Cardiomyopathy Overview
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Questions and Answers

What is the most common type of cardiomyopathy?

  • Restrictive cardiomyopathy
  • Arrhythmic cardiomyopathy
  • Hypertrophic cardiomyopathy
  • Dilated cardiomyopathy (correct)
  • What distinguishes primary cardiomyopathy from secondary cardiomyopathy?

  • Primary affects only diastolic function, while secondary affects systolic function.
  • Primary involves genetic or acquired diseases, whereas secondary results from multiorgan disorders. (correct)
  • Secondary is more common than primary.
  • Primary is due to systemic disorders, while secondary is genetic.
  • Which pathophysiological feature is NOT characteristic of cardiomyopathy?

  • Inappropriate ventricular hypertrophy
  • Systematic hypertension (correct)
  • Life-threatening arrhythmias
  • Congestive cardiac failure
  • What is a primary underlying cause of cardiomyopathy?

    <p>Genetic mutations in myocardial proteins</p> Signup and view all the answers

    Which of the following statements about cardiomyopathy is true?

    <p>Arrhythmias can arise from any form of cardiomyopathy.</p> Signup and view all the answers

    What is the classic macroscopic pattern observed in hypertrophic cardiomyopathy?

    <p>Disproportionate thickening of the ventricular septum relative to the left ventricle free wall</p> Signup and view all the answers

    What percentage of patients with hypertrophic cardiomyopathy experience dynamic obstruction to the left ventricular outflow?

    <p>25%</p> Signup and view all the answers

    Which of the following complications is NOT associated with hypertrophic cardiomyopathy?

    <p>Pulmonary hypertension</p> Signup and view all the answers

    Which genetic factor significantly influences the prognosis of hypertrophic cardiomyopathy?

    <p>Specific mutations in sarcomeric proteins</p> Signup and view all the answers

    What is an effective pharmacologic intervention for patients with hypertrophic cardiomyopathy?

    <p>β-adrenergic blockade to decrease heart rate and contractility</p> Signup and view all the answers

    Which characteristic is associated with endomyocardial fibrosis?

    <p>Fibrosis extends from the apex upward involving heart valves</p> Signup and view all the answers

    What is a notable feature of Loeffler endocarditis?

    <p>It includes peripheral eosinophilia and is associated with myeloproliferative disease.</p> Signup and view all the answers

    At what stage of life is endocardial fibroelastosis most commonly observed?

    <p>In the first two years of life with congenital abnormalities</p> Signup and view all the answers

    What is the underlying cause of restricted cardiomyopathy?

    <p>Underpinned by various aetiologies and may involve different treatments</p> Signup and view all the answers

    Which of the following is NOT a key feature of restrictive cardiomyopathy?

    <p>Dilation of the cardiac chambers</p> Signup and view all the answers

    What characterizes dilated cardiomyopathy morphologically and functionally?

    <p>Progressive cardiac dilation and contractile dysfunction</p> Signup and view all the answers

    Which of the following is a common genetic cause of dilated cardiomyopathy?

    <p>Mutation of dystrophin</p> Signup and view all the answers

    Which statement correctly describes hypertrophic cardiomyopathy?

    <p>It has a primary disease of the myocardium with preserved systolic function.</p> Signup and view all the answers

    What is the typical ejection fraction in end-stage dilated cardiomyopathy?

    <p>Typically less than 25%</p> Signup and view all the answers

    What characterizes restrictive cardiomyopathy?

    <p>Decreased ventricular compliance</p> Signup and view all the answers

    What are common findings in the pathology of dilated cardiomyopathy under microscopy?

    <p>Hypertrophied muscle cells and interstitial fibrosis</p> Signup and view all the answers

    Which of the following is NOT a systemic disorder associated with restrictive cardiomyopathy?

    <p>Ischemic heart disease</p> Signup and view all the answers

    Which of the following factors is associated with peripartum cardiomyopathy?

    <p>Hypertension and nutritional deficiencies</p> Signup and view all the answers

    What distinguishes the pathogenesis of hypertrophic cardiomyopathy?

    <p>100% genetic causes with autosomal dominant transmission</p> Signup and view all the answers

    What is a common microscopic finding in restrictive cardiomyopathy?

    <p>Non-specific fibrosis</p> Signup and view all the answers

    What is the primary definitive treatment for end-stage dilated cardiomyopathy?

    <p>Cardiac transplant</p> Signup and view all the answers

    In restrictive cardiomyopathy, what is often observed regarding the size of the ventricles?

    <p>Normal size or slightly enlarged</p> Signup and view all the answers

    Which condition is an example of an iatrogenic cause of restrictive cardiomyopathy?

    <p>Radiation-induced fibrosis</p> Signup and view all the answers

    Study Notes

    Cardiomyopathy Overview

    • Disease of cardiac myocytes, associated with mechanical and/or electrical dysfunction.
    • Can result in inappropriate ventricular hypertrophy or dilatation.
    • Often has genetic causes; can be classified as primary or secondary.

    Types of Cardiomyopathy

    • Dilated Cardiomyopathy: Most common type; characterized by cardiac dilation and systolic dysfunction.
    • Hypertrophic Cardiomyopathy: Not simply myocardial hypertrophy; involves left ventricular hypertrophy with impaired diastolic filling.
    • Restrictive Cardiomyopathy: Least common; marked by decreased ventricular compliance and impaired filling during diastole.

    Pathogenesis

    • Identifies genetic mutations leading to dysfunctional myocardial proteins.
    • Involves mutations affecting contraction, cell communication, and cytoskeletal integrity.
    • Abnormal contraction or relaxation and dysregulated ion transport are common consequences.

    Dilated Cardiomyopathy Features

    • Morphological Characteristics: Enlarged, heavy heart (~2-3 times normal size) and flabby due to chamber dilation; common mural thrombi.
    • Pathological Causes: Genetic mutations (20-50% involve dystrophin), viral myocarditis, toxic exposure (alcohol), and conditions like peripartum cardiomyopathy and iron overload.
    • Clinical Significance: Poor prognosis with <25% ejection fraction; high mortality within 2 years without heart transplant.

    Hypertrophic Cardiomyopathy Features

    • Defined by myocardial hypertrophy and impaired diastolic filling; systolic function usually preserved.
    • Genetic Basis: Involves autosomal dominant transmission with more than 400 known mutations in nine genes.
    • Clinical Significance: Dynamic obstruction can occur; complications include atrial fibrillation, heart failure, and ventricular arrhythmias. Significant risk for young athletes.

    Restrictive Cardiomyopathy Features

    • Characterized by impaired ventricular filling with normal or slightly enlarged size; firm, non-compliant myocardium.
    • Causes: Systemic disorders (e.g., amyloidosis, sarcoidosis), radiation exposure, multifactorial conditions, and idiopathic cases.
    • Specific Entities:
      • Endomyocardial Fibrosis: Common in tropical regions, affects young adults.
      • Loeffler Endocarditis: Associated with myeloproliferative disorders, presents with eosinophilia.
      • Endocardial Fibroelastosis: Fibroelastic thickening of left ventricular endocardium, mainly in infants.

    Summary Points

    • Cardiomyopathies encompass a variety of diseases leading to myocardial dysfunction with distinct pathophysiological mechanisms.
    • Accurate diagnosis and understanding of underlying causes are crucial for effective management and treatment strategies.

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    Description

    This quiz focuses on the definition and features of cardiomyopathy, including dilated, hypertrophic, and restrictive types. By participating, students will deepen their understanding of the clinical, pathophysiological, and pathological aspects of this condition. Ideal for those studying anatomical pathology.

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