11

Hemodynamic features of restrictive cardiomyopathy

--impaired ventricular filling due to stiff ventricles --> lower EDV --> lower SV

12

Clinical presentation of restrictive cardiomyopathy

-poor prognosis
-infiltrate: amyloidosis and sarcoidosis
-infiltrate --> noncompliant (but not dilated) ventricles
-impaired diastolic fxn
-normal systolic fxn
-dx via echo
-can lead to HFrEF and fatal arrhythmias

13

Myocarditis definition and general characteristics

-inflammatory disease of heart
-in healthy adults/children=usually viral in origin
-often an autoimmune reaction (e.g. cross-rxn between viral epitopes and myocardium)

14

Treatment of dilated cardiomyopathy

-tx of HF: diuretics, ACEi, beta-blockers, etc.
-anticoagulation
-anti-arrhythmic agents (drugs, defibrillators/pacers)
-heart transplants

15

General features of hypertrophic cardiomyopathy

-LV is hypertrophied but not dilated
-often disproportionate hypertrophy of septum

16

General features of restrictive cardiomyopathy

-infiltration or fibrosis of ventricles
-usually no dilation