Cardiomyopathies Flashcards by Kaitlyn Yeager

By echocardiography, patients with congestive cardiomyopathy have left ventricles that are:

A. Hypertrophied with normal chamber size
B. Thick and hyperdynamic
C. Dilated and poorly contracting
D. Increased shortening fraction and hypertrophy

Dilated and poorly contracting

How well did you know this?

Not at all

Perfectly

All of the following are Doppler findings in patients with hypertrophic obstructive cardiomyopathy (HOCM) EXCEPT:

A. Outflow gradient that increased with a Valsalva maneuver
B. Late peaking systolic spectral trace
C. Increased A-to-E ratio on mitral inflow
D. Outflow gradient that decreases with a Valsalva manuever
E. Subaortic turbulence by color flow

Outflow gradient that decreases with a Valsalva maneuver

How well did you know this?

Not at all

Perfectly

In patient with IHSS:

A. LV posterior wall to septal ratio is usually greater than 1.3
B. Mitral regurgitation is often present
C. The aortic valves will show mid-diastolic closure
D. Systolic anterior motion of the MV will decrease with a Valsalva maneuver

Mitral regurgitation is often present

How well did you know this?

Not at all

Perfectly

Patients with a dilated cardiomyopathy frequently experience multiple symptoms which may include all of the following EXCEPT:

A. Migraine headaches
B. Syncope
C. Dyspnea
D. Tachycardia

Migraine headaches

How well did you know this?

Not at all

Perfectly

If your patient has right heart failure, what classic signs and symptoms would you expect to see?

A. Hemoptysis
B. Tricuspid stenosis
C. Atrial fibrillation
D. Lower extremity edema

Lower extremity edema

How well did you know this?

Not at all

Perfectly

Pulsus alternans is a clinical sign of which of the following?

A. Cardiac tamponade
B. Right ventricular volume overload
C. Hyperdynamic left ventricle
D. Left ventricular failure

Left ventricular failure

How well did you know this?

Not at all

Perfectly

When amyl nitrite is administered to a patient who has hypertrophic obstructive cardiomyopathy (HOCM) it is likely to:

A. Increase the systolic anterior motion of the mitral valve
B. Increase pulmonary venous return
C. Decrease systolic flow velocity in the LVOT
D. Decrease septal thickening

Increase the systolic anterior motion of the mitral valve and the outflow tract gradient

How well did you know this?

Not at all

Perfectly

Patients with a congestive cardiomyopathy usually have an ejection fraction in the range of:

A. 50-65%
B. 40-55%
C. 70-80%
D. 10-20%
E. 25-35%

10-20%

How well did you know this?

Not at all

Perfectly

All of the following might be a physical symptom in patients with congestive (dilated) cardiomyopathy EXCEPT:

A. Systemic hypertension
B. Fatigue
C. Sinus tachycardia
D. Edema
E. Dyspnea

Systemic hypertension

How well did you know this?

Not at all

Perfectly

All of the following are etiologies for congestive (dilated) cardiomyopathies EXCEPT:

A. Viral
B. Hemochromatosis
C. Metabolic
D. Peripartum
E. Ischemic

Hemochromatosis

How well did you know this?

Not at all

Perfectly

All of the following are echo findings in patients with hypertrophic obstructive cardiomyopathy (HOCM) EXCEPT:

A. Small left ventricular cavity size
B. Midsystolic closure of the aortic valve
C. Left ventricular hypertrophy
D. Decreased ejection fraction
E. Systolic anterior motion (SAM) of the mitral valve

Decreased ejection fraction

How well did you know this?

Not at all

Perfectly

If you obtain a systolic, high velocity and late peaking jet in the left ventricular outflow tract by continuous wave Doppler from the apex, the likely diagnosis is:

A. Hypertrophic obstructive cardiomyopathy
B. Tricuspid regurgitation
C. Mitral regurgitation
D. Valvular stenosis

Hypertrophic obstructive cardiomyopathy

How well did you know this?

