Lec 9 Cardiomyopathy Pathology Flashcards Preview

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Flashcards in Lec 9 Cardiomyopathy Pathology Deck (25):
1

What is a cardiomyopathy?

structural or functional abnormality of myocardium independent of other valvular/coronary/myocardial involvement in systemic disease

2

What are 3 types of cardiomyopathy?

- dilated
- hypertrophic
- restrictive

3

What is most common type of cardiomyopathy?

dilated

4

Who gets dilated cardiomyopathy [DCM]?

- may occur at any age
- most common males 20-50
- often idiopathic or congenital

5

What are findings of dilated cardiomyopathy?

- left ventricular dilation
- systolic dysfunction [EF < 50%]
- S3
- heart failure
- dilated heart on echo
- balloon appearance of heart on CXR

6

What are causes of dilated cardiomyopathy?

- idiopathic or congenital
- ABCCCD
--- Alcohol abuse
--- wet bebriberi [thiamine deficiency]
--- coxsackie B virus myocarditis
--- chronic cocaine use
--- chagas disease
--- doxorubicin toxicity
- hemochromatosis
- peripartum cardiomyopathy

7

What is major genetic cause of dilated cardiomyopathy?

mutation in TTN gene that encodes titin
autosomal dominant

8

What are pathological findings of dilated cardiomyopathy?

- enlarged globular heart [2-3x normal weight]
- 4 chamber dilation + hypertrophy
- thin flabby walls
- annular dilation of atrial-ventricular valves
- eccentric hypertrophy

9

What are histo features of dilated cardiomyopathy?

- hypertrophied myocytes
- boxcar nuclei
- some myocytes stretched and irregular
- interstitial fibrosis

10

What are major infectious causes of dilated cardiomyopathy?

viral myocarditis: coxsackie B, adenovirus

parasite: T. cruzi = chagas disease

11

What are some toxins that can cause dilated cardiomyopathy?

alcohol or cocaine use

12

What are mechs of alcoholic dilated cardiomyopathy?

- direct toxic affect of alcoholic
- secondary nutritional thiamine deficiency
- alcohol additives

13

Who gets dilated cardiomyopathy from alcohol?

men 30-55 with > 10 yrs of alcohol consumption

14

If sudden cardiac death in young athlete what should you think?

hypertrophic cardiomyopathy

15

Who gets hypertrophic cardiomyopathy?

100% familial/genetic
males > females
young atheletes

16

What happens in hypertrophic cardiomyopathy?

left ventricle hypertrophy
diastolic dysfunction = can't fill the heart

17

What is genetics of hypertrophic cardiomyopathy?

mutation in sarcomere protein for myosin heavy chain
autosomal dominant

18

What are path findings of hypertrophic cardiomyopathy?

hypertrophy of myocardium
- asymmetrical hypertrophy beflow aortic valve in most pts
- greater hypertrophy of interventricular septum than free LV wall
- aberrant myofibers in conduction system --> fatal arrhythmia + sudden death

19

What is most common cause of restrictive cardiomyopathy?

amyloidosis

20

What are path findings of restrictive cardiomyopathy?

- ventricles normal or slightly enlarged
- myocardium firm and normal thickness
- bi-atrial dilation because poor ventricular filling and pressure overloads
- patchy areas of fibrosis

21

What is arythmogenic right ventricular cardiomyopathy [ARVC]?

inherited cardiomypathy
- causes RV failure and rhythm disturbances [ventricular fibrillation or tachycardia]
- fatty and fibrous tissue replace heart muscle
- can lead to suddne death
- usually in young people
- autosomal dom mut in desmosomal protein

22

What is isolated left ventricular noncompaction [LVNC]?

congentical myocardial disorder causes CM in children

persistence of noncompacted endocardial layer charactersisc of early fetal period

LV dilated or hypertrophied

sponge-like appearance of LV wall

23

If you see eosinophils in cardiomyopathy what should you think?

hypersensitiviy
parasites [Chagas]

24

If you see lymphocytes in cardiomyopathy what should you think?

viral

25

If you see giant cells in cardiomyopathy what should you think?

sarcoidosis
giant cell myocarditis