Cardiomyopathy/Pericarditis Flashcards Preview

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Flashcards in Cardiomyopathy/Pericarditis Deck (35):
1

Mycarditis - etiology

1) Infection - VIRUS, parasite, fungal, bacteria
2) Drug/toxin
3) Autoimmune
4) Metabolic

2

Myocarditis symptoms

Fever, myalgia, muscle tenderness, chest pain with ECG arrhythmia, fatigue, dyspnea, CHF

3

pathology of viral myocarditis

imflammation with lymphocytes

4

Fungal myocarditis

more common in immunosuppressed

5

Autoimmune myocarditis

collagen vascular or CT disease systemic, (lupus, scleroderma, RA) to affect all three layers of heart

6

Adriamycin

chemo drug to lead to toxic accumulation and myocarditis

7

What toxins cause mycarditis

Adriamycin, ethanol, cobalt, hemochromatosis

8

Amyloidosis

Protein deposition (beta pleated sheets) to cause myocarditis

9

Dilated Cardiomyopathy

systolic dysfunction

10

Associated symptoms of dilated cardiomyopathy

normal HF, ventricular thrombus, M/T regurgitation, arrhythmia

11

Increased BNP in dilated cardiomyopathy

worse outcome

12

Hypertrophic Cardiomyopathy

disproportionate Septum thickening to cause diastolic dysfunction.
Myocyte dissaray and concentric hypertrophy.

13

EF in dialated ver hypertrophic

dilated is reduced
hypertrophy - normal of hyperdynamic

14

Murmur is hypertrophic cardiomypathy

systolic murmur that increases with standing and valsava

15

SAM

Systolic anterior movement of mitral valve... gets stuck in outflow track to lead to mitral regurgitation murmur in systole.

16

Surgical tx of hypertrophic cardiomyopathy

myomectomy and alcohol ablation

17

Restrictive cardiomyopathy

diastolic dysfunction due to scar and fibrosis of heart. Most common cuases are amylodosis, sarcoidosis, hemochromatosis, raditiaion

18

Arrhythmogenic Right Ventricular cardiomyopathy

mycardium is replaced by fibroblast --> arrhythmia prone. More prevalent in RV than LV.

19

Secondary cuases of Hypertension

renal (diabetes, renal a. stenosis), endocrine, cardiovascualr

20

ECG finding of acute pericarditis

diffuse ST elevation

21

electrical alternans

alteration of QRS amplitude between beats in pericardial effusion

22

Pulsus paradoxus

decreased systolic BP >10 mm with inspiration - in pericardial effusion and cardiac tamponade.

23

ECHO in cardiac tamponade

effusion, RV and RA collapse, dialted IVC

24

Symptoms of constrictive pericarditis

elevated JVP, edema, ascites, tachy, hepatomegaly, 3rd heart sound.

25

Long QT1

Loss of function mutation in IKS - cannot hyperpolarize

26

Long QT2

loss of function mutation in IKR

27

Long QT3

gain of function in INa - does not inactivation

28

Gain of Function in Long QT

I Na - no inactivation

29

Timothy syndrome

incomplete ICa inactivation to prolong phase 2
mutation in CaV1.2 (de novo) to have also immunodeficiency and cognitive abnormalities (autism)
G406R and G402S (exon 8 and 8A)

30

Bruguda Syndrome

Sudden unexplained death syndrome that makes one prone to ventricular arrhythmias due to Na Channel mutation, ankryn mutation, and Cav1.2 to shorten QT

31

Finnish Syndrome

Mutation in IKs so it cannot bind to Yotiao. Yotiao binds PKA to Ca and K channels. Thus a mutation in IKs means that when increased sympathetic activity, there wont be enough K channels to match increased Ca current and leads to afterpolarizations.

32

how to overcome re-entry?

1) unidirection --> bidirectional block
2) prolong refractory time

33

how do you convert uni to bidirectional block?

1) slow conduction velocity so it cant propogate into depressred region
2) prolong refractory peroid

34

Catecholaminergic polymorphic Ventricular Tachy (CPVT)

no ECG abnormality, but apparent wit exercise of catecholamines.
RyR2 mutation that leads to Ca leaking from SR or increases RyR2 senstivity.
OR
Calsequestrin mutation so it can no longer buffer and RyR2 is no longer regulated.

35

Treatment of CPVT

Beta blockers, Block RyR (tetracaine) or flecanidide (block Na channels).