dilated CMP
causes of dilated CMP
idiopathic, inherited, noncompaction of myocardium, postpartum, infectious, drug abuse, hemochromatosis
what is ASH?
asymmetrical septal hypertrophy; septum is thicker than other walls
abnormal diastolic function from increased stiffness of myocardium & decreased compliance of ventricle
arrhythmogenic RV dysplasia is clinically characterized by what?
arrhythmias, HF, sudden death
what are cardiomyopathies?
Disease process of the myocardium associated with ventricular dysfunction
how does frank-starlings mechanism work with dilated CMP?
Initially chambers respond by stretching to hold more blood to pump through body as a compensatory reaction which helps strengthen contraction (via frank-starling) & maintain CO, however over time the muscle weakens & contraction
what is SAM of the MV?
systolic anterior motion of the MV or MV apparatus towards the IVS and obstructs outflow
what is infiltrative restrictive CMP?
accumulation of infiltrative materials disrupts myocardial contraction & relaxation
what is the triangle of dysplasia?
localized pattern of dysfunction affecting inflow, outflow, and apical regions of RV
many forms of cardiomyopathies are ______
inherited
with dilated CMP, a secondary finding is evidence of low cardiac output. how?
from decreased excursion of the MV leaflets
a cause of SAM is the venturi effect. what is the venturi effect?
high velocity flow moving against septum slowing RBC along edge causing low pressure zone that pulls MV & MV apparatus anteriorly into outflow tract causing obstruction
what is amyloidosis and how does it affect the heart?
systemic disease & global process affecting entire heart due to increased ventricular thickness, thickened valves, & thickness affects coronaries or conduction system
how is the myocardium structural altered with noncompaction?
two layers: thin, compacted myocardium on epicardial side & thicker noncompacted endocardial layer
when does diastolic function become restrictive in all cardiomyopathies, regarless of underlying lesions or classifications?
end stage
what does the ventricular assist device do? what happens to the AV under normal operation?
assists function of failing heart by pulling blood from LV & pumps it into ascending aorta
AV remains closed to prevent clot due to lack of blood flow
if there is already an obstruction showing on doppler and you valsalva the patient, what would happen to the velocities?
the velocities will increase across an obstruction that already exists
with amyloidosis, thickness and survival have what kind of relationship?
direct
what is the best way to diagnose noncompaction?
contrast
what are symptoms of cardiomyopathies?
dyspnea, orthopnea, fatigue, palpations/arrhythmias, sudden cardiac death
what are echo findings of rejection of a heart transplant?
pericardial effusion, increased wall thickness due to inflammation & myocardial edema, decreased LVF, acute MI, abnormal diastolic function
what is an alcohol septal ablation?
small amount of absolute alcohol injected into septal branch of LAD supplying the hypertrophied portion of the IVS & causes controlled MI to reduce obstruction & improves symptoms, reducing severity of MR
how do you treat restrictive CMP?
treat the cause or treat the symptoms to improve quality of life with blood thinners, chemotherapy, diuretics, pacemaker/defibrillator, heart transplant
what is the big risk with the thicker layer of noncompaction?
thrombi
what is hypovolemia?
an acquired form of outflow obstruction which results in small chamber & dynamic contraction