Restrictive And Other Cardiomyopathies Flashcards
Restrictive cardiomyopathy is also known as what?
What does RCMO refer to?
Increased resistance to LV filling due to increased myocardial stiffness
What is the main cause of RCMO?
Abnormal infiltration, storage or fibrosis within the myocardium
What is the cause of non-infiltrative RCMO?
Idiopathic, familial, hypertrophic (can cause restrictive physiology), scleroderma, diabetic (fibrosis)
What is the cause of infiltrative RCMO?
Amyloidosis, sarcoidosis, Hurler’s disease, Loeffler’s disease
What is the cause of storage disease RCMO?
Hemochromatosis, Fabry disease, glycogen storage disease
What is the cause of endomyocardial RCMO?
Endomyocardial fibrosis, carcinoid heart disease, radiation, toxic effects from anthracycline (chemo)
What is the etiology of infiltrative diseases related to RCMO?
Disease of heart muscle that is secondary to disease/disroder that produces histologic changes to cardiac muscle
What kind of diastolic function is seen with RCMO?
HFnEF (backwards failure)
What symptoms are seen with Left CHF?
Dyspnea, orthopnea, paroxysmal nocturnal dyspnea, fatigue, cough, weight gain
What symptoms are seen with right CHF?
Jugular venous distension, hepatomegaly, peripheral edema, ascites, anasarca
What echocardiographic findings are seen with RCMO?
Normal LV cavity, increased wall thickness, bi-atrial enlargement, small pericardial effusion
What things will you see on an ECG with RCMO?
Atrial and ventricular arrhythmias, low voltage QRS, conduction defects
What things will you see on a chest xray with RCMO?
Cardimegaly, pulmonary congestion/effusion
What things will you see on a cardiac MRI with RCMO?
May demonstrate infiltration
What are medical tx for RCMO?
Treat underlying etiology, diuretics, ACE inhibitors, anticoagulants, anti-arrhytmics, pacemaker
What are surgical tx for RCMO?
Very limited, cardiac transplant
What is the most common type of RCMO?
Infiltrative CMO - amyloidosis
Why is infiltrative CMO amyloidosis misdiagnosed in early stages as LVH?
Due to hypertension
What does infiltrative CMO amyloidosis do?
Produces a stiff myocardium which prevents filling
What are the four classifications of amyloid disease?
Primary/idiopathic, secondary, familial, senile
What is secondary amyloid disease associated with?
Inflammatory disorders like rheumatoid arthritis, tuberculosis, Chron’s disease
What is senile amyloid disease also known as?
Transthyretin (TTR) type CMO
What is a very important finding for amyloid?
LVH on 2D plus low voltage ECG from myocardium
Pseudo-infarction pattern with amyloid shows as what on the ECG and is caused by what?
Abnormal Q waves and is caused by myocardial fibrosis
How does the myocardium appear with amyloid?