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Flashcards in Cardiovascular Pathology Deck (52)
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1

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

2

Classification of myopathy?

Dilated
Hypertrophic
Restrictive

Arrhythmogenic right ventricular dysplasia

3

What is a simple description of hypertrophic cardiomyopathy?

Muscle bound

4

What is a simple description of restrictive cardiomyopathy?

Stiff

5

What is a simple description of dilated cardiomyopathy?

Weak/flabby

6

Features of dilated cardiomyopathy?

Flabby/floppy heart
Big heart= 2-3 times normal size
Histological features are non-specific

7

Main cause of DCM (dilated cardiomyopathy)?

Genetics- AD,AR, X-linked and mitochondrial
Genes that encode heart muscle proteins eg
Desmin and dystrophin

8

Causes of DCM?

Genetics
Alcohol
Drugs- chemotherapy drugs

9

Rare causes of DCM?

Pregnancy
Cardiac Infection

10

Clinical features of DCM?

General picture of heart failure
Shortness of breath, poor exercise tolerance
Low ejection fraction (low cardiac output)

11

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)

12

Causes of hypertrophic cardiomyopathy?

Genetics - lots of different genes
-Beta myosin heavy chain, Myosin binding protein C, alpha tropomyosin

13

Examples of genes that cause hypertrophic cardiomyopathy?

-Beta myosin heavy chain
- Myosin binding protein C
- Alpha tropomyosin

14

Pathophysiology of hypertrophic cardiomyopathy?

Bulging interventricular septum
Outflow tract obstruction
LV luminal reduction

15

Features of restrictive cardiomyopathy?

Lack of heart compliance
Stiff heart
Doesn't fill well so diastolic dysfunction
Can look normal
Biatrial dilatation as a result of back pressure

16

What happens to the walls of the ventricles in restrictive cardiomyopathy?

Walls become stiff but not necessarily thickened
(Heart may appear grossly normal)

17

Causes of restrictive cardiomyopathy?

Deposition of something in myocardium
Metabolic byproducts - Iron
Amyloid
Sarcoid- multi system granulomatous disorder
Tumours
Fibrosis - following radiation

18

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

19

2 Main types of amyloids?

AA- most main- related to chronic diseases like rheumatoid
AL
Haemodialysis associated
Familial forms
Diabetes
Alzheimers

20

Features of amyloid?

Generally resembles restrictive cardiomyopathy
Arrhythmogenic death

21

What is arrhythmogenic right ventricular dysplasia?

Genetic Disease - autosomal dominant with low penetrance
Causes- syncope and funny turns
Arrhythmia
Non specific features- difficult diagnosis

22

What are the features of ARVD?

Right ventricle becomes largely replaced by fat
Big and floppy

Problem== RV always looks a bit fatty

23

What is myocarditis?

Inflammation of the heart

24

Types of myocarditis?

Infectious
Non-infectious (Most common)

25

Types of infectious myocarditis?

Viral
Bacterial
Fungal
Protozoal
Helminthic

26

Most common cause of infectious myocarditis?

Viral

27

Viruses which cause infectious myocarditis?

ECHO virus
Chaga's disease
Borrelia burgdorferi- Lyme's disease
HIV

28

Pathophysiology of infectious myocarditis?

Thickened beefy myocardium

29

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)

30

Pathophysiology of rheumatic fever?

Classic mitral stenosis with thickening and fusion of valve leaflets
Short thick chordae tendinae
Myocardium also patchily inflammed