Pericarditis and Cardiac Tamponade Review

Cardiomyopathy

• Cardiomyopathy is a disease of the heart muscle, leading to structural and functional changes.
• 50% of occurrences are due to genetic mutations, linked to over 100 genes.
• Three main groups of cardiomyopathy: dilated, hypertrophic, and restrictive.

Dilated Cardiomyopathy (DCM)

• Develops when ventricles become enlarged, leading to systolic dysfunction.
• Noncardiac causes include genetic and systemic abnormalities, increased age, familial history, and other factors.
• Presents with symptoms such as dyspnea, palpitations, and edema.

Peripartum Cardiomyopathy

• Occurs during the last trimester of pregnancy or the first 5 to 6 months after delivery.
• Presents with left ventricular dysfunction, such as dyspnea, palpitations, and edema.
• Criteria for diagnosis include heart failure, no identifiable cause of heart failure, and evidence of systolic dysfunction.

Stress Cardiomyopathy (Takotsubo Cardiomyopathy)

• Reversible left ventricular dysfunction in response to profound psychological or emotional stress.
• Affects women, who present with angina and no evidence of CAD in Cath.
• Impaired myocardial contractility, with unclear etiology.

Hypertrophic Cardiomyopathy (HCM)

• Mainly affects diastolic function, with hypertrophied ventricular wall.
• Sudden cardiac death in young people, especially in teens or younger adults.
• Cardiac arrhythmias occur due to enlarged ventricular wall or septum muscle blocking the outflow into the aorta.

Restrictive Cardiomyopathy

• Rare in the U.S., presents with symptoms such as dyspnea, fatigue, and ascites.
• Treatment includes pericardiocentesis, pericardiectomy, and surgical removal or ablation.

Electrical Alterations

• Due to impulse formation and/or conduction problems, leading to bradyarrhythmia or tachyarrhythmias.
• Diagnosis and treatment involve history, physical exam, and EKG, with pharmacology as the mainstay of treatment.

Valve Disorders

• Mitral valve disorders: stenosis, regurgitation, and prolapse.
• Aortic valve disorders: stenosis and regurgitation.
• Presents with symptoms such as systolic murmur, and a mid-systolic CLICK.

Constrictive Pericarditis

• Calcified scar tissue develops between the visceral and parietal layers of the serous pericardium.
• Decreased preload and affects the cardiac output.
• Causes include mediastinal radiation, cardiac surgery, and infection.
• Manifestations include ascites, pedal edema, dyspnea on exertion, and fatigue.

Infective Endocarditis

• Invasion of the heart valves and endocardium by a microbial agent.
• Formation of bulky, friable vegetations and destruction of underlying cardiac tissues.
• Common causes include Staphylococcus, Streptococci, Enterococci, and Haemophilus sp.