Cardiomyopathy & Myocarditis Flashcards
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?
- standing/valsalva
- squatting
Of the primary cardiomyopathies, which are genetic, which are acquired, and which are mixed?
genetic- HCM
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?
compensatory hypertrophy.
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 ______
disarray
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?
dyspnea
Why might people with HCM have anginal chest pain?
very thick heart walls, decreased blood flow there.
