Table 1

Infective Non infective Myocardidits Pericarditis

Endocarditis myocarditis
 Heart sounds

Atrial Septal Defect

Sound
- Wide, fixed splitting of S2

- systolic Ejection murmur

- best heard at second intercostal space along the left
sternal border

- opening in atrial septum

- asymptomatic until adulthood

/
 Takotsubo CM
Peripartum
(stressed induced CM
DCM ARVD/C HCM RCM Cardiomyopath
or broken heart
y
syndrome
1/500-common
Prevalence 1/2500 1/1000-5000 2-5% CM 1:1000-1:4000
primary CM
1/3 SCD in
40-59 (but can athletes
tropical regions-india, Africa, South and
Demographics occur at any 30's prevalent in post-menopausal women
Central America-endomyocardial fibrosis
age) nonwhite and
males
w/
1/2 cases- maternalincreasi
familial; ng age, black
Diseased race,
desmosomal preclampsia, abrupt onset of LV dysfx
AD mutations of
proteins HTN, multiple in response to severe
Etiology genes encoding
characterized by gestations, and emotional or
for sarcomeres
fibrofatty history of physiological stress
infiltration of peripartum
healthy cardiomyopathy
myocardium- in previous
pregnancy
enlarged leads to thinning
impaired non-dilated
ventricles, and ballooning
LVH w/o ventricles w/ impaired LV Systolic Dysfx in last trimester to 6
Characteristics normal LV wall of of ventricular
chamber dilation filling; marked biatrial monts postpartum
thickness, wall, typically
enlargement
systolic dysfx R.Vent
HF (fatigue,
atypical chest
palpitations, dyspnea, peripheral edema, dyspnea presentation typical of
arrythmia and pain (w/meals,
syncope, edema (hepatomegaly on exertion)-can acute coronary
Symptoms thromboembolic dehydration or
ocassionally and ascites), fatigue be confused syndrome; diaphoresis
event exertion); SCD
SCD (↓CO, ↓preload) with pregnancy and dyspnea
(fam w/SCD)
complications
systolic murmur that ↑ in intensity w/valsalva; may feel systolic thrill; Normal S1, S2 but
PE: Auscultation
may hear S4. harsh crescendo-descrendo- not transmitted to carotids
prominent
abnormal Q
waves, P-wave
inverted T- abnormalities,
waves and LVH, L. Atrial
Diffuse, reduced voltage Variable and unique pattern of apical
EKG variable findings epsilon waves in Enlargement,
or prolonge PR interval nonspecific ballooning of LV
right precodial L.Axis deviation;
leads deeply inverted
T-waves in V2-
V4 in apical
variant HCM
Hypertrophy of biatrial enlargement and
L.ventricle w/ diastolic dysfx; L.vent
LV dilation, LV systolic Dysfx and pulmonary
Echocardiography reduction in diastolic volume, wall
HTN
ventricular thickness and systolic fx
chamber volume appear normal
pulmonary vascular congestion and normal
CXR
cardiac silhouette
cardiac imaging
may reveal RV
confirmed by abnormalities Often asymptomatic and diagnosed by
Diagnosis Echocardiograp (aneurysms, family screening, auscultation of murmur or
hy segmental abnormal EKG
dilation, reduced
EF)
2011 ACCF/AHA
task force on Follow standard HF therapy, but must
Guidelines
practice consider pregnancy
guidelines
decrease
aimed at
exertional
reducing address underlying
therapy goals dyspnea and
arrhythmia and cause
chest pain;
SCD:
prevent SCD
First line
treatment for
Symptomatic
HCM: beta
blockers; If B-
Blockers not
well tolerated-->
B-blockers, give
Antiarrhytmic nondihydropyridi
avoid ACEI/
leading drugs, catheter ne CCB symptomatic Tx consistent w/ acute
ARBs; avoid
indicaton for ablation, (veramapil); interventions: manage coronary syndrome;
hypotension and
Treatment heart transplant; implantable Cardiology volume overload w/ anticoagulants indicated
reduced uterine
follow guidelines cardioverter- evaluation: diuretics or aldosterone whenloss of wall motion
perfusion w/ too
for HF defibrillator; consideration for antagonists in left ventricular apex
much diuresis
heart surgical septal
transplantation myectomy;
alcohol septal
ablation and
dual chamber
pacing, heart
transplantation
(severe systolic
symptoms)
all HCM pts-risk
stratification for
SCD and treatment w/drawn
evaluation for Evaluate for AV block/ concurrently with
placement of Pacemaker insertion reversal if symptoms w/
implantable in a month
cardioverter-
defibrillator
Avoid Avoid
Prevention competitive competitive
sports sports