Cardiology Board Review in cardiomyopathy: Difference between revisions
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{{CMG}} | {{CMG}} | ||
==Classification== | |||
CMPs can be divided into genetic, mixed and acquired ones. | |||
==Dilated CMP== | |||
*Look for reversible causes alcohol, hemochromatosis, and soa | |||
==Restrictive Cardiomyopathy== | ==Restrictive Cardiomyopathy== | ||
*5 yr survival only 64%, CCB, diuresis are mainstays. SOmewhat preload dependent. Slow heart rate and may drop CO., transplant may be best option. | |||
*Atrial bigger than ventricles, hige atria to fill ventricles | |||
*Little atrial contribution to filling since pressure so high | |||
*Non-hypertrophied ventricles | |||
*Restrictive physiology not the same as restr cmp | |||
*Classic square root sign | |||
===Muscle or Myocardial=== | |||
===Endomay | |||
==Hypereosinophilia== | ==Hypereosinophilia== | ||
*Bright endomyocardium on echocardiogram | |||
*May affect valve function with progressive scarring | |||
*Mobile scars may require chemotherapy | |||
==Amyloid Cardiomyopathy== | ==Amyloid Cardiomyopathy== | ||
*Small volts on EKG | |||
*Shimmering on Echo | |||
*Very thick myocardium | |||
*Often a small pericardial effusion | |||
==Arrhythmogenic Right Ventricular Dysplasia== | ==Arrhythmogenic Right Ventricular Dysplasia== | ||
*Fibrofatty replacement of RV free wall, almost no muscle left | |||
*Repol abn on EKG | |||
*30% have + FH | |||
*AICD and avoid athletics | |||
==Non-Compaction Cardiomyopathy== | ==Non-Compaction Cardiomyopathy== | ||
*More commonly diagnoses now | |||
*Heart muscle does not compact down in utero | |||
*Beta myosin heavy chain most common | |||
*See crypts and ressesin wall | |||
*MRI a good imaging modality | |||
*Dyspnea is the most common symptom, may not have may sx | |||
*Increased risk of SCD | |||
*If systolic function normal: Risk strat for SCD using HCM criteria, treat with stage B CHF | |||
*Low EF: treat like HCM | |||
Class 2B recommendation fo AICD | |||
If FH, SVT put in AICD | |||
==HOCM== | ==HOCM== | ||
Revision as of 18:12, 29 September 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Classification
CMPs can be divided into genetic, mixed and acquired ones.
Dilated CMP
- Look for reversible causes alcohol, hemochromatosis, and soa
Restrictive Cardiomyopathy
- 5 yr survival only 64%, CCB, diuresis are mainstays. SOmewhat preload dependent. Slow heart rate and may drop CO., transplant may be best option.
- Atrial bigger than ventricles, hige atria to fill ventricles
- Little atrial contribution to filling since pressure so high
- Non-hypertrophied ventricles
- Restrictive physiology not the same as restr cmp
- Classic square root sign
Muscle or Myocardial
===Endomay
Hypereosinophilia
- Bright endomyocardium on echocardiogram
- May affect valve function with progressive scarring
- Mobile scars may require chemotherapy
Amyloid Cardiomyopathy
- Small volts on EKG
- Shimmering on Echo
- Very thick myocardium
- Often a small pericardial effusion
Arrhythmogenic Right Ventricular Dysplasia
- Fibrofatty replacement of RV free wall, almost no muscle left
- Repol abn on EKG
- 30% have + FH
- AICD and avoid athletics
Non-Compaction Cardiomyopathy
- More commonly diagnoses now
- Heart muscle does not compact down in utero
- Beta myosin heavy chain most common
- See crypts and ressesin wall
- MRI a good imaging modality
- Dyspnea is the most common symptom, may not have may sx
- Increased risk of SCD
- If systolic function normal: Risk strat for SCD using HCM criteria, treat with stage B CHF
- Low EF: treat like HCM
Class 2B recommendation fo AICD If FH, SVT put in AICD