Flashcards in MHD - lec # 10 - Cardiomyopathy/cmyocarditis/pericardial heart disease Deck (18):
What are the main etiologies of DILATED CARDIOMYOPATHY?? (KNOW THIS)
1. Post myocarditis (coxsackie B and enterovirus infections)
3. Doxorubicin and Daunarubicin (chemo agents)
4. Peripartum Cardiomyopathy
5. Genetic --> affecting CYTOSKELETON
6. Iron Overload
What is the cause of hypertrophic cardiomyopathy?
State the most common.
- missense mutation in SARCOMERE proteins
(usually B - myosin heavy chain)
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
What does IHSS often progress into?
Diastolic or systolic failure?
- cardiac insufficiency develops due to impaired diastolic filling & reduced compliance
DECREASED SV (EF is normal)
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)
- increase in intestine of murmur due to enhancement of obstruction with maneuvers that DECREASE PRELOAD, left ventricular volume, and therefore LV size
- 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
What is the treatment for Hypertrophic cardiomyopathy (2)
drugs that increase LV relation
1. B blockers
2. non-dyhydropyridine calcium channel blockers
What occurs in restrictive cardiomyopathy?
decrease in ventricular compliance and impaired ventricular filling during diastole
What are the main etiologies of estrictive cardiomyopathy
- radiation fibrosis
- metastatic tumor
-inborn errors of metabolism
- LOEFLER ENDOMYOCARDITIS
What are amyloids?
protein buildup in B pleated sheet
1. stain congo red
2. apple green under polarized light
What bacteria can cause myocarditis (2)
Borrelia (lyme disease)
WHat 3 viruses can cause myocarditis?
MOST COMMON CAUSE OF MYOCARDITIS is viral infection
1. Coxsackie A & B (other enteroviruses)
3. Influenza virus
Flabby heart with mottled myocardium is characteristic of what type of heart disease?
- also see interstitial inflammatory infiltrate and focal myocyte necrosis
The following clinical findings are associated with what disease?
- increased venous pressure (JVD)
- distant heart sounds
- PULSUS PARADOXUS
What is Dressler's Syndrome?
What does it cause?
Autoimmune phenomenon resulting in pericarditis several weeks post MI
Acute bacterial infection would present with what type of exudate?
- frank pus with reddened granular pericardial surface
What is the CLASSIC clinical finding on an EKG for a Pericarditis?
DIFFUSE St elevation
( happening on all leads)
What is the genetic inheritance of hypertrophic cardiomyopathy?
Which proteins are affected
B- myosin of myosin binding protein
or Troponin T