Module 16 : Restrictive and Other Cardiomyopathies Flashcards
(45 cards)
1
Q
what is another term for restrictive cardiomyopathy RCMO
A
- infiltrative CMO
2
Q
what does RCMO refer to
A
- disease other than ischemici heart disease which cause increased resistance to LV filling due to increased myocardial stiffness
- increased LVEDP
- increase mLAP
3
Q
what is the main cause of RCMO
A
- abnormal infiltration, storage, or fibrosis within the myocardium
4
Q
what are the 4 classes of RCMO
A
- non infiltrative
- infiltrative
- storage disease
- endomyocardial
5
Q
what are the 2 main causes of non infiltrative RCMO
A
- HCMO
- diabetic CMO
6
Q
what are the 2 causes of infiltrative RCMOq
A
- amyloidosis
- sarcoidosis
7
Q
what is a main cause of storage disease RCMO
A
- GSD
8
Q
what are the 2 endomyocardial causes of rCMO
A
- endomyocardial fobroelastosis
- carcinoid heart disease
9
Q
what is the etiology of infiltrative RCMO
A
- disease of heart muscle secondary to a disorder that produces histological changes to cardiac muscle by depositing a substance inside or in between muscle cells
10
Q
what 2 things may infiltrative RCMO lead to
A
- infiltration of myocardium
- restrictive filling pattern
11
Q
what are the 3 clinical findings of RCMO
A
- diastolic dysfunction (HFnEF) backwards failure
- early stags normal systolic function
- arrhythmias
12
Q
what are the echo findings in RCMO
A
- LV cavity size normal
- wall thickness increased
- bi atrial enlargments
- small pericardial effusion
13
Q
what are the 5 roles of echo in RCMO
A
- asses chamber function and size
- degree of DD
- degree of MR or TR
- determine RVSP
- differentiate from constrictive pericarditis
14
Q
what will the ECG look like with RCMO
A
- atrial and ventricular arrhythmias
- low voltage QRS
- conduction defects
15
Q
what are the 5 medical treatments of restrictive CMO
A
- treat underlying aetiology
- diuretics
- ace inhibitors
- anticoagulnats
- anti arrhythmias
16
Q
what are the 2 surgical treatments of RCMP
A
- pace maker / defibrilaors
- cardiac transplant
17
Q
what is the most common type of RCMO
A
- amyloidosis
18
Q
what is amyloidosis RCMO
A
- deposits of amyloid protein in between myocytes
- inderdiagnosed
19
Q
is diagnosis of amyloid CMO easy or hard
A
- very difficult
20
Q
what 5 other organs may be affected by amyloid CMP
A
- heart
- liver
- kidnyes
- spleen
- skin
21
Q
what are the 4 classifications of amyloid disease
A
- primary idiopathic = more common in males
- secondary
- familial
- senile
22
Q
what will amyloid CMO look like eon ECG
A
- low voltage ECG
- LVH plus low voltage ECG importnatn
- pseudo infarction
- afib
- ventricular arrhytmias
- conduction defects
23
Q
what are the 4 medical treatments of amyloid CMO
A
- digitalis, digoxin
- diuretics
- vasodilators
- anticoagulants
24
Q
what are the 4 surgical treatments of amyloid CMO
A
- bone marrow stem cell transplant
- pacemaker
- implantable device
- transplant
25
what are the 7 echo features of amyloid CMO
- granular speckled appearance
- concentric LVH and RVH
- WMA
- asymmetric septal thickening
- bi atrial enlargements
- pericardial effusion
- PHTN
26
what does an increase in wall thickness mean in regards to DD
- thick the wall = more severe diastolic dysfunction
27
what are the early changes in systolic function with amyloidosis
- LV systolic function normal and normal size
28
what are the late changes seen in systolic function with amyloidosis
LV may dilates
| - LVEF reduce
29
what is sarcoidosis
- multiple granulomatous disease which involves the heart
- females more
- rare
30
what is theist common site for granulomas to infiltrate
- lungs
31
what are the clinical features of sarcoidosis
- progressive heart failure
- diffuse pulmonary fibrosis = PHTN
- death
- dysrhtymias
- 3rd degree AV blocks
32
what are the echo features of sarcoidosis
- pericardial effusion
- increase anterior RV thickness > 5mm
- PTHN
- RV dysfunction
- MR/TR
- DD
- late = dilation of LV, wall thinning, reduced EF, WMA
33
what is hemochromatosis and what are the 2 groups
- iron storage disease affecting multiple organ systems resulting in organ damage and malfunction
- primary, secondary
34
what is primary hemochromatosis
- inherited
35
what is secondary hemochromatosis
- iron overload due to repeated blood transactions with patients with chronic anemia, hemodialysis, alcoholic liver disease
36
what is the clinical pentad of hemochromatosis
- CHF
- cirrhosis
- impotence
- diabetes
- arthritis
37
what will the ECG look like with hemochromatosis
- AF
- low voltage
- SVTs
- AV blocks
38
what is another name for endomyocardial syndrome
- hypereosinphilic
| - perisitant elevated blood eosinophil counts
39
what are the four causes of perisitant elevated blood eosinophil counts
- idiopathic
- malignant
- reactive
- infectious
40
what does endomyocardial syndrome evolve from
- infiltration of eosinophils to thrombosis
| - restriction due to fibrotic tissues that lines myocardium decreased LV function and CHF then death
41
what is GSD
- excessive storage of glycogen in tissue
- hereditary
- heart becomes enlarged and globular in shape
- thickened RV LV and IVS
42
what are 4 other infiltrative CMOS
- arrhytmogenic RV dysplaisia
- carcinoid heart disease
- fabrys disease
- collagen disorders
43
characteristics of arrhytmogenic RV dysplasia
- genetiv
- fibrofatty
- RV systolic and diastolic dysfunction
- RV dilation RV small aneurysms
- RV trabeculation get bigger
- normal LV
- arrhytmias
44
characteristics of LV non compaction
- gentic
- LV wall thickening with deep recess between trabeculae
- hypokinesis
- arrhytmias
- heart failure
45
development of LV non compaction
- embryonic development
- before coronary arteries blood supplied by trebeculation in blood
- once coronaries developed the LV compass from epicardium to endocardium and base to apex
- LV non compaction is seen usually in apex
