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Clin Med - Cardio Exam #2 > Cardiomyopathies > Flashcards

Cardiomyopathies Flashcards

(47 cards)

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1
Q

Definition of Cardiomyopathy

A

Intrinsic disease of myocardium that causes hemodynamic dysfuction
-heart failure, L and/or R biventricular failure

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2
Q

What percentage of heart failure diagnosed in the US is cardiomyopathy?

A

5-10%

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3
Q

The cause of Cardiomyopathy is usually __________ although it can be secondary to multi vessel disease.

A

Non-ischemic

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4
Q

T/F cardiomyopathy can be related to valve disease, and/or systemic HTN

A

F!

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5
Q

What are the 2 categories of etiologies of cardiomyopathy?

A

Primary intrinsic

Secondary intrinsic

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6
Q

What causes Primary intrinsic cardiomyopathy?

A

Genetic disorders of myocardial fibers

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7
Q

What causes secondary intrinsic cardiomyopathy?

A

Sarcoidosis
Hemachromatosis
Chronic anemia

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8
Q

What are the three main PATTERNS of cardiomyopathy?

A

Dilated
Hypertrophied
Restrictive

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9
Q

Signs and symptoms of all cardiomyopathies

A

DOE (increased LV/LA/PA pressure)
Fatigue (decreased CO)
As disease advances so do symptoms

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10
Q

What is the most common type of cardiomyopathy?

A

dilated

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11
Q

Define dilated cardiomyopathy

A

enlarge LV with decreased systolic function and ejection fraction.

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12
Q

What must the ejection fraction be less than to consider dilated cardiomyopathy as diagnosis?

A

EF less than 50%

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13
Q

Epidemiology of dilated cardiomyopathy

A

Men more than women
Blacks more than whites
Age of onset 20-50

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14
Q

In dialated cardiomyopathy ______ failure is more pronounced than _______ failure

A

Systolic failure is more pronounced than diastolic failure

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15
Q

With dilated cardiomyopathy the heart can be enlarged _____ - _____ x normal weight

A

2-3X

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16
Q

Causes of intrinsic dilated cardiomyopathy

A 
Genetic (20-50%)
Idiopathic
CAD
RX's (ETOH, and chemo drugs)
Thyroid dz 
Peripartum 
infections
chronic tachy
sarcoidosis
amyloidosis
hemochromatosis
DM
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17
Q

Signs and symptoms of Dilated cardiomyopathy

A 
Pulmonary rales
Elevated JVD
Cariomegaly
S3 Gallop rhythm
Murmurs of mitral or tricuspid regurg. (systolic)
peripheral edema
ascites
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18
Q

What symptoms are present in severe heart failure secondary to dilated cardiomyopathy?

A

Cheyne-stokes breathing -
Pulsus alterans
Pallor
cyanosis

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19
Q

What diagnostic studies can be used in workup for dilated cardiomyopathy?

20
Q

What would you be looking for on Echo to confirm dil. Cmyop.

Study These Flashcards
A

Presnence of dilated ventricle and reduced systolic function

EF less than 40%

21
Q

What would you be looking for on ECG to confirm dil. Cmyop.

Study These Flashcards
A

Sinus tachy

Ventricular/atrial arrhythmias

22
Q

What would you be looking for on CXR to confirm dil. Cmyop.

Study These Flashcards
A

Cardiomegaly
L and or right heart enlargement
Pleural effusion

23
Q

What 2 types of Hypertrophic Cardiomyopathies (HCM) exist?

Study These Flashcards
A

Obstructive

Non-obstructive

24
Q

What is age of onset of HCM

Study These Flashcards
A

any age but commonly seen post-puberty

25
What is the most common genetic cause of cardiac death in young people including trained athletes?
HCM
26
Definition of HCM
Increased LV hypertrophy without the presence of an underlying cause such as valve dz, volume overload or systemic HTN.
27
What is the primary dysfunction of HCM
increased diastolic filling pressure from a stiff and small chambered hypertrophied LV
28
In obstructive HCM (there is outflow track obstruction) there is characteristic ________ that can obstruct outflow by narrowing the LV outflow track and decreasing EF.
asymmetric interventricular septal hypertrophy
29
Causes of intrinsic HCM
Genetic (50-80% of cases) MC genetic CV issue Idiopathyic IDMM (infants of diabetic mothers)
30
Signs and symptoms of HCM
``` Can range from mild to severe Sudden death (need for good family hx) Progressive DOE Anginal CP Presyncope/syncope after valsalva maneuver or exercise, palpitations Cardiac failure ```
31
cardiac exam s/s of HCM
``` Atrial ventricular arrhythmias Sustained PMI Lous S4 (stiffened hypertrophied ventricles) Systolic ejection murmur Bisferiencs carotid pulse (biphasic) ```
32
What anomaly of the carotid pulse is characteristic of HCM
Bisferiens carotid pulse- | double peaked pulse of the carotid
33
What will occur to the systolic ejection murmur of a pt with HCM if they squat down?
Decreases the sound (Increases LV filling)
34
What will increase the sound of a systolic ejection murmur of a pt with HCM?
Valsalva and standing | decreases LV size and LV filling
35
What diagnostic studies can be done to test for HCM?
Echo Cardiac cath ECG
36
What is the definitive test for HCM?
Echo
37
What will a echo that is positive for HCM show?
small hyper contractile LVH Delayed relaxation and filling of LV in diastole turbulent flow and pressure gradient in the outflow track and mitral regurgitation
38
What is the benefit of doing a cardiac cath on a pt with HCM?
confirms echo | also rules out CAD
39
What findings on an ECG might be consistent with HCM?
LVH in symptomatic pt's | Atrial or ventricular fib
40
Conservative tx and recommendations for HCM
avoid strenuous exercise hydrate screen all 1st degree relatives w/ echo genetic testing
41
Medical tx for HCM?
``` BB-1st line Verapamil Dysopyramide (adjunct) diuretics Surgical tx ```
42
What surgical tx are available for a pt with HCM?
Myotomy-myomectomy | Mitral valve replacement
43
what is the main cause of restrictive cardiomyopathy?
Amyloidosis
44
In restrictive cardiomyopathy the walls of the ventricles become ____ but not necessarily _____.
stiff | Thickened
45
What is the difference between restrictive cardiomyopathy and constrictive pericarditis?
Res cardiomyopathy-no pulsus paradoxus | Pericarditis-does have pulsus paradoxus
46
s/s of restrictive cardiomyopathy
mostly due to elevated ventricular diastolic pressure that restricts filling: Pulmonary and systemic venous pressure DOE, orthopnea-pulmonary HTN R sided Heart failure
47
Tx for restrictive cardiomyopathy
``` Tx underlying dz (amyloidosis) Tx diastolic heart failure BB Loop diuretics Thiazides aldosterone antagonists ```

Clin Med - Cardio Exam #2 (12 decks)

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