Dilated and restrictive cardiomyopathy

Question 1

Pathophysiology of dilated cardiomyopathy

Answer 1

Causative agents weaken myocardial contractions -> high end diastolic volume -> compensatory remodeling and hypertrophy (eccentric) -> weak myocardial contractility and systolic dysfunction-> reduced EF and HF

Question 2

Etiology of dilated cardiomyopathy

Answer 2

Idiopathic, familial
Alcohol and cocaine
Peripartum onset
Viral (coxsackie B, Chagas, HIV)
Cardio toxic drugs (trastuzumsb)
SLE, amyloid

Question 3

Symptoms, diagnosis, and treatment of dilated cardiomyopathy

Answer 3

Dyspnea, angina, HF, maybe holosystolic murmur due to functional mitral regurg
Diagnosis:
Echo: dilated ventricle
X-ray: cardiomegaly, pulmonary edema

Treatment: treat HF, stop offending agents, consider ICD/resynchronization therapy or heart transplant

Question 4

Pathophysiology of restrictive cardiomyopathy

Answer 4

Infiltration of myocardium -> low ventricular compliance -> stiff ventricles and diastolic dysfunction because they cannot expand to hold more blood

Question 5

Etiology of restrictive

Answer 5

Amyloid, sarcoid, hemochromatosis, endomyocardial fibrosis, radiation

Question 6

Diagnosis and treatment of restrictive

Answer 6

Echo, ecg, X-ray all show nonspecific changes

Treatment is symptomatic control, poor prognosis