Cardiovascular: 16% of Blueprint
Dilated Cardiomyopathy
- Key features: Systolic dysfunction-EF<50%. Gradual CHF-mostly dyspnea.
- Causes: Often Idiopathic, chronic alcohol, postpartum, myocarditis, chronic tachycardia, Amloidosis, Sarcoidosis, Hemochromatosis, R ventricular Dysplasia, NOT related to ischemic heart disease, HTN, nor Valvular disease
1) H&P: rales, elevated JVP, cardiomegaly, S3 gallop rhythm, often murmurs of functional mitral or tricuspid regurgitation, peripheral edema, or ascites. pulsus alternans (variation of amplitude in every other beat on an art-line), pallor, and cyanosis,
2) Lab and diagnostic studies:
-ECG: low voltage, Sinus tachycardia, LBBB, Ventricular or atrial arrhythmias
-CXR: cardiomegaly, pulmonary congestion, Pleural effusions[R>L]
-Doppler Echo: LV dilation, thinning, and global dysfunction
-Stress test: May suggest underlying disease
-MRI: helpful in infiltrative disease
3) Key words/Pathognomonic-
4) Treatment: Not much, stop alcohol, treat hyper/hypothyroidism, acromegaly, pheochromocytoma, treat CHF, Long term anticoagulation, consider bivent pacer, ICD in EF<35%, transplant, immunosuppressive Tx NOT indicated.
5) Pharmacology: Treat CHF; diuretics and beta-blockers, ACE inhibitors, Aldosterone inhibitors
paspoke 