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PATH: Myocardium
Diseases of the Myocardium
| Question | Answer |
|---|---|
| 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
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