Flashcards in Cardiomyopathy & Myocarditis Deck (21):
Is hyoertrophic cardiomyopathy more of a systolic or a diastolic dysfunction?
diastolic. LV outflow obstruction
What is SAM?
systolic anterior motion of the mitral valve. mitral valve gets stuck in the aortic valve and causes outflow obstruction.
What causes a systolic murmur to get louder (in HCM)? What causes it to get softer?
Of the primary cardiomyopathies, which are genetic, which are acquired, and which are mixed?
Mixed- Dilated CM, restrictive CM
Acquired- inflammatory (myocarditis)
Describe clinical presentation and possible outcomes of acute myocarditis?
-acute inflammation (usually viral)
-often affects young adults
With low EF and HF there is high mortality. Some recover, others develop chronic dilated cardiomyopathy.
myocardial dilation is often accompanied by what?
dilated cardiomyopathy pathophysiology.
decreased CO leads to activation of the renin-angiotensin-aldosterone system-- causes increase in BP. AT-II causes endothelial dysfunction and prothrombotic effects.
Also, sympathetic nervous system is activated--release of norepinephrine is associated with ventricular remodeling (bad).
thinking about the pathophys from the last card which drugs would you want to give to someone with dilated cardiomyopathy?
ACE-inhibitors, angiotensin II receptor blockers (ARBs), and
Beta-blockers (decrease sympathetic tone)
ACE and Beta especially. They are helpful for improving function and reversing remodeling.
On clinical presentation, people with dilated cardiomyopathy present with symptoms of what?
heart failure. volume overload, dypnea, orthopnea, PND, edema etc..
what might happen to the atria in left ventricular hypertrophy?
left atrial enlargement
Higher levels of what biomarker is indicative of a worse prognosis in dilated CM?
brain natriuretic peptide (BNP)
hypertrophic CM causes myocyte ______
dilated CM has _____ hypertrophy while hypertrophic CM has ______ hypertrophy.
concentric (sarcomeres added in parallel)
eccentric (sarcomeres added in series)
What is the most frequent symptom on exertion of HCM?
Why might people with HCM have anginal chest pain?
very thick heart walls, decreased blood flow there.
what is the study of choice for HCM and what does it usually reveal?
septal hypertrophy on echocardiogram
What are some important treatment procedures of HCM?
surgical myomectomy (cut out some of the heart)
alcohol ablation (kills some heart cells)
What are the hallmarks of restrictive cardiomyopathy?
amyloidosis (cardiac amyloid) and sarcoidosis (systemic disorders)
HCM has a good or bad contractility?
good. pumps like a beast
What is ARVC and common presentation?
arrythmogenic Right ventricular cardiomyopathy- there is progressive replacement of the myocardium with fibrofatty tissue. Get dilated cardiomyopathy (RV or LV) and can get sudden death in young and middle aged pats.