Myocarditis and Cardiomyopathy (complete) Flashcards Preview

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Flashcards in Myocarditis and Cardiomyopathy (complete) Deck (13)
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Discuss the clinical presentation of acute myocarditis

- Acute inflammation of cardiac muscle (using from a virus)
- Often seen in young adults and children => 50% have respiratory/GI symptoms

Common presentations:
- Fever
- Chest pain w/ ECG changes
- Arrhythmia
- HF


Describe the possible outcomes of acute myocarditis

Low EF and HF => high mortality

Some recover but others develop a chronic dilated cardiomyopathy


What are the difference classes of cardiomyopathies? What are their distinct features?

1) Dilated => dilated LV w/ minimal hypertrophy

2) Hypertrophic => marked LV hypertrophy

3) Restrictive => Infiltrated or fibrotic LV


Describe the presentation of dilated cardiomyopathy

- HF w/ large silent heart
- Both ventricles dilated, more spherical
- low EF
- Impaired systolic function (poor contraction)
- Arrhythmia (injury, fibrosis, dilation)
- Thromboemboli


What are the causes of dilated cardiomyopathy?

- Usually idiopathic
- Genetic
- Viral
- Ischemic
- Muscular dystrophies
- Alcohol
- Hemochromatosis


Descibe what you would see on a chest xray of a person w/ dilated cardiomyopathy

- Enlarged heart
- Congested lungs


Describe the treatment of dilated cardiomyopathy

- Treat the HF (diuretics, ACEI, BBs, AldAntag, etc.)
- Anticoagulation
- Anti-arrhythmic agents (drugs, ICD)
- Anti-inflammatory/immuno-suppressive


Describe hypertrophic cardiomyopathy without aortic outflow obstruction

- Diastolic dysfunction (b/c of impaired diastolic relaxation/^ stiffness)
- ^ LV diastolic pressure => ^ pulmonary venous and capillary pressures
- Dyspnea on exertion


Describe hypertrophic obstructive cardiomyopathy

- Asymmetric myocardial hypertrophy
- Diastolic dysfunction
- Normal or enhanced systolic function
- Dynamic LV outflow obstruction
- Increased risk for syncope and sudden death


Why is there a LV outflow obstruction?

- Mitral valve partially blocks outflow track below aortic valve
- Leads to decreased EF b/c of ejection disruption


Describe the clinical manifestations of hypertrophic obstructive cardiomyopathy

- Variable: asymptomatic to severe symptoms
- Dyspnea (^ LV filling pressure)
- Angina (hypertropic LV and ^ systolic LV pressure)
- Sudden death (arrhythmia) => cause for this in athletes


Describe the treatment options of hypertrophic obstructive cardiomyopathy

- Avoid competitive spores/extreme exertion
- Decrease contractility (BBs, verapamil)
- Surgical myomectomy or alcohol ablation


Describe restrictive cardiomyopathy

- Mostly infiltrative: amyloidosis/sarcoidosis
- Impaired ventricular filling b/c of stiff ventricles
- Systolic function is normal
- Ventricle not usually dilated
- Diagnosed by echo w/ doppler assessment of ventricular filling