Cardiomyopathy Flashcards
What are the 3 types of cardiomyopathy?
Restrictive - Stiffening of Myocardium
Hypertrophic - hypertrophy of myocardium
Dilated - Dilation of ventricles
What causes DCM?
- Genetics e.g. Muscular Dystrophy
- Drugs/alcohol/chemicals
- Endocrine disorders
- Inflammation
- Injury
- Idiopathic
How does DCM present?
Fatigue - Dyspnoea/Orthopnea/PND - Oedema - Cough
Weak Pulses - Raised JVP - Tachycardia - Audible S3
How is DCM tested for?
CXR - Pulm congestion + Cardiomegaly MRI Biopsy - Visibally stretched fibres ECG Echo - Dilated ventricles ESR + FBC - Polycythaemia
How do we treat DCM?
Reduce Strain - Diuretic + ACEI + Spironlactone Increase COntractility - Digoxin Prevent Vfib - ICD Warfarin -> Reduce Thrombus risk Treat Cause Heart Transplant
What causes RCM?
Amyloidosis Sarcoidosis Haemochromatosis Fibrosis - MI, drugs, radiation, idiopathic Genetics Diabetes
How does RCM present?
Cough - Chest Pain - Dyspnoea/Orthopnea - Oedema - Ascites - Fatigue
Hepatomegaly
Raised JVP - Tachycardia - Audible S3/4
How do we test for RCM?
Serum Fe - Haemochromatosis
Biopsy - Visible sarcoid/amyloidosis
ECHO - biatrial enlargement and patchy fibrosis from infiltrative disease
MRI
CXR - Pulm congestion + normal heart size
Biopsy - Visible amyloid and sarcoid
ECG
How do we treat RCM?
Treat the cause ICD Heart Transplant Warfarin -> Prevent Thrombus B-blockers - ACEI - Diuretic -> Reduce strain on heart
What causes HCM?
Purely genetic in origin
Comes with growth of interventricular septum to occlude aortic valve
How does HCM present?
Asymptomatic until the valve is occluded or the heart cant pump enough blood anymore:
Fatigue - Chest Pain - Dyspnoea - Palpitations - Tachycardia - Presyncope - Exertional Arrythmias
Notched Pulse - Raised JVP - Audible S4 - Systolic ejection murmur worse on valsalva
How do we test for HCM?
ECG ECHO - Visible hypertrophy and smaller chambers MRI Biopsy - myocyte dissaray CXR - Cardiomegaly + Pulm congestion Genetic Testing
How do we treat HCM?
Heart Transplant Warfarin Beta blockers + reduce exercise/stress ICD Surgical mitral repair Surgical removal (myomectomy) or repair of outgrowing section of IV septum (percutaneous septal ablation)
