Flashcards in Cardiovascular Pathology Deck (52)
What is cardiomyopathy?
Any disease of the cardiac muscle
-Often results in changes in the size of the heart chambers and thickness of the heart
Classification of myopathy?
Arrhythmogenic right ventricular dysplasia
What is a simple description of hypertrophic cardiomyopathy?
What is a simple description of restrictive cardiomyopathy?
What is a simple description of dilated cardiomyopathy?
Features of dilated cardiomyopathy?
Big heart= 2-3 times normal size
Histological features are non-specific
Main cause of DCM (dilated cardiomyopathy)?
Genetics- AD,AR, X-linked and mitochondrial
Genes that encode heart muscle proteins eg
Desmin and dystrophin
Causes of DCM?
Drugs- chemotherapy drugs
Rare causes of DCM?
Clinical features of DCM?
General picture of heart failure
Shortness of breath, poor exercise tolerance
Low ejection fraction (low cardiac output)
Features of hypertrophic cardiomyopathy?
Big Solid hearts
-Hypertrophic and strong contraction (differes from DCM)
-Diastolic dysfunction- (not systolic as contraction is fine)
-Heart can't relax
-Eventual outflow obstruction
(causes sudden death in athletes)
Causes of hypertrophic cardiomyopathy?
Genetics - lots of different genes
-Beta myosin heavy chain, Myosin binding protein C, alpha tropomyosin
Examples of genes that cause hypertrophic cardiomyopathy?
-Beta myosin heavy chain
- Myosin binding protein C
- Alpha tropomyosin
Pathophysiology of hypertrophic cardiomyopathy?
Bulging interventricular septum
Outflow tract obstruction
LV luminal reduction
Features of restrictive cardiomyopathy?
Lack of heart compliance
Doesn't fill well so diastolic dysfunction
Can look normal
Biatrial dilatation as a result of back pressure
What happens to the walls of the ventricles in restrictive cardiomyopathy?
Walls become stiff but not necessarily thickened
(Heart may appear grossly normal)
Causes of restrictive cardiomyopathy?
Deposition of something in myocardium
Metabolic byproducts - Iron
Sarcoid- multi system granulomatous disorder
Fibrosis - following radiation
What is amyloid?
Abnormal deposition of an abnormal protein
Lots of different types as lots of abnormal proteins
Tendency to form beta pleated sheets
Body can't get rid of them
2 Main types of amyloids?
AA- most main- related to chronic diseases like rheumatoid
Features of amyloid?
Generally resembles restrictive cardiomyopathy
What is arrhythmogenic right ventricular dysplasia?
Genetic Disease - autosomal dominant with low penetrance
Causes- syncope and funny turns
Non specific features- difficult diagnosis
What are the features of ARVD?
Right ventricle becomes largely replaced by fat
Big and floppy
Problem== RV always looks a bit fatty
What is myocarditis?
Inflammation of the heart
Types of myocarditis?
Non-infectious (Most common)
Types of infectious myocarditis?
Most common cause of infectious myocarditis?
Viruses which cause infectious myocarditis?
Borrelia burgdorferi- Lyme's disease
Pathophysiology of infectious myocarditis?
Thickened beefy myocardium
Causes of non-infectious myocarditis?
Immune mediated hypersensitivity reactions
Hypersensitivity to infection- Rheumatic fever after strep throat
Hypersensitivity to drugs- eosinophillic myocarditis
Systemic lupus erythematosus (SLE)