CARDIOMYOPATHY .

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thorough Hx in - lafmmahon of the heart
-
-

Morphologically S functionally abnormal

(most important )
myocardium ( heart muscle ) in
direct invasion
the absence of any other disease family ltx : i .
-

2-
production of cardiotoxic substances
.
HF
CMP
3 -
chronic inflammation
of Heart failure
-

-
5 -
10%
skeletal
-

myopathy viral
conduction disorders MC :
]
.
-

missense
CMT
"
Asuttbstitution
-
: -

tachyamlthmias mutations T .
CNN ( protozoa ) -
S America -

intolerance
Exertion at
f- early Sx sudden death Endomyocardial fbrosis Equatorial Africa
-

I Breathlessness
-

/ fatigue -
Hx :

down Alcohol -
chemo / Radio TX
Dyspnea / cough when lying at night
- -

peripheral edema -

Assess
'

Drugs
#
-
ability to perform routine

congestive heart failure iortnnfsfafitfnfsp f AUTE VIRAL MYOCARDITIS If PARASITIC MYOCARDITIS BACTERIAL
result of fluid retention
-
-

Bmi
- - -

progressive dyspnea S weakness ( fevers myalgia)

i .
Direct invasion
all 3 types of Cmp
-

-
common to 2 Abscess formation
( d wks ) after recent viral syndrome
-

CHA G ASDISEASETR
'
1.
w/
-

cardiac structural ds
Egg ology
S assoc
contractility
.

filling # pressures
pericarditis ) infective cardiomyopathy MC cause of d in severe infection
positional chest ( due
-
-

pain to
-
T cruzi
- .
-

SIRS

common to 3 types of CMP -

GENETIC
-

heart failure -

Reduviidbug (vector ) ex .

inherited autosomal dominant -

Rural S -
s Central America Towards systemic infection
AV Valve
regurgitation
-
-

-
occasional autosomal recess ,e
: -
Nonspecific , Acute myocarditis
atypical chest pain
-

Cg
-

Typical S
X lined S Meningoehcephallhs
-

FULMINANT MYOCARDITIS
-

DIPTHERIA
ventricular tacky arrhythmias
i .

Atrial s m >f
- -
- -

Infection SILENT STAGE : Toxin → Heart block

.pro#jessorylo-30yCY2Ptx)
rapid progression fr initial viral
- -
-

Embolic events
.

current therapy is based on phenotype → cardiogenic shock -

cardiac S Gl system u'CL0STRlD1VM_
multiple Autonomic dysfxn
organ systems involved
myocardial damage
- : -

-
Toxin →
microvascular damage
-

TRADITIONAL CLASSIFICATION renalfailure

-

hepatic failure
↳ GAS bubbles in
myocardium (
pathogenesis
- .

.
-

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Path't STREPTOCOCCAL S B HEMOUYTI INFECTION
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Ill - -

Hypertrophic young adults dismissed fr neuronal damage Acute Rheumatic fever

recently primary
- - -
- .

antibiotics ( bronchitis ) chronic immune activation

113 familial Inflames fibrosis of
-

→ ca s
-
-

ART ( viral syndromes )

-

NEW CLASSIFICATION major causes : cm : s systemic CT

Inflame myocarditis
-

overlap w/ non -
dilated CMP Tondu Chon system abnormalities
myocarditis
.
- .
-

idiopathic
-

D
toxic ECG
primary MRI Av nodes
- -

sinus s
metabolic miscellaneous
-
-

, .
genetic 2b Echo Endo myocardial biopsy -

RBBB IV .

TB
-

Inherited metabolic defect -

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2- Mixed I lymphocytic infiltration (to -20%)
familial Annals ventricular tacky arrhythmias typical affinity for
' -

the pen'c
- -

3- Acquired ,
-

myoate necrosis
diseases Thwmbogenlc dilated ventricles TB pericarditis
-

9.
secondary systemic
-
-
to
CM →
pulmonary s systemic emboli -
constrictive -

effushepe
-

enlarged LV T DI
: ↳ pleural effusion →
constricted
No
specific therapy →
f systolic function ( contractility failure) ELISA ( IgM)
-

Avoid anti inflammatory -

during Acute lnfxn t

/ immunosuppress ne stage
T v . WHIPPLE 'S DISEASE
HF regimens
MX " G
-

t viral replication
-

- pacemakers to tachymhythmia
-
GIT involvement
g- prone
-

myocardial injury ICD pericarditis

B blocker
-
-

I
-

deterioration prone to embolism

Anticoagulation
-

RAAS inhibitors ( ACE Ihhibs)

-

prognosis -
Benzmdazoie , Nifurtimox
-
anti parasitic
-
-

coronary arteritis
- advance stage
-
cardiac transplant -

( no successful case)
-
valve lesions
-
Most resolve spontaneously -
HE
-
others progress to cardiomyopathy
-
L 3- 6M duration
II. AFRICAN TRYPANOSOMIASIS
42 Major improvement LVEF
-

→ in
-
Tse Tse fly
during next 6 -
12M -

African sleeping sickness

repeat 2b echo Whn Gmos

-

T brucei
-
.

'

DI Trypanosome
-

in blood , lymph nodes

#
Antiparasitic

Hl-T0XOPLASM
401 of dying. HIV Ptt

⇐ Chonoretinitis
encephalitis /
myocarditis
-

pericardial effusion
-

constrictive pericarditis
heart failure
-

immunocompromised ptx w/
myocarditis
↳ Ct ) IgG titer

N pyrimethamine
-
sulfadiazine
clindamycin
-

-
N -

TRICHINELLOSIS
#

Cmj myalgia -

weakness
-

fever
-

facial edema
-

pen orbital
- -

-
conjunctival s retinal

hemorrhages
-

eosinophilic lnflam
response → clinical heart
:
failure crane)
Ty
Albendazole ) anti helminthic
I
-

Mebendazoce