Non-ischaemic Heart disease Flashcards
(43 cards)
what is cardiomyopathy?
any disease of the cardiac muscle
what does cardiomyopathy odten result in?
changes in SIZE of heart chambers and THICKNESS of heart
what are the 3 types of cardiomyopathy?
1) dilated
2) hypertrophic
3) restrictive
what is dilate cardiomyopathy?
= heart is expanded and therefore cannot pump blood effectively as it becomes weaker
- big heart = 2 or 3 times normal
- heart is flabby & floppy
what are the causes of dilated cardiomyopathy?
1) genetics
2) toxins
3) alcohol
4) chemotherapy agents
e. g. doxorubicin
Rarer;
5) cardiac infection
6) pregnancy
what are 4 features of dilated cardiomyopathy?
1) general picture of heart failure
2) shortness of breath
3) poor exercise tolerance
4) low ejection fraction ( low CO)
what is hypertrophic cardiomyopathy?
= big solid hearts.
= portion of the heart becomes thickened
= hypertrophic and strong contractions (doesn’t dilate, it gets bigger - very thick left ventricle)
what can hypertrophic cardiomyopathy result in?
diastolic dysfunction
= as the heart cannot relax
= eventually causing outflow obstruction
= sudden death in athletes
Yes or No.
In hypertrophic cardiomyopathy, is systolic contraction affected?
no - systolic contraction is fine, it is only diastolic dysfunction
what causes hypertrophic myopathy?
- majority is genetic
e.g. genes that create actin and myosin
= beta myosin heavy chain
= myosin binding protein C
= alpha tropomyosin
what are 3 features of hypertrophic cardiomyopathy?
1) building inter ventricular septum
2) LV luminal reduction
3) outflow tract obstruction
in hypertrophic cardiomyopahty, what would you see on a microscope of the myofibrils?
disorganised myo-fibres
what does restrictive cardiomyopathy cause?
- a LACK OF COMPLIANCE causes a STIFF HEART so the heart doesn’t relax during systole
- therefore, heart doesn’t fit well so diastolic dysfunction
Yes or No.
Can the heart appear normal in restrictive cardiomyopathy?
yes.
what causes restrictive cardiomyopathy?
= deposition of something in myocardium Examples; - metabolic byproducts, iron. - amyloid. - sarcoid = multi system granulomatous disorder. - tumours. - fibrosis
what is amyloidosis?
abnormal deposition of an abnormal protein
in amyloid, what is the tendency of the abnormal depositions to form?
tendency to form beta pleated sheets
what are the 6 classifications of amyloid?
1) AA
- relates to chronic diseases e.g. rheumatoid
2) AL
- light chains, abnormal immunoglobulin
3) haemo-dialysis associated beta 2 micro globulin
4) familial forms
5) diabetes
6) Alzheimer’s
under a microscope, what would an amyloid look like?
- waxy pink material
- stains positively for Congo red
- exhibits apple green birefringence
what does amyloid resemble?
restrictive cardiomyopathy
what is arrhythmogenic right ventricular dysplasia?
= genetic disease
- when fat replaces the right ventricle - prone to arrhythmias and therefore sudden death.
what is myocarditis?
inflammation of heart that can be infectious or non-infectious
what is infectious myocarditis most commonly caused by?
- viruses
e
= coxsackie A&B
= ECHO virus - bacterial
- fungal
- protozoal
- helminntthic
in infectious myocarditis, what happens to the myocardium?
it is thickened
