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Cardiomyopathy (Pathoma) (Hypertrophic Cardiomyopahty (Clinical Features…

- - - - stretching heart is no longer able to act properly
        
        Complications
        
        Mitral and Tricuspid Regurgitation
        
        reason: stretching on valves causes regurgitation
        
        arrhythmia
        
        stretching of conduction system of heart
        
        results in systolic problem
        
        poor emptying
        
        Biventricular CHF
  - - - AD mutations
    - - Coxsackie
        
        lymphocytic infiltrates in myocardium
        
        chest pain
        
        arrhythmia w/ sudden death
        
        HF
        
        late complications: dilated cardiomyopathy
        
        Treatment: Transplant
    - - Doxorubicin
      - cocaine
    - - late 3rd Try or postpartum
- - - - reason: hypertrophy makes heart wall tight, can't fill heart
        
        loss of compliance: Diastolic dysfunction
    - - due to ventricular arrhythmias
        
        most common cause of death in young athletes
    - - preferential involvement of inter ventricular septum just beneath Aortic valve
        
        can't move blood out of LV: syncope
  - - - normally myocytes line parallel, notice myocytes are in all different directions (myocyte disarray)
- - - - decreased compliance of ventricular endomyocardium
        
        Can't fill: Diastolic Problem
    - - Amyloidosis
        
        fills heart, hard to expand
      - Sarcoidosis
        
        granulomas enter wall of heart, hard to expand
      - Hemochromatosis
        
        iron gets into heart wall
      - Endocardial Fibroelastosis (children, rare)
        
        dense layer of fibrosis/elastic tissue in endocardium. Fucks with expansion of heart
      - Loeffler syndrome
        
        Eosinophil infiltration in heart wall
        
        results: fibrosis of endomyocardium (2 layers), hard to expand
      - Constrictive Pericarditis (not cardiomyopathy but similar presentation)
        
        Sticky pericarditis
        
        Pericardial knock
        
        sounds like S3
    - - CHF
        
        blood backs up behind heart
      - Kussmaul sign
        
        Konstriction/restriction sign
        
        no pulses paradoxus
    - - low voltage (classic) with diminished QRS amp
- - - - histology: abundant ground substance
    - - cardiac myocytes are permanent cells, won't produce tumors
      - mesenchymal tumors only
      - Pathogenesis
        
        grows in LA as pedunculate mass
        
        obstructs mitral valve: syncope
  - - - usually arises in ventricle
    - - assd. w/ Tuberous Sclerosis
  - - - enter pericardium
        
        result: pericardial effusion
    - - breast and lung carcinoma
      - melanoma
      - lymphoma