Cardiomyopathy and anti-arrythmatic Flashcards Preview

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Flashcards in Cardiomyopathy and anti-arrythmatic Deck (64)
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31

What si restrictive cardiomyopathy histology?

patchy or diffuse intersitial fibrosis and disease specific changes

32

What is the clinical features of RCM?

congestive heart failure
--severe pulmonary congestion
--hepatic congestion
similar S/S as constricitve pericarditis
Dx: endomyocardial biopsy

33

What happens in senile cardiac amyloidosis?

transthyretin (prealbumin)-deposits in ventricles and atria
>60 yrs of age
AA majority

34

What are the restrictive hemodynamics?

asymptomatic
pressure atrophy of fibers
deposition in regions of conduction system leads to arrhythmiass

35

Loeffler endomyocarditis?

endomyocardial fibrosis, large mural thrombi, peripheral eosinophilia, eosinophilic infiltrates in organs

36

Endocardial fibroelastosis is indicated by what?

common first two years of life, in young children in africa, focal or diffuse fibroelatic thickening

37

What can hyperthyroidism cause with respect to the heart?

tachy, palpitations and cardiomegaly

38

What can hypothyroidism cause with respect to the heart?

CO is decreased
flabby, enlarged and dilated
myofiber swelling

39

What is the effect of catecholamines on the heart when induced either in intesnse stress or froma pheochromocytoma?

takotsubo cardiomyopathy

40

What is afterdepolarizations?

spontaneous action potentials during or immediately after phase 3 repolarization. Produced by abnormal Ca2+ influx during or after phase 3 of ventricular action potential

leading to premature contractions and ventricular tachycardia

observeed with digoxin toxicity and conditions that prolong QT interval

41

Quinidine therapy results in what?

action potential prolognation increased QT duration, early afterdepolarizations and torsade de pointes

42

Class 1 are sodium channel blockers do what?

bind fast sodium channels in the open and inactivated states and dissociate from channels during resting state

43

What is in ddrug class 1a?

quinidine, procainamide, disopyramide

44

What is the drug dissociationrate of drug class 1a?

slow

45

What is the drug dissociation of drug class 1B?

lidocaine, mexilitene; rapid

46

What is drug dissociation rate of class 1C?

very slow

47

What is drug class 1a mechanism of action?

slow phase 0, and conduction velocity and prolong action portential duration and refactory period

proarrhythmic

48

Class 1b drugs does what?

greater affinity for inactivated vs open channel

49

What is special about lidocaine?

extensive first pass hepatic inactivation; more active in ischemic tissue due to less negative resting membrane, minimal effect on normal cardiac tissue

50

What is class 1c drugs?

block fast sodium chanels more potently than class 1 agents, slow conduction throughout heart, less effect on K+ current

51

What is flecainide used to treat

SVT and VT,
may inhibit Ca2+ releases from cardiac SR

52

What is propafenone side effects?

ventricular proarrhythmia, agranulocytosis, anemia, thrombocytopenia

53

What are class II Beta-blockers do?

inhibit sympathetic activation of cardiac autmoaticity and conduction

effect mainly occurs at AV node refactory period;

54

What are class III anti-arrhythmic drugs?

block potassium recitifier, demonstrate reverse-use dependence

with more potent Kv block occuring at slower heart rates.

55

What is amiodarone?

iodinated compound, half life approx 40 days

decrease SA node automaticity, decrease AV conduction velocity

56

What are the side effects of amiodarone?

hypothyroidism, hyperthyroidism, neulogic toxicity, and more

QT prolongation

57

What does amiodarone block?

Ikr and Iks

58

What does sotalol do?

selectively blocks beta-adrenoreceptors and delayed recitifier potassium channel

slow AV conduction velocity

blocks Ikr

59

What does dofetilide do?

block rapidly activating delayed recitifier channel,may prolong QT and produce TdP; blocks Ikr

60

What does class 4 drugs do?

block voltage gated L type Ca2+ channels

decrease AV node conduction