Flashcards in Myocarditis and Cardiomyopathy (complete) Deck (13):
1
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
2
Describe the possible outcomes of acute myocarditis
Low EF and HF => high mortality
Some recover but others develop a chronic dilated cardiomyopathy
3
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
4
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
5
What are the causes of dilated cardiomyopathy?
- Usually idiopathic
- Genetic
- Viral
- Ischemic
- Muscular dystrophies
- Alcohol
- Hemochromatosis
6
Descibe what you would see on a chest xray of a person w/ dilated cardiomyopathy
- Enlarged heart
- Congested lungs
7
Describe the treatment of dilated cardiomyopathy
- Treat the HF (diuretics, ACEI, BBs, AldAntag, etc.)
- Anticoagulation
- Anti-arrhythmic agents (drugs, ICD)
- Anti-inflammatory/immuno-suppressive
8
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
9
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
10
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
11
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
12
Describe the treatment options of hypertrophic obstructive cardiomyopathy
- Avoid competitive spores/extreme exertion
- Decrease contractility (BBs, verapamil)
- Surgical myomectomy or alcohol ablation
- ICD
13