Cardiomyopathy and anti-arrythmatic Flashcards Preview

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Flashcards in Cardiomyopathy and anti-arrythmatic Deck (64)
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1

What are the features of the heart in dilated cardiomyopathy?

progressive cardiac dilation
systolic dysfunction
hypertrophy
enlarged, heavy flabby heart

2

What are common causes of dilated cardiomyopathy?

ischemia
valvular
HTN
idiopathic
familial
inflammmatory-infectious
toxic
metabolic
nutritional
neuromusc

3

What percentage of dilated myopaties are indicated by genetic casues?

20-50% majority autosomal dominant mutations encoding cytoskeleton proteins

4

What viruses have been linked to dilated cardiomyopathy?

coxasckie B or echovirus, self limited in young ppl
unclear mecchanism

5

What two ways can alcohol cause dilated cardiomyopathy?

alcohol: direct toxic effect myocardium
alcohol: indirect toxic effect associated with thiamine disease (beriberi disease0

6

What chemotherapy drug can lead to dilated cardiomyopathy

doxorubicin as well as other anthracyclines, which is dose dependent

7

What is the dilated cardiomyopathy due to pregnancy?

peripartum cardiomyopathy; late in pregnancy or several weeks to months posptartum;
probable cause
HTN
volume overload
nutritional def
prolactin

8

What is the dilated cardiomyopathy gross morphology?

four chamber dilation
variable thickness
mural thrombi
valves are normal, but may have tricuspid or mtiral regurg
cardiomegaly

9

What is the histology associated with dialted cardiomyopathy?

myocyte hypertrophy
interstital & endocardial fibrosis; no necrsois
not specific for DCM unless iron overload is cause adn iron present

10

What puts you at increased risk for idiopathic dilated cardiomyopathy

black
male
HTN
chronic Beta-agonist; relatively rare

11

How does idiopathic dilated cardiomyopathy usually present?

heart failure symtpoms
or anginal chest pain
occasionally sudden death

12

What are the treatmments for dilated cardiomyopahty?

ACE inhibitor, other diuretics
potassium/magnesium
beta blocker
digoxin in face of persistnent syndromes
wafarin-with thrombus/afib
ICD- MI oruncontrolled vT

13

What is the definition of arrhythmogenic right ventricular cardiomyopathy?

inherited disease of cardiac muscle
right ventricle failure and various rythm disturbance
sudden death possible

--right ventricle is severely thinned bc of loss of myocytes with extensive fatty infiltration and fibrosis---

14

What is the inheritance of arrhythmogenic right ventricular cardiomyopathy?

autosomal dominant

15

Where is the defect in arrhythmogenic right ventricular cardiomyopahty?

defective cell adhesion proteins in desmosomes that link adjacent cardiac myocytes

16

What is the clinical syndrome associated with arrhythmogenic right ventricular cardiomyopathy?

young adults
arrhythmia (VTach)
sudden death
right ventricular failure

17

What is the morphology of arrhythmogenic right ventricular cardio?

thin & dilated right ventricular wall with fatty infiltration (essential feature) and intersitial fibrosis

18

What is hypertrophic cardiomyopathy?

myocardial hypertrophy, with abnormal diastolic filling, poorly complian
heart is thick-walled, heavy and hypercontracting
priimarily diastolic dysfunction, systolic functio usually perserved
ventricular outflow obstruction

19

What is the gross morphology of HCM

massive myocardial hypertrophy, frequent disporportionate thickening of septum
endocardial thickening and mural plaques in outflow tract

20

What is the histology of HCM?

marked hypertrophy
intersitial fibrosis
**myofiber disarray**
intersitial fibrosis

21

What are the mutations associated with HCM?

increase myofilament activation resutling in myocyte cotnractility

missesnse in sarcomeric proteins
myosin heavy chain
myosin binding protein
cardiac TnT

DEFECTS IN DIRECT SARCOMERE FUNCTION
DEFECT IN TRANSFER OF ENERGY TO SARCOMERE

22

What is the genetic inheritance of HCM?

prognosis correlated with mutation
familiail, AD, Variable expression
one of the most common causes of sudden unexplained death in athletes

23

What are the arrythmias associated with HCM?

paroxysmal supraventricular arrthmias
Afib
Non-sustained ventricular tachy
sustained ventricular tachy/ventricular fibrillation

24

What are the clinical features of HCM?

presentation after puberty
asymptomatic frequently
sudden death in young athletes
syncope due to left ventricular outflow obstruction

Tx: surgical excision, ventricular relaxing drugs

25

What are the risk facctors for cardiac death in HCM?

marked ventricular hypertrophy
young age
hypotension on excercise
syncope
hx of aborted cardiac rest
FHx of sudden cardiac death
certain geneti mutations

26

What is used to treat HCM

Beta blockers

27

What is a dual chamber pacemaker used for?

HCM, used in pts with sxs who cant tolerate surgical therapy

28

How do you prevent sudden cardiac death in HCM pts?

pts at high risk receive implantable cardioverter-defibrillators

29

What is restrictive cardiomopathy?

primary deccrease in ventricular compliance resulting in impaired ventricular during

-idiopathic
-secondary to
-post radiation fibrosis
-amyloidosis
sarcoidosis
metastases
inborn error of metabolism

30

What is restrictive cardiomyopathy morphology gross?

-normal ventricles
-bi-atrial dilation
-firm myocardium
-interstital fibrosis