MHD - lec # 10 - Cardiomyopathy/cmyocarditis/pericardial heart disease Flashcards Preview

PHARM/MHD - Exam #4 > MHD - lec # 10 - Cardiomyopathy/cmyocarditis/pericardial heart disease > Flashcards

Flashcards in MHD - lec # 10 - Cardiomyopathy/cmyocarditis/pericardial heart disease Deck (18):
1

What are the main etiologies of DILATED CARDIOMYOPATHY?? (KNOW THIS)

LIST 7!

1. Post myocarditis (coxsackie B and enterovirus infections)
2. ALcohol
3. Doxorubicin and Daunarubicin (chemo agents)
4. Peripartum Cardiomyopathy
5. Genetic --> affecting CYTOSKELETON
6. Iron Overload
7. Idiopathic

2

What is the cause of hypertrophic cardiomyopathy?

State the most common.

- missense mutation in SARCOMERE proteins

(usually B - myosin heavy chain)

3

What is the most common cause of Left ventricle outflow obstruction in hypertrophic cardiomyopathy?

What can be seen histologically?

- systolic anterior motion of the mitral valve an mitral septal contact

- disorganized myocytes!
= MYCOTES IN DISSARRAY & hypertrophy of myocytes

4

What does IHSS often progress into?

Diastolic or systolic failure?

DIASTOLIC HF!

- cardiac insufficiency develops due to impaired diastolic filling & reduced compliance

DECREASED SV (EF is normal)

5

The following clinical symptoms are characteristics of what disorder:

Systolic ejection murmur that increases in loudness during maneuvers the DECREASE PRELOAD (SQUATTING to STANDING position)

Explain why

Hypertrophic cardiomyopathy

- increase in intestine of murmur due to enhancement of obstruction with maneuvers that DECREASE PRELOAD, left ventricular volume, and therefore LV size

ex:
- upright position from squatting, sitting, or supine
- Valsalva maneuver
- and vasodilators
(all decrease preload and venous return to the heart)


- decrease murmur with sitting or squatting, handgrip, or passive elevation of legs

6

What is the treatment for Hypertrophic cardiomyopathy (2)

drugs that increase LV relation

1. B blockers
2. non-dyhydropyridine calcium channel blockers

7

What occurs in restrictive cardiomyopathy?

decrease in ventricular compliance and impaired ventricular filling during diastole

8

What are the main etiologies of estrictive cardiomyopathy

- radiation fibrosis
- amyloidosis
- sarcoidosis
- metastatic tumor
-inborn errors of metabolism
-endomyocardial fibrosis
- LOEFLER ENDOMYOCARDITIS

9

What are amyloids?

protein buildup in B pleated sheet

1. stain congo red

2. apple green under polarized light

10

What bacteria can cause myocarditis (2)

Borrelia (lyme disease)

Corynebacterium Dipthereae

11

WHat 3 viruses can cause myocarditis?

MOST COMMON CAUSE OF MYOCARDITIS is viral infection

1. Coxsackie A & B (other enteroviruses)
2. HIV
3. Influenza virus

12

Flabby heart with mottled myocardium is characteristic of what type of heart disease?

MYOCARDITIS

- also see interstitial inflammatory infiltrate and focal myocyte necrosis

13

The following clinical findings are associated with what disease?
- hypotension
- increased venous pressure (JVD)
- distant heart sounds
- PULSUS PARADOXUS

Cardiac Tamponade

14

What is Dressler's Syndrome?

What does it cause?

Autoimmune phenomenon resulting in pericarditis several weeks post MI

PERICARDITIS

15

Acute bacterial infection would present with what type of exudate?

SUPPURATIVE

- frank pus with reddened granular pericardial surface

16

What is the CLASSIC clinical finding on an EKG for a Pericarditis?

DIFFUSE St elevation
( happening on all leads)

17

What is the genetic inheritance of hypertrophic cardiomyopathy?

Which proteins are affected

Autosomal Dominant

SARCOMERE
B- myosin of myosin binding protein
or Troponin T

18

What is Beck's triad?

What condition is it associated with?

1. Hypotension
2. Elevated JVD
3. Muffled heart sounds

Cardiac temponade