g. Prognosis: poor; 5 year survival - 25%

h. Treatment: heart transplantation

2. Hypertrophic cardiomyopathy a. Synonyms: asymmetrical septal hypertrophy, idiopathic hypertrophic subaortic stenosis (IHSS)

b. Etiology i. Hereditary: autosomal dominant disorder (>50% of cases)

ii. Idiopathic c. Common cause of sudden cardiac death in young athletes d. Gross i. Asymmetrical cardiac hypertrophy, which is most prominent in the ventricular septum ii. The ventricular outflow tract is often obstructed by the septal hypertrophy.

e. Micro: cardiac myofiber hypertrophy and disarray

3. Restrictive cardiomyopathy a. Definition: uncommon form of cardiomyopathy caused by diseases that produce restriction of cardiac filling during diastole b. Etiology i. Amyloidosis ii. Sarcoidosis iii. Endomyocardial fibroelastosis iv. Loeffler endomyocarditis Carcinoid Heart Disease

1. Carcinoid heart disease a. Definition: right-sided endocardial and valvular fibrosis secondary to exposure to serotonin in patients with carcinoid tumors which have metastasized to the liver b. Plaque-like thickening of the endocardium and valves of the right side of the heart c. Carcinoid syndrome i. Skin flushing ii. Diarrhea iii. Cramping iv. Bronchospasm and wheezing v. Telangiectasias d. Diagnosis: urinary 5-hydroxyindoIeacetic acid (5-HIAA) Cardiac Tumors

1. Cardiac myxoma a. Benign tumor usually arising within the left atrium near the fossa ovalis b. Micro: stellate-shaped cells within a myxoid background c. Complications i. Tumor emboli ii. "Ball-valve" obstruction of the valves

2. Cardiac rhabdomyoma a. Benign tumor usually arising within the myocardium b. Associated with tuberous sclerosis

Your Heart and Nutrition

Your Heart and Nutrition

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