Not at all

Perfectly

Hemochromatosis is most commonly associated with which of the following cardiomyopathies?

A. Congestive
B. Infiltrative
C. Hypertrophic
D. Dilated

Infiltrative

How well did you know this?

Not at all

Perfectly

Which of the following is NOT a common symptom of congestive heart failure?

A. Pedal edema
B. Dyspnea on exertion
C. Syncope
D. Orthopnea

Syncope

How well did you know this?

Not at all

Perfectly

A common valvular regurgitation found in patients with a dilated (congestive) cardiomyopathy is:

A. Pulmonic
B. Mitral
C. Aortic
D. Tricuspid

Mitral

How well did you know this?

Not at all

Perfectly

The shape of the left ventricle as it remodels in patients with a dilated cardiomyopathy is:

A. Rectangular
B. Elongated
C. Asymmetric
D. Spherical

Spherical

How well did you know this?

Not at all

Perfectly

All of the following are echo findings in patients with restrictive (Infiltrative) cardiomyopathies EXCEPT:

A. Small or normal ventricular cavity
B. Pericardial effusion
C. Hypercontractile left ventricle
D. “Ground glass” myocardium
E. Ventricular hypertrophy

Hypercontractile left ventricle

How well did you know this?

Not at all

Perfectly

All of the following are frequent echocardiographic findings in patients with IHSS EXCEPT:
A. Systolic anterior motion of the mitral valve
B. Asymmetric septal hypertrophy
C. Mitral valve prolapse
D. Midsystolic closure of the aortic valve

Mitral valve prolapse

How well did you know this?

Not at all

Perfectly

Patients with IHSS and a high resting outflow gradient may be offered which of the following treatments?

A. Lipitor medical therapy
B. Surgical septal myectomy
C. Contrast septal ablation
D. Sublingual nitroglycerin

Surgical septal myectomy

How well did you know this?

Not at all

Perfectly

All of the following are echo findings in patients with congestive (dilated) cardiomyopathy EXCEPT:

A. Left ventricular hypertrophy
B. Dilated left ventricle
C. Increased aortic root excursion
D. Global hypokinesis
E. Reduced mitral valve excursion

Increased aortic root excursion

(It is actually reduced)

How well did you know this?

Not at all

Perfectly

All of the following are etiologies for restrictive (Infiltrative) cardiomyopathies EXCEPT:

A. Sarcoidosis
B. Endomyocardial fibrosis
C. Hemochromatosis
D. Amyloidosis
E. Renal failure

Renal failure

How well did you know this?

Not at all

Perfectly

A cardiomyopathy is a disease that diffusely affects the _____, resulting in enlargement and/or ventricular dysfunction

A. Endocardium
B. Epicardium
C. Myocardium
D. Heart valves

Myocardium

How well did you know this?

Not at all

Perfectly

What is the proper technique for Dopplering the mitral inflow looking for diastolic dysfunction

A. Apical 2ch, pulsed Doppler, at mitral tips
B. Apical 4ch, pulsed Doppler, at mitral tips
C. Apical 4ch, pulsed Doppler, at mitral annulus
D. Apical 4 ch, color Doppler, at mitral tips
E. Apical 2ch, pulsed Doppler, at mitral annulus

Apical 4ch, pulsed Doppler, at mitral tips

How well did you know this?

Not at all

Perfectly

The bright myocardium in a patient with amyloid cardiomyopathy is caused by:

A. High frequency transducer
B. Amyloid infiltrates
C. Hypertrophic cardiomyopathy
D. Myocardial fiber disarray
E. Ground glass

Amyloid infiltrates

How well did you know this?

