PSYCH 1XX3 Lecture Notes - Lecture 19: Tricuspid Insufficiency, Hemodynamics, Cardiomyopathy
19 May 2018
School
Department
Course
Professor
Cardiac Failure
A syndrome caused by any abnormality of the heart that may be characterised by a set of haemodynamic,
neural, and endocrine abnormalities
LVF
• Causes:
o IHD
o Hypertension
o Valve disease
o Myocardial disease
• Consequences:
o Impaired pulmonary outflow
▪ Congestion and oedema
o Reduced renal perfusion
▪ Salt and water retention +
ATN
o Reduced CNS perfusion
(encephalopathy)
RVF
• Causes:
o Left-sided heart failure
(Congestive)
o Chronic Lung Pathology - Cor
Pulmonale
• Consequences:
o Portal, systemic and peripheral
congestion
o Tricuspid regurgitation
o Renal congestion (R > L)
Cardiomyopathy
Causes
Features
Hypertrophic
Inherited (50% AD)
Sporadic cases
Pathology - heavy muscular hypertrophy with poor
compliance
Often asymmetrical septal hypertrophy
Sequelae:
- Arrhythmias - AF
- LV outflow obstruction
- CHF
- Sudden deathYoung man
Syncope, FH of sudden death, Jerky pulse and double
apical impulse, Ejection systolic murmur (+/- mild mitral
murmur)
Dilated
Idiopathic
Four-chambered hypertrophy and dilatation
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Document Summary
A syndrome caused by any abnormality of the heart that may be characterised by a set of haemodynamic, neural, and endocrine abnormalities. Ihd: hypertension, valve disease, myocardial disease, consequences: Impaired pulmonary outflow: congestion and oedema, reduced renal perfusion, salt and water retention + Rvf: causes, left-sided heart failure (congestive, chronic lung pathology - cor. Pulmonale: consequences, portal, systemic and peripheral congestion, tricuspid regurgitation, renal congestion (r > l) Syncope, fh of sudden death, jerky pulse and double apical impulse, ejection systolic murmur (+/- mild mitral murmur) Progressive loss of mycoytes causing dilation + heart failure + arrhythmias. Pathology - restriction of ventricular filling with myocardial fibrosis. Usually due to mutation in cell adhesion genes. Stenosis: pressure overload + hypertrophy, develops slowly. Complications: hypertrophy, lvf, worsening of ihd, heart failure, pro-arrhthymia, rheumatic fever/endocarditis, functional (e. g. mitral/tricuspid valve disease, degeneration (e. g calcific aortic stenosis) Regurgitation: volume overload, develops quickly or slowly, dilation, mitral and atria, risk of endocarditis.
