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PATH: Myocardium

Diseases of the Myocardium

most common cardiomyopathy Dilated
Primary causes of Dilated cardiomyopathy AD, X-linked and Mitochondrial -1/3 of cases are primary
AD Dilated Cardiomyopathy most common primary reason affects sarcoglycan, troponin and myosin
X linked dilated cardiomyopathy affects the dystrophin gene on X21 in teen boys (related to MD) no transmission of force
Mitochondrial primary Dilated cardiomyopathy accounts for? <10% of primary cardiomyopathy
Global Balloon heart dilated cardiomyopathy
PE findings of Dilated Cardiomyopathy 100% S4, 75% S3, arrythmias
Main complication of dilated cardiomyopathy CHF
treatment and 5 year 25% 5 year .. Need transplant
Secondary causes of Dilated Cardiomyopathy Drugs, pregnancy Metabolic
Drugs resulting in Dilated cardiomyopathy most alcohol, cocaine, chemo (antracyclin) all dose dependent
Pregnancy induced secondary dilated cardiomyopathy when? third trimester or postpartum
Secondary metabolic Dilated cardiomyopathy is caused by Hyper OR Hypothyroid or Thiamine Deficiency
what percent of hypertrophic cardiomyopathies are inherited autosomal dominant more than 50%
most likely cause of sudden death in young athletes hypertrophic cardiomyopathy
affected components of hypertrophic cardiomyopathy B-myosin heavy chain, Troponin I and T, myosin and alpha cardiac actin
when you you have LV outflow obstruction when there is assymmetrical hypertrophy
Whorling is seen with hypertrophic cardiomyopathy
PE of someone with hypertrophic cardiomyopathy palpitations, chest pain, syncope, S4, S3, arrythmias, MITRAL REGURGE,
Treat hypertrophic cardiomyopathy? Ca and B blockers
restrictive cardiomyopathy results from? infiltration resulting in normal size with stiff walls
localized amyloidosis of the heart restrictive cardiomyopathy in the elderly pale heart with amyloid around the vessels and myocardium
Systemic amyloidosis affecting the heart most common cause of death in people with plasma cell dyscrasia
what causes sytemic amyloidosis granulomatous disease, glycogen storage disease, Hurlers, Gauchers, Fabry, hemochromatosis, metastatic disease
what is the treatment for restrictive cardiomyopathy none need transplant or to treat underlying disease
how does restrictive cardiomyopathy present? CHF mostly R-sided, edema, hepatomegaly, ascites, PE, Cardiomegaly, arrythmia
what is the 10yr of restrictive cardiomyopathy 10%
Obliterative restrictive Cardiomyopathy low volume low compliance cardiomyopath
what are the two kinds of obliterative cardiomyopathies Endomyocardial fibrosis (loefflers) and Endocardial fibroelastosis
Loeffler's endomyocarditis Obliterative restrictive cardiomyopathy caused by hypereosinophilia common in the subtropics of africa
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
myocarditis inflamation of the myocardium due to primary and secondary causes
Primary causes of myocarditits viral usually viral (coxsackie A/B, polio, Echo, influenza, CMV, HSV
primary bacterial corynebaterium, borrelia and rickettsial/fungal in immunosuppressed
secondary causes of myocarditis SLE, RF, Radiation, Drug hypersensititvity
what happens when there is myocarditis heart enlarges with mild ventricular dilation
Viral myocarditis leaves? mononuclear inflam with edema and necrosis
bacterial myocarditis leaves Patchy PMN with microabcess
Autoimmune/allergic myocarditis leaves? no necrosis with diffuse inflammatino
symptoms with myocarditis often asymptomatic
serous effusion clear yellow transudate(CHF)
serosanguinous effusion serous and blood exudate via increased permeability (trauma)
chylous effusion lymphatic obstruction or damage to the thoracic duct
Cholesterol effusion fluid plus cholesterol is rare and idiopathic
hemoparicardium pure blood from MI or great vessel aneurysm
Primary pericarditis is usually viral
serous pericarditis is due to autoimmune or uremia
fibrinous pericarditis is due to MI or Radiation (bread and butter appearance)
Hemorrhagic pericarditis is due to? Tb or tumor and always scars
Caseous pericarditis is due to? Tb common cause of chronic constrictive pericarditis
suppurative pericarditits is due to? infection always and can form adhesions
which pericarditis can progress to chronic supporative, hemorrhagic and caseous
what are the two types of choronic pericarditis adhesive and constrictive
difference between chronic adhesive and chronic constrictive adhesive pulls and dilated the heart which constrictive (scar) enclosed and decreases the size of theheart
how many ccs does it take to produce cardiac tamponade 200 ccs
most common primary cardiac tumor Myoxoma Mostly left atrium this is a friable tumor
where are mets likely to come from? lung, breast, malignant melanoma, lymphomas
what is the most common primary tumor in children (cardiac) rhabdomyosarcoma associated with tuberous necrosis
Created by: jmuame03