Not at all

Perfectly

M-mode findings seen in a patient with IHSS include all the following EXCEPT: A. Mid systolic closure of the aortic valve B. Asymmetric septal hypertrophy C. Dilated left ventricle D. Systolic anterior motion of the mitral valve

Dilated left ventricle

Patients with dilated cardiomyopathy frequently experience multiple symptoms, such as: A. Hypertension B. Dyspnea C. Increased cardiac output D. WPW

Dyspnea

What is the proper technique for Dopplering the pulmonary venous inflow looking for diastolic dysfunction? A. Apical 4ch, pulsed Doppler, 3 cm in the pulmonary vein B. Apical 4ch, color Doppler, 1-2 cm in the pulmonary vein C. Apical 2ch, color Doppler, 1-2 cm in the pulmonary vein D. Apical 4ch, pulsed Doppler, 1-2 cm in the pulmonary vein E. Apical 2ch, pulsed Doppler, 1-2 cm in the pulmonary vein

Apical 4ch, pulsed Doppler, 1-2 cm in the pulmonary vein

Common echo findings in dilated cardiomyopathy include all the following EXCEPT: A. Low Doppler velocity in the left ventricular outflow tract B. Increased left ventricular wall thickness C. Dilated atrial and ventricular cavities D. Diffusely reduced ventricular contractility

Increased left ventricular wall thickness

What causes a B-notch on M-mode? A. Increased LV end diastolic pressure B. Decreased LV end diastolic pressure C. Dilatation of the left ventricle D. Low cardiac output E. Increased after load

Increased LV end diastolic pressure

All of the following might be a physical symptom in patients with hypertrophic obstructive cardiomyopathy (HOCM) EXCEPT: A. Angina B. Systemic hypotension C. Systemic hypertension D. Sudden death E. Syncope

Systemic hypertension

M-mode findings in a patient with idiopathic hypertrophic subaortic stenosis (IHSS) might include all of the following EXCEPT: A. Mitral valve prolapse B. Systolic anterior motion of the mitral valve C. Mid systolic closure of the aortic valve D. Asymmetric septal hypertrophy

Mitral valve prolapse

Contraindications to amyl nitrite inhalation include all the following EXCEPT: A. Hemodynamic instability B. Allergies to nitrites C. Moderate mitral regurgitation D. Recent stroke E. Severe aortic stenosis

Moderate mitral regurgitation

A ventricular septum demonstrating “speckling” or a “ground glass” appearance by 2D echo is typical for a: A. Endomyocardial fibrosis B. Dilated cardiomyopathy C. Infiltrative cardiomyopathy D. Ischemic caridiomyopathy E. Hypertrophic cardiomyopathy

Infiltrative cardiomyopathy

Patients with Chagas Disease might develop which type of cardiomyopathy? A. Congestive B. Infiltrative C. Ischemic D. Hypertrophic E. Restrictive

Congestive

If a patient with IHSS has a resting outflow velocity of 3 m/sec what is the peak gradient? A. 100 mmHg B. 36 mmHg C. 9 mmHg D. 64 mmHg

36 mmHg (4V2)

Echo features of amyloid heart disease include all the following EXCEPT: A. Pericardial effusion B. Mitral valve prolapse C. Multivalvular regurgitation D. Increased wall thickness

Mitral valve prolapse

Patients with a dilated cardiomyopathy may demonstrate which of the following Doppler patterns of mitral inflow? A. Pseudo normal pattern B. Normal inflow pattern C. Abnormal relaxation D. Restrictive inflow pattern

Abnormal relaxation

The bright myocardium seen in Infiltrative cardiomyopathies is referred to as: A. Myocardial fiber disarray B. Overgained myocardium C. Ground glass D. Hypertrophic cardiomyopathy

Ground glass

Patients with a hypertrophic cardiomyopathy usually have an ejection fraction in the range of: A. 50-65% B. 10-20% C. 40-55% D. 25-35% E. 70-80%

70-80%

Which type of cardiomyopathy might you see in a patient with AIDS? A. Restrictive B. Infiltrative C. Congestive D. Hypertrophic E. Obstructive

