Cardiomyopathies 12/02

Question 1

Most common cardiomyopathy? percentage?

Answer 1

Dilated cardiomyopathy. 90 percent.

Question 2

What chambers dilate in dilated cardiomyopathy?

Answer 2

All 4 chambers.

Question 3

What dysfunction is in dilated cardiomyopathy?

Answer 3

Systolic dysfunction (ventricles cannot pump).

Question 4

What genetic mutation is in dilated cardiomyopathy?

Answer 4

Autosomal dominant.

Question 5

What dilated cardiomyopathy cause is due to Coxsackie A or B?

Answer 5

Myocarditis.

Question 6

How is described myocarditis in micro?

Answer 6

Lymphocytic infiltrate in the myocardium.

Question 7

What cardiomyopathy is caused by alcohol and cocaine, drugs (doxorubicin) use?

Answer 7

Dilated cardiomyopathy.

Question 8

What cardiomyopathy is caused by hemochromatosis?

Answer 8

Dilated and restrictive cardiomyopathy.

Question 9

What cardiomyopathy is caused by Wet Beriberi and Chagas disease?

Answer 9

Dilated cardiomyopathy.

Question 10

What cardiomyopathy is caused by sarcoidosis, thyrotoxicosis and peripartum cardiomyopathy?

Answer 10

Dilated cardiomyopathy.

Question 11

Findings of dilated cardiomyopathy?

Answer 11

HF, S3, systolic regurgitant murmur. Dilated heart on ECG. Balloon appearance of heart on CXR.

Question 12

Treatment of dilated cardiomyopathy?

Answer 12

Na restriction, ACE inh., Beta block, diuretics, digoxin, ICD. HEART TRANSPLANT.

Question 13

What hypertrophy is in dilated cardiomyopathy?

Answer 13

Eccetric (sarcomeres in series).

Question 14

How is described Takotsubo cardiomyopathy?

Answer 14

Ventricular apical ballooning likely due to increased sympathetic stimulation.

Question 15

Which cardiomyopathy is called ,,broken heart syndrome’’?

Answer 15

Takotsubo.

Question 16

What is the most common cause of dilated cardiomyopathy?

Answer 16

Idiopathic.

Question 17

What is the most common cause of hypertrophic cardiomyopathy?

Answer 17

Familial –> autosomal dominant.

Question 18

What genes are mutated in hypertrophic cardiomyopathy?

Answer 18

In genes encoding sarcomeric proteins (myosin binding protein C and beta-myosin heavy chain).

Question 19

What are findings in hypertrophic cardiomyopathy?

Answer 19

S4, systolic murmur. May seen mitral regurgitation due to impaired mitral valve closure.

Question 20

What hyperptrophy is seen in hypertrophic cardiomyopathy?

Answer 20

Concentric (sarcomeres in parallel). Often septal predominance.

Question 21

Treatment of hypertrophic cardiomyopathy?

Answer 21

Cessation of high-intensity athletics. USe Beta blockers or nondihydropyridine Ca blockers (e.g. varapamilis). ICD if patient is high risk.

Question 22

What are causes of hypertrophic cardiomyopathy excluded familial?

Answer 22

Chronic HTN, Friedreich ataxia.

Question 23

What dysfunction is in hypertrophic cardiomyopathy?

Answer 23

Diastolic –> decreased CO.

Question 24

Why young athletes dead having hypertrophic cardiomyopathy?

Answer 24

Ventricular arrhythmias.

Question 25

Why there is syncope in hypertrophic cardiomyopathy?

Answer 25

Subaortic hypertrophy of the ventricular septum --> functional aortic stenosis --> outflow obstruction --> dypnea, syncope.

Question 26

What changes are seen in biopsy of hypertrophic cardiomyopathy?

Answer 26

Myofiber hypertrophy with disarray, fibrosis.

Question 27

Why there is ...................... dysfunction in hypertrophic cardiomyopathy?

Answer 27

Diastolic. Because ventricle cannot fill.

Question 28

What dysfunction is in restrictive cardiomyopathy?

Answer 28

Diastolic dysfunction.

Question 29

What are 5 causes of restrictive cardiomyopathy?

Answer 29

Amyloidosis, Sarcoidosis, Loffler endocarditis, Endocardial fibroelastosis, Hemochromatosis.

Question 30

What is Loffler syndrome?

Answer 30

Endomyocardial fibrosis with an eosinophilic infiltrate and eosinophilia.

Question 31

What cells are seen in Loffler syndrome?

Answer 31

Eosinophils.

Question 32

What is classic finding in restrictive cardiomyopathy?

Answer 32

Low-voltage EKG with diminished QRS amplitude.