Cardiology Board Review in cardiomyopathy
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