Congestive (dilated)

If a patient with IHSS has a resting outflow velocity of 5 m/sec what is the peak gradient? A. 20 mmHg B. 5 mmHg C. 64 mmHg D. 100 mmHg

100 mmHg (4V2)

Patients with a dilated cardiomyopathy may develop apical thrombi. When looking for them in the left ventricular apex you should use: A. Saline contrast B. Tissue harmonics imaging C. Higher frequency transducer D. Lower frequency transducer

Higher frequency transducer

The classic motion of the aortic valve by M-mode in patients with hypertrophic obstructive cardiomyopathy (HOCM) is: A. Systolic flutter B. Diastolic closure C. Mid systolic closure D. Diastolic flutter

Mid systolic closure

Which echo findings are typically associated with idiopathic hypertrophic subaortic stenosis (IHSS)? A. Systolic anterior motion of the mitral valve and asymmetric septal hypertrophy B. Redundant mitral valve leaflets and right ventricular enlargement C. Left ventricular enlargement and abnormal septal thinning D. Left ventricular hypertrophy and decreased left ventricular contractility

Systolic anterior motion of the mitral valve and asymmetric septal hypertrophy

A large E-wave and short A-wave is the typical Doppler spectral trace of mitral inflow for which type of cardiomyopathy? A. Restrictive B. Hypertrophic C. Dilated D. Ischemic E. Congestive

Restrictive

Patients with hypertrophic obstructive cardiomyopathy (HOCM) will often have “bright” myocardial appearance by echo due to: A. Amyloid deposits B. Left ventricular hypertrophy C. Small cavity size D. Myocardial fiber disarray E. Using too high a gain setting

Myocardial fiber disarray

Patients with IHSS and a high resting outflow gradient may benefit from a surgical septal myectomy to decrease the gradient. What is a common complication from this procedure? A. Mitral regurgitation B. Ventricular septal defect C. Atrial fibrillation D. Aortic insufficiency

Ventricular septal defect (Occurs if too much of the septal muscle is removed)

Hemochromatosis is a restrictive cardiomyopathy that is caused by an excess of: A. Calcium B. Sodium C. Vitamin B D. Iron

Iron

Another echo term for a systolic, high velocity, and late peaking jet in the left ventricular outflow tract by continuous wave Doppler from the apex is: A. Rounded shape B. Classic shape C. Dagger shape D. Elliptical shape

Dagger shape

By echo measurements asymmetrical septal hypertrophy is present when the interventricular septum to posterior wall ratio is: A. > 1.2:1 B. < 1.3:1 C. < 1.2:1 D. > 1.3:1

> 1.3:1

In patients with asymmetric septal hypertrophy (ASH) what is the septal to posterior wall ratio? A. 1:1.5 B. Any ratio greater than 1:1 C. 1:1.3 D. 1.3:1 E. 1.5:1

1.3:1

Patients with advanced symptoms from having a dilated cardiomyopathy might benefit from all of the following EXCEPT: A. Mitral valve replacement B. Heart transplant C. Left ventricular assist device (LVAD) D. Intra-aortic balloon pump (IABP)

Mitral valve replacement

Patients with IHSS and a high resting outflow gradient may be offered all of the following treatments EXCEPT: A. Sublingual nitroglycerin B. Medical therapy C. Alcohol septal ablation D. Septal myectomy

Sublingual nitroglycerin (Used in patients with angina)

Amyloid and sarcoid are what type of cardiomyopathy? A. Restrictive B. Congestive C. Hypertrophic D. Infiltrative E. Dilated

Infiltrative

Patients with hypertrophic obstructive cardiomyopathy (HOCM) might have which of the following murmurs? A. Diastolic crescendo-decrescendo that decreases with Valsalva B. Diastolic crescendo-decrescendo that increases with Valsalva C. Systolic crescendo-decrescendo that increases with Valsalva D. Holosystolic murmur that increases with Valsalva E. Systolic crescendo-decrescendo that decreases with Valsalva

