Flashcards in Myocarditis and Pericarditis Deck (72)
What are the types of cardiomyopathy?
What is hypertrophic cardiomyopathy?
Inappropriate ventricular hypertrophy
What is the distribution of hypertrophic cardiomyopathy?
Asymmetric septal hypertrophy
What are the genetic features of hypertrophic cardiomyopathy?
Usually autosomal dominant, familial condition
Genetic heterogeneity - over 30 different genetic variants described
Phenotypic heterogeneity - expression varies even within families who have the same genes
What do genes affected by hypertrophic cardiomyopathy control?
What interaction is abnormal in beta myosin heavy chains in hypertrophic cardiomyopathy?
Abnormal interaction between actin and myosin filaments
When does hypertrophic cardiomyopathy usually manifest?
Early to mid teenage years
What is the effect of hypertrophic cardiomyopathy on ventricular contraction?
Normal or increased in the majority of patients
What is the effect of hypertrophic cardiomyopathy on systole and diastole?
Systole - LVOT obstruction
Diastole - reduced compliance
What is a common effect on relaxation in hypertrophic cardiomyopathy?
Impaired relaxation is a common feature
What is the effect of hypertrophic cardiomyopathy on systolic function?
Usually adequate with some functional abnormality
In what percentage of people with hypertrophic cardiomyopathy is the cause genetic?
What is the effect of hypertrophic cardiomyopathy on diastolic function?
Impaired with poor capacity to fill and reduced cardiac compliance
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
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
What are the features of dilated cardiomyopathy?
Reduced contraction of one or both ventricles
Progressive and irreversible condition
What is the mortality of dilated cardiomyopathy?
25% 1 year mortality
50% 5 year mortality
What is the aetiology of dilated cardiomyopathy?
Common expression of myocardial damage, probably due to a number of different disease processes
What are the features of restrictive and infiltrative cardiomyopathy?
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
What are the non-infiltrative causes of cardiomyopathy?
What are the infiltrative causes of cardiomyopathy?
What are the storage diseases which cause cardiomyopathy?
What are the endomyocardial causes of cardiomyopathy?
What is the pathology of dilated cardiomyopathy?
Inability to fill a ventricle which has a reduced compliance
When is alcohol heart disease potentially reversible?
In early stages with immediate and complete abstinence
What is myocarditis?
Involvement of the heart in an inflammatory process, usually caused by an infective agent
What infective agents cause myocarditis?
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
What are the common pericardial diseases?