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Cardiovascular > Cardiomyopathy and myocardial disease > Flashcards

Cardiomyopathy and myocardial disease Flashcards

1
Q

gross morphology Restrictive CM

A

normal vent

bi-atrial dilation

fibrous myocardium

interstitial fibrosis

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1
Q

stain for amyloidosis

A

congo red > apple green birefringence under polarizd

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1
Q

heart impacts of thyroid disease - hyperthyroidism

A

tachycardia

palpitations

cardiomegaly

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2
Q

Loeffler endomyocarditis

A

endomyocardial fibrosis

large mural thrombi

peripheral eosinophilia + eosinophilic infiltrates in organs

(damage via maj. basic protein

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2
Q

cardiac impact of hypothyroidism

A

output decreased

advanced hypothyroidism

myxedema - flabbly, enlarged, dilated

fluid in accumulation

myofiberr swelling w/loss of striation, basophil degen

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3
Q

___ fxn in hypertrophic CM is disturbed, ____ fxn in largely preserved

A

dystolic dysfunction

normal systole

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3
Q

main lethal even for many with Hypertrophic CM

A

sustained Vtach/Vfib

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4
Q

mutations of hypertrophic CM

A

myosin heavy chain B-MHC

myosin binding protein MYBP-C

cardiac cnc

sarccomere fucntion - defect of energy transfer

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5
Q

clinical presentation arrhythmogenic right ventricular cardi myapthy / dysplasia

A

young adults

Vtac

sudden death

RV failure

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5
Q

mechanisms of myocardial ischemia in hypertrophic CM

A

supply/demand mismatch due to mass increase

icreased wall tension due to decreased relaxation

abnormal intramyocardial arteries

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6
Q

Arrhythomgenic right ventricular cardiomyopathy, morphology

A

inherited

RV failure and various rythm disturbance (Vtac or Vfib)

RV wall thinned due to loss of myocytes w/extensive fatty inflitration and fibrosis

defective desmosomes?

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6
Q

restrictive hemodynamics of amyloidosis

A

asymptomatic

pressure atrophy of fibers

depostion in regions of conduction system > arrhythmias

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7
Q

clinical presentation dilated CM

A

Heart failure

angina

syncope

sudden cardiac death

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8
Q

dilated cm gross morphology

A

four chamber dilation

variable wall thickness (hyper, normal, flabby)

**normal **valves

mitral or tricus regurg 2ndry two dilation

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9
Q

heart morphology cardiomyopathy

A

progressive cardiac dilation

hypertrophy

enlarged, heavy, flabby heart

regurgitation (functional)

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9
Q

pathovisiology hypertrophic CM (5 processes)

A

LV outflow tract obstruction

Mitral regurg

diastolic dsfxn

myocariial asichemia

cardiac arrhythmias

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10
Q

histology restrictive CM

A

patch or diffuse interstitial fibrosis and diseases specific changes

amyloid fibers

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11
Q

cardiotoxic drugs

A

lithium

pehnothiazines

chloroquine

cocaine

12
Q

histology hypertrophic CM

A

fibrosis, irregular organization

13
Q

gross morphology hypertrophic CM

A

banana ventricle

enlarged atrium

endocardial thickening

mural plaques in outflow tract

15
Q

Dilated cardiomyopathy genetics

A

genetic encoding cytoskeleton proteins

X-linked (often dystrophin)

also mitochondrial mutations (ox phos and FA B-ox)

16
Q

SAM of hypertropohic CM

A

anterior dispalcement of mital leaflets during systole

SAM - systolic anterior motion of mitral valve

17
Q

sarcoidosis

A

restriction

conduction system disease = arrhythmias

sudden cardiac death

19
Q

Acute viral myocarditis (dilated cardiomyopathy) infection and impact

A

Coxasacie B or echovirus

myocyte cell death and fibrosis

immune mediated injury

20
Q

Alcohol cardiomyopathy =

A

dilated (leads to beriberi heart disease)

21
Q

restrictive CM =

A

primary decrease in ventricular compliance resulting in impaired v filling during diastole

23
Q

increased risk for idiopathic dilated cardiomyopathy

A

male

African American

HTN

chronic beta-agonist use

24
Q

heart wall of hypertrophic CM

A

thick, heavy, hypercontracting

25
Q

doxorubicin causes

A

dilated cardiomyopathy (dose-dependent)

26
Q

Restrictive CM clinical presentation

A

Right and left congestive HF (pulmonary congestion, hepatic congestion)

pericardial+epicardial inflammation compressing the heart

(dx with endomyocardial biopsy)

28
Q

non-pharm tx hypertrophic CM

A

surgical septal myectomy

alcohol induced septal ablation

dual chamber pacemaker

29
Q

cardiac effects of catecholamines (seen in pts of pheochromocytoma)

A

sudden intense emotional or physical stress leading to acute ventricular dysfxn

takotsubo cardiomyopathy

30
Q

Hypertrophic CM pathogenesis

A

mutatio in sarcomeric proteins increase myofilament activation resulting in hypercontractility

31
Q

Senile cardiac amyloidosis

A

Transthyretin depostis in ventrilces and atria

33
Q

__ dysfunction in dilated cardiomyopathy

A

systolic

34
Q

morphology of amyloiddosis

A

normal heart or firm and rubbery

eosinophilic amyliodi depsits

35
Q

treatment hypertrophic CM

A

beta blockers (for negative ionotrope)

Ca channel blockers

Dispyramide (pts with resting gradient)

37
Q

dilated CM histology

A

myocyte hypertrophy

deranged nuclei

fibrosis between myocytes (interstitial and endocardial)

38
Q

morphology arrhythmogenic right ventricular cardiomyopathy

A

thin and dilated RV with **fatty infiltration **and interstitial fibrosis

39
Q

clinical presentation hypertrophic CM

A

post puberty

exertional dyspnea

syncopes (LV outflow obstruction)

Afib with mural thrombus

Sudden death in young atheletes

40
Q

endocardio fibroelastosis =

A

focal or diffuse fibroelastic thiecnking usually involving mural of LV endocardium

41
Q

peripartum cardiomyopathy =

A

dilated

42
Q

hypertrophic cardiomyopathy may lead to ____ outflow obstruction

A

left ventricular

43
Q

iron overload from transfusion or hemochromatosis causes what type of cardiomyopathy

A

dilated

Cardiovascular (39 decks)

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