Restrictive cardiomyopathy resident survival guide: Difference between revisions
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::❑ Non-specific ST- and T-wave abnormalities | ::❑ Non-specific ST- and T-wave abnormalities | ||
::❑ Eventually Depolarization abnormalities: Such as bundle-branch or ventricular hypertrophy, or abnormalities of conduction, including atrioventricular block, atrial fibrillation, pseudoinfarction, | ::❑ Eventually Depolarization abnormalities: Such as bundle-branch or ventricular hypertrophy, or abnormalities of conduction, including atrioventricular block, atrial fibrillation, pseudoinfarction, | ||
::❑ Left-axis deviation | ::❑ Left-axis deviation | ||
:❑ <u>Chest x-ray:</u> Cardiac size is usually normal, atrial enlargement, pulmonary congestion, interstitial edema with Kerley B lines, pleural effusions? | :❑ <u>Chest x-ray:</u> Cardiac size is usually normal, atrial enlargement, pulmonary congestion, interstitial edema with Kerley B lines, pleural effusions? | ||
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::❑ Pulmonary-vein or hepatic-vein flow: systolic forward flow is less than diastolic forward flow/ increased reversal of diastolic flow after atrial contraction with inspiration in the hepatic and pulmonary veins | ::❑ Pulmonary-vein or hepatic-vein flow: systolic forward flow is less than diastolic forward flow/ increased reversal of diastolic flow after atrial contraction with inspiration in the hepatic and pulmonary veins | ||
::❑ shortened deceleration time across the mitral and tricuspid valves, mitral and tricuspid regurgitation common | ::❑ shortened deceleration time across the mitral and tricuspid valves, mitral and tricuspid regurgitation common | ||
::Increased wall thickness, thickened cardiac valves, granular sparkling texture (in amyloidosis) | ::Increased wall thickness, thickened cardiac valves, granular sparkling texture (in amyloidosis) | ||
❑ <b>Invasive imaging and tests:</b> | ❑ <b>Invasive imaging and tests:</b> | ||
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::❑ Right ventricular systolic pressure may be elevated | ::❑ Right ventricular systolic pressure may be elevated | ||
:❑ <u>Endomyocardial biopsy</u> | :❑ <u>Endomyocardial biopsy</u> | ||
::❑ For patients in whom the diagnosis is not clear by other methods of evaluation</div>}} | ::❑ For patients in whom the diagnosis is not clear by other methods of evaluation</div>}} | ||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 12:51, 10 March 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Steven Bellm, M.D. [2]
Restrictive cardiomyopathy resident survival guide Microchapters |
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Overview |
Classification |
Causes |
Diagnosis |
Treatment |
Do's |
Dont's |
Overview
Restrictive cardiomyopathy is defined as heart-muscle disease with impaired ventricular filling usually due to increased stiffness. The diastolic volume of either or both ventricles is normal or decreased,the systolic function usually remains normal and wall thickness may be normal or increased. The symptoms and signs may consist of right (jugular venous pressure, peripheral edema, and ascites) or left ventricular failure (breathlessness and evidence of pulmonary edema).[1]
Classification
Restrictive cardiomyopathy | |||||||||||||||||||||||||||||||||||||
Myocardial | Endomyocardial | ||||||||||||||||||||||||||||||||||||
Nininfiltrative | Infiltrative | Storage Disease | |||||||||||||||||||||||||||||||||||
Causes
Common Causes
- Idiopathic cardiomyopathy
- Amyloisosis
- Sarcoidosis
- Endomyocardial fibrosis
- Radiation
- Toxic effects of anthracycline
Complete Diagnostic Approach
A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.
History and symptoms: ❑ Hints for etiology (history of pericarditis/ tuberculosis/ trauma DD:contrictive pericarditis)
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Physical examination: ❑ Vital signs:
❑ General appearance:
❑ Heart:
❑ Lungs:
❑ Abdomen:
❑ Extremities:
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Laboratory findings: ❑ Complete blood count
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Imaging and additional tests: ❑ Noninvasive imaging and tests:
❑ Invasive imaging and tests:
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Treatment
shown
hidden
Do's
Dont's
References
- ↑ Kushwaha SS, Fallon JT, Fuster V (1997). "Restrictive cardiomyopathy". N Engl J Med. 336 (4): 267–76. doi:10.1056/NEJM199701233360407. PMID 8995091.