Systolic “diamond shaped” crescendo-decrescendo murmur that increases with Valsalva

Patients with a restrictive cardiomyopathy typically have a Doppler finding of: A. Large early E wave with short deceleration time and a small A wave B. Respiratory variation in the early diastolic E wave C. Small early E wave with short deceleration time and a large A wave D. Prolonged isovolumic relaxation time interval

Large early E wave with short deceleration time and a small A wave

Which of the following is the most common etiology for a patient to develop a restrictive cardiomyopathy? A. Pompe’s disease B. Endomyocardial fibrosis C. Amyloidosis D. Hemochromatosis E. Sarcoidosis

Amyloidosis (10:1 more common than sarcoidosis)

The restrictive transmittal filling pattern is most consistently associated with which physiological parameters? A. Low LA pressures, increased ventricular stiffness B. Elevated LA pressures, decreased ventricular stiffness C. Low LA pressures, decreased ventricular stiffness D. Elevated LA pressures, increased ventricular stiffness

Elevated LA pressures, increased ventricular stiffness

Which of the following is true regarding the mitral Doppler spectral trace in a patient with a restrictive/infiltrative cardiomyopathy? A. Diastolic function is normal B. Resembles constrictive pericarditis C. Resembles cardiac tamponade D. Shows E and A reversal

Resembles constrictive pericarditis (Large E wave and small A wave)

Which of the following is a common etiology for a patient to develop a congestive (dilated) cardiomyopathy? A. Toxic B. Parasitic C. Metabolic D. Peripartum E. Amyloidosis

Toxic (Toxins such as alcohol or chemotherapy drugs such as adriamycin)

Which of the following is a common echo finding in patients with a restrictive cardiomyopathy? A. Left ventricular dilation B. Asymmetric septal hypertrophy C. Right ventricular dilation D. Normal left atrial size E. Pericardial effusion

Pericardial effusion

Which of the following is a common Doppler finding in patients with a restrictive cardiomyopathy? A. Aortic outflow gradient B. E greater than A ratio on mitral inflow C. Equal E to A ratio on mitral inflow D. A greater than E on mitral inflow E. Mitral inflow Doppler not valid

E greater than A ratio on mitral inflow

Common echo findings in dilated cardiomyopathy include all the following EXCEPT: A. Increased left ventricular wall thickness B. Dilated atrial and ventricular cavities C. Low Doppler velocity in the left ventricular outflow tract D. Diffusely reduced ventricular contractility

Increased left ventricular wall thickness

The dagger shaped Doppler spectral trace (late peaking systolic gradient) is classic for which of the following etiologies? A. Restrictive cardiomyopathy B. Mitral stenosis C. Aortic stenosis D. Mitral stenosis and mitral regurgitation E. Hypertrophic obstructive cardiomyopathy

Hypertrophic obstructive cardiomyopathy

Which of the following is an echo finding in patients with a dilated cardiomyopathy (DCM)? A. B notch on M-mode B. Increased mitral valve excursion C. Exaggerated E-point to septal separation D. Increased ventricular function E. Exaggerated aortic root excursion

B notch on M-mode

Which of the following is the most common type of cardiomyopathy? A. Dilated B. Restrictive C. Infiltrative D. Hypertrophic

Dilated

The ratio of early transmitral (E) to atrial (A) Doppler filling velocities are influenced by by all of the following factors EXCEPT: A. Left ventricular preload B. Transducer frequency C. Delayed left ventricular relaxation D. Patients age

Transducer frequency

Hemochromatosis is most commonly associated with which of the following cardiomyopathies? A. Infiltrative B. Hypertrophic C. Congestive D. Dilated

Infiltrative

Cardiomyopathies Flashcards

(68 cards)