Diseases of the Myocardium
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| most common cardiomyopathy | Dilated
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| Primary causes of Dilated cardiomyopathy | AD, X-linked and Mitochondrial -1/3 of cases are primary
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| AD Dilated Cardiomyopathy | most common primary reason affects sarcoglycan, troponin and myosin
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| X linked dilated cardiomyopathy | affects the dystrophin gene on X21 in teen boys (related to MD) no transmission of force
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| Mitochondrial primary Dilated cardiomyopathy accounts for? | <10% of primary cardiomyopathy
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| Global Balloon heart | dilated cardiomyopathy
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| PE findings of Dilated Cardiomyopathy | 100% S4, 75% S3, arrythmias
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| Main complication of dilated cardiomyopathy | CHF
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| treatment and 5 year | 25% 5 year .. Need transplant
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| Secondary causes of Dilated Cardiomyopathy | Drugs, pregnancy Metabolic
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| Drugs resulting in Dilated cardiomyopathy | most alcohol, cocaine, chemo (antracyclin) all dose dependent
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| Pregnancy induced secondary dilated cardiomyopathy when? | third trimester or postpartum
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| Secondary metabolic Dilated cardiomyopathy is caused by | Hyper OR Hypothyroid or Thiamine Deficiency
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| what percent of hypertrophic cardiomyopathies are inherited autosomal dominant | more than 50%
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| most likely cause of sudden death in young athletes | hypertrophic cardiomyopathy
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| affected components of hypertrophic cardiomyopathy | B-myosin heavy chain, Troponin I and T, myosin and alpha cardiac actin
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| when you you have LV outflow obstruction | when there is assymmetrical hypertrophy
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| Whorling is seen with | hypertrophic cardiomyopathy
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| PE of someone with hypertrophic cardiomyopathy | palpitations, chest pain, syncope, S4, S3, arrythmias, MITRAL REGURGE,
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| Treat hypertrophic cardiomyopathy? | Ca and B blockers
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| restrictive cardiomyopathy results from? | infiltration resulting in normal size with stiff walls
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| localized amyloidosis of the heart | restrictive cardiomyopathy in the elderly pale heart with amyloid around the vessels and myocardium
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| Systemic amyloidosis affecting the heart | most common cause of death in people with plasma cell dyscrasia
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| what causes sytemic amyloidosis | granulomatous disease, glycogen storage disease, Hurlers, Gauchers, Fabry, hemochromatosis, metastatic disease
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| what is the treatment for restrictive cardiomyopathy | none need transplant or to treat underlying disease
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| how does restrictive cardiomyopathy present? | CHF mostly R-sided, edema, hepatomegaly, ascites, PE, Cardiomegaly, arrythmia
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| what is the 10yr of restrictive cardiomyopathy | 10%
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| Obliterative restrictive Cardiomyopathy | low volume low compliance cardiomyopath
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| what are the two kinds of obliterative cardiomyopathies | Endomyocardial fibrosis (loefflers) and Endocardial fibroelastosis
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| Loeffler's endomyocarditis | Obliterative restrictive cardiomyopathy caused by hypereosinophilia common in the subtropics of africa
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| endocardial fibroelastosis | Restrictive obliterative cardiomyopathy with normal wall but large endocardium (10x normal) with cartilage like fibroelastic endocardial thickening common in those age 0-2 Left more than right
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| myocarditis | inflamation of the myocardium due to primary and secondary causes
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| Primary causes of myocarditits viral | usually viral (coxsackie A/B, polio, Echo, influenza, CMV, HSV
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| primary bacterial | corynebaterium, borrelia and rickettsial/fungal in immunosuppressed
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| secondary causes of myocarditis | SLE, RF, Radiation, Drug hypersensititvity
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| what happens when there is myocarditis | heart enlarges with mild ventricular dilation
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| Viral myocarditis leaves? | mononuclear inflam with edema and necrosis
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| bacterial myocarditis leaves | Patchy PMN with microabcess
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| Autoimmune/allergic myocarditis leaves? | no necrosis with diffuse inflammatino
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| symptoms with myocarditis | often asymptomatic
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| serous effusion | clear yellow transudate(CHF)
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| serosanguinous effusion | serous and blood exudate via increased permeability (trauma)
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| chylous effusion | lymphatic obstruction or damage to the thoracic duct
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| Cholesterol effusion | fluid plus cholesterol is rare and idiopathic
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| hemoparicardium | pure blood from MI or great vessel aneurysm
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| Primary pericarditis is usually | viral
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| serous pericarditis is due to | autoimmune or uremia
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| fibrinous pericarditis is due to | MI or Radiation (bread and butter appearance)
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| Hemorrhagic pericarditis is due to? | Tb or tumor and always scars
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| Caseous pericarditis is due to? | Tb common cause of chronic constrictive pericarditis
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| suppurative pericarditits is due to? | infection always and can form adhesions
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| which pericarditis can progress to chronic | supporative, hemorrhagic and caseous
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| what are the two types of choronic pericarditis | adhesive and constrictive
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| difference between chronic adhesive and chronic constrictive | adhesive pulls and dilated the heart which constrictive (scar) enclosed and decreases the size of theheart
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| how many ccs does it take to produce cardiac tamponade | 200 ccs
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| most common primary cardiac tumor | Myoxoma Mostly left atrium this is a friable tumor
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| where are mets likely to come from? | lung, breast, malignant melanoma, lymphomas
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| what is the most common primary tumor in children (cardiac) | rhabdomyosarcoma associated with tuberous necrosis
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