Myocarditis and Pericarditis Flashcards Preview

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Flashcards in Myocarditis and Pericarditis Deck (72)
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1

What are the types of cardiomyopathy?

Hypertrophic
Dilated
Restrictive
Obliterative

2

What is hypertrophic cardiomyopathy?

Inappropriate ventricular hypertrophy

3

What is the distribution of hypertrophic cardiomyopathy?

Asymmetric septal hypertrophy
Apical hypertrophy
Generalised hypertrophy

4

What are the genetic features of hypertrophic cardiomyopathy?

Usually autosomal dominant, familial condition
Sporadic cases
Genetic heterogeneity - over 30 different genetic variants described
Phenotypic heterogeneity - expression varies even within families who have the same genes

5

What do genes affected by hypertrophic cardiomyopathy control?

Contractile porteins

6

What interaction is abnormal in beta myosin heavy chains in hypertrophic cardiomyopathy?

Abnormal interaction between actin and myosin filaments

7

When does hypertrophic cardiomyopathy usually manifest?

Early to mid teenage years

8

What is the effect of hypertrophic cardiomyopathy on ventricular contraction?

Normal or increased in the majority of patients

9

What is the effect of hypertrophic cardiomyopathy on systole and diastole?

Systole - LVOT obstruction
Diastole - reduced compliance

10

What is a common effect on relaxation in hypertrophic cardiomyopathy?

Impaired relaxation is a common feature

11

What is the effect of hypertrophic cardiomyopathy on systolic function?

Usually adequate with some functional abnormality

12

In what percentage of people with hypertrophic cardiomyopathy is the cause genetic?

90%

13

What is the effect of hypertrophic cardiomyopathy on diastolic function?

Impaired with poor capacity to fill and reduced cardiac compliance

14

What is the pathology of hypertrophic cardiomyopathy?

Myocyte hypertrophy and disarray
Can be generalised or segmented with wall thickness
Coronary arteries are also affected with small vessel narrowing and consequent ischaemia and fibrosis
Arrhythmias common

15

What is dilated cardiomyopathy?

Effectively a structural and functional description, ventricular function is impaired - usually affects the left ventricle but all 4 chambers can be dilated

16

What are the features of dilated cardiomyopathy?

Cardiac enlargement
Reduced contraction of one or both ventricles
Progressive and irreversible condition

17

What is the mortality of dilated cardiomyopathy?

25% 1 year mortality
50% 5 year mortality

18

What is the aetiology of dilated cardiomyopathy?

Common expression of myocardial damage, probably due to a number of different disease processes

19

What are the features of restrictive and infiltrative cardiomyopathy?

Less common
Systolic function may or may not be impaired
About 50% related to specific clinical disorders
Non-compliant heart so fills poorly regardless of systolic function which has a profound effect on haemodynamics

20

What are the non-infiltrative causes of cardiomyopathy?

Familial
Scleroderma
Diabetes
Pseudoxanthoma elastic

21

What are the infiltrative causes of cardiomyopathy?

Amyloid
Sarcoid

22

What are the storage diseases which cause cardiomyopathy?

Haemochromatosis
Fabry disease

23

What are the endomyocardial causes of cardiomyopathy?

Fibrosis
Carcinosis
Radiation
Drug effects

24

What is the pathology of dilated cardiomyopathy?

Inability to fill a ventricle which has a reduced compliance

25

When is alcohol heart disease potentially reversible?

In early stages with immediate and complete abstinence

26

What is myocarditis?

Involvement of the heart in an inflammatory process, usually caused by an infective agent

27

What infective agents cause myocarditis?

Toxins
Drugs
Allergic reactions
Vasculitic disorders
Viral
Ricketsia
Bacteria
Fungi
Protozoa
Metazoan
Spirochaetes

28

What is the clinical course of myocarditis?

Usually a self-limiting sub-clinical condition during the course of a viral infection
Can develop into acute and fulminating heart failure

29

What are the common pericardial diseases?

Acute pericarditis
Pericardial effusion
Constrictive pericarditis

30

What is acute pericarditis?

Acute inflammation of the pericardium