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17 Cards in this Set
- Front
- Back
Module 4 - logbook 9: definition cardiomyopathy |
Ventricular chamber enlargement and contractile dysfunction with normal left ventricular wall thickness. Diagnosis of exclusion |
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Module 4 - logbook 9: epidemiology |
20-60 year old, men > women. Black > white. 2/10,000 - almost 1/2 genetic |
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Module 4 - logbook 9: risk factors |
Heart disease, recreational drug use, alcohol and co-morbidities (HIV/SLE) |
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Module 4 - logbook 9: common presentation |
Symptomless - heart failure, stroke from thromboembolism, arrhythmias, and sudden cardiac death.
Congestive heart failure: dyspnoea, weakness, fatigue, oedema, raised JVP, pulmonary congestion, cardiomegaly, loud third and/or fourth heart sound |
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Module 4 - logbook 9: investigations |
Echocardiogram, CXR (cardiomegaly) and ECG |
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Module 4 - logbook 9: pathophysiology |
Heart failure > left ventricular remodeling, which manifests as increases in left ventricular end-diastolic +end-systolic volumes, wall thinning, and change in chamber geometry to a more spherical shape - usually associated with a continuous decline in ejection fraction |
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Module 4 - logbook 9: prognosis |
Five-year survival for patients with dilated cardiomyopathy is about 30%. Mitral regurgitation or diastolic dysfunction is associated with a worse prognosis. Arrhythmias can be a cause of sudden death |
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Module 4 - logbook 9: management |
Lifestyle - especially alcohol Medication: diuretics, ACE, beta blocker and maybe spironolactone. Prevention/treatment of arrhythmias Anticoagulation if required Surgery: transplant |
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Module 4 - logbook 9: drugs - ASPIRIN |
Antiplatelet - Acetyl donor to COX rendering it inactive which reduces thromboxane A2 |
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Module 4 - logbook 9: drugs - OMEPRAZOLE |
PPI. Reduces gastric acid secrection by inhibiting H+K+ ATPase enzyme system. |
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Module 4 - logbook 9: drugs - INSULIN |
Promotes glucose and amino acid uptake into muscle and adipose tissues. Stimulates glycogen, inhibits gluconeogenesis. |
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Module 4 - logbook 9: drugs - ATORVASTATIN |
Hypercholesterolemia - enzyme inhibitor HMG coA reductase, reducing quantity of mevalinic acid, a precursor of cholesterol |
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Module 4 - logbook 9: drugs - FUROSEMIDE |
Loop diuretic - Inhibits water reabsorption in nephron by acting on sodium potassium chloride cotransporter |
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Module 4 - logbook 7: aetiology |
Genetic, inflammatory, toxic (alcohol), metabolic |
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Module 4 - logbook 9: drugs - WARFARIN |
Vitamin K antagonist, precursor of clotting facotrs |
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Module 4 - logbook 9: Shock |
Types: Cardiac, hypovolemic (fluid) and distributive (vasodilation) (septic, anaphylactic and neurogenic) Cardiac shock (failure of pump action of heart)- high JVP. Give ionotropes such as dopamine. |
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Module 4 - logbook 9: Cardiomyopathies |
Cardiomyopathy = heart muscle is structurally and functional abnormal Hypertrophic : LVH (can't relax) Dilated : enlargement and contractile dysfunction (can't contract) Restrictive: rigid but not thickened - caused by amyloidosis
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