Cardiomypathies - • Sudden death or ventricular...

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Cardiomypathies Chapter 55
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Diseases that alter myocardial structure and function Dilated, Hypertrophic, Restrictive, arrhythmogenic right ventricular cardiomyopathy
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Dilated Cardiomyopathy Low cardiac output, end systolic and diastolic ventricular volumes, dilation with hypertrophy CHF like symptoms, peripheral embolization, chest pain CXR: CM, cephalization EKG: LVH, atrial enlargement, poor R wave progression Tx: Digoxin, diuretics
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Hypertrophic Impaired diastolic relaxation, restricted LV filling DOE, palpitations, syncope SEM best at L sternal border or apex (inc. by valsalva) EKG: LVH, atrial enlargment CXR: normal Tx: Exercise restriction, beta blockers
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Restricitve Elevated end diastolic pressures, normal systolic function CHF symptoms without CM or systolic dysfunction S3 present EKG: low voltage Tx: Symptom directed
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Arrhythmogenic Right Ventricular Cardiomyopathy Progressive replacement of RV myocardium with fibrofatty tissue
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Unformatted text preview: • Sudden death or ventricular dysrhythmia in a young pt • EKG: RBBB, precordial T wave inversion • TX: antidysrhythmics, defribillator Myocarditis • Inflammation of the heart muscle • Fever, sinus tach, chest pain • PE: friction rub • Elevated cardiac enzymes • Supportive treatment Pericarditis • Sharp chest pain worse when supine • Low grade fever, dyspnea, dysphagia • PE: friction rub • EKG: ST segment elevation • Cardiac enzymes may be elevated if assoc with myocarditis • TX: NSAIDS Cardiac tamponade • Increased fluid in the pericardial sac • Distant heart sound, JVD, hypotension • Pulsus paradoxicus • EKG: low voltage • TX: Fluids, pericardiocentesis Constrictive Pericarditis • Fibrous thickening of the pericardium prevents passive diastolic filling • DOE, LE swelling • JVD, no friction rub, Pericardial “knock” • EKG: no specific findings • TX: pericardiectomy...
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Cardiomypathies - • Sudden death or ventricular...

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