The Road to 250

16 May 2017
Heart Failure Connections
Heart Failure
Heart Failure
Heart Failure
Dilated cardiomyopathy
Eccentric hypertrophy
Sarcomeres added in series
S3
S3 is usually associated with?
Increased filling pressure
Systolic regurg murmurs
What are the systolic murmurs?
Aortic stenosis, Mitral and tricuspid regurg, Mitral valve prolapse, VSD
Dilated Cardiomyopathy Etiologies
Alcohol abuse and wet Beriberi
Cocaine use
Coxsackie B
Chagas disease
Doxorubicin
Hemochromatosis
Idiopathic of familial
Sarcoidosis
Pregnancy
Alcohol Abuse and Wet Beriberi
EOTH
Acetyleldahyde is toxic to mitochondria; disrupts cytochrome C from the
inner mitochondrial membrane. When cytochrome C is liberated into the
cytoplasm it activates Caspases.
What happens when you liberate caspases?
Apoptosis
B1 deficiency
Needed for pyruvate dehydrogenase to make ATP
Cocaine use
Chemically induced toxicity to myocytes
Directly damages the mitochondria
Coxsackie B
Directly invades myocytes and triggers an immune attack.
Chagas disease
Releases a potent neurotoxin that damages the specialized conduction
cells
Doxorubicin
Doxorubicin
Hemochromatosis
Sarcoidosis
Pregnancy
Significant increase in plasma volume
Systolic dysfunction
SV
EF
EDV

Congestion of Blood
LVLALungs

And
JVD
Hypertrophic cardiomyopathy
Familial, autosomal dominant
Mutation in sarcomeric proteins
Myosin binding protein C and -myosin heavy chain
Concentric hypertrophy
Sarcomeres added in parallel
Myofibrillar disarray and fibrosis
S4
What is S4 usually associated with?
Compliance (stiff ventricle)
Associated with Friedreich ataxia
What is the genetic info for this disease?
AR, trinucleotide repeat (GAA) on Chromosome 9 which codes for fraxtaxin
Diastolic dysfunction
EF Additionally,
EDV hypertrophic tissue
Compliance has O2
requirements

Compliance leads
to Pressure in LA
Compensatory
mechanisms

Baroreceptors in
aortic arch and
carotid sinus
Compensatory
mechanisms

Baroreceptors in
aortic arch and
carotid sinus
Targeting the
Compensatory
mechanisms

Hydralazine

ACE and
Aldosterone
antagonist

Blockers