Developmental – Degenerative cardiac Flashcards Preview

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Flashcards in Developmental – Degenerative cardiac Deck (19):
1

Cardiomyopathy

"Heart disease resulting from a primary*
abnormality in myocardium"

Primary myofiber abnormality: anatomic or metabolic

2

Generally Excluded is secondary cardiomyopathy which are much more common


Ischemic disease (“ischemic cardiomyopathy”)
Hypertensive disease
Valve-associated abnormality

3

Clinical Significance of Cardiomyopathy

Mechanical dysfunction
Electrical dysfunction

4

Functional pattern of cardiomyopathy

Dilated
Hypertrophic
Restrictive

5

Myocyte Hypertrophy can be cause by:

(note this is NOT cardiomyopathy)

HTN
Valve disease
MI

6

•Mechanism: Impaired contractility
•Microscopic Changes: Non-specific
•Complications:
-mural thrombus formation
-systemic embolization
-arrhythmia

Dilated Cardiomyopathy

7

DCM ________ of cases have associated genetic mutations,

30-40%

Cytoskeletal muscle fibers*/nuclear membrane proteins affects

8

DCM walls can be:

Thick or thin

9

100% due to genetic mutations**

Thickened interventricular septum bulges into the LV outflow tract during early systole

Outflow obstruction through aortic valve (~25%) / ejection murmur

Hypertrophic Cardiomyopathy

10

Hypertrophic Cardiomyopathy

3 mutations are present in
70 ‐ 80% of Hypertrophic Cardiomyopathies

Myosin-binding protein C
Myosin heavy chain
Cardiac Trop C

11

Hypertrophic Cardiomyopathy
Complications

sudden death (young athletes)

Cannot relax in diastole (impaired compliance)

12

Hypertrophic Cardiomyopathy
•Pathologic Changes

Hypertrophy & disarray of
fibers

More characteristic than other cardiomyopathies

13

Cannot relax during diastole (impaired compliance)

• Typically acquired (not really genetically linked)
• Amyloid deposition and radiation-induced fibrosis are good examples

Restrictive Cardiomyopathy

14

DCM etiology

Genetic
INfectious
alcoholic
peripartum

15

HCM etiology

100% genetic!

16

Restrictive Cardiomyopathy etiology

Amyloidosis**
Hemochromatosis
scleroderma
radiation therapy--> fibrosis**

17

DCM pathophys

Impaired systolic contraction

18

HCM pathophys

Impaired diastolic relaxation
Obstruction

19

Restrictive Cardiomyopathy pathophys

"Stiff" LV
impaired diastolic relax