Cardiomyopathy and myocardial disease

Question 1

gross morphology Restrictive CM

Answer 1

normal vent

bi-atrial dilation

fibrous myocardium

interstitial fibrosis

Question 1

stain for amyloidosis

Answer 1

congo red > apple green birefringence under polarizd

Question 1

heart impacts of thyroid disease - hyperthyroidism

Answer 1

tachycardia

palpitations

cardiomegaly

Question 2

Loeffler endomyocarditis

Answer 2

endomyocardial fibrosis

large mural thrombi

peripheral eosinophilia + eosinophilic infiltrates in organs

(damage via maj. basic protein

Question 2

cardiac impact of hypothyroidism

Answer 2

output decreased

advanced hypothyroidism

myxedema - flabbly, enlarged, dilated

fluid in accumulation

myofiberr swelling w/loss of striation, basophil degen

Question 3

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

Answer 3

dystolic dysfunction

normal systole

Question 3

main lethal even for many with Hypertrophic CM

Answer 3

sustained Vtach/Vfib

Question 4

mutations of hypertrophic CM

Answer 4

myosin heavy chain B-MHC

myosin binding protein MYBP-C

cardiac cnc

sarccomere fucntion - defect of energy transfer

Question 5

clinical presentation arrhythmogenic right ventricular cardi myapthy / dysplasia

Answer 5

young adults

Vtac

sudden death

RV failure

Question 5

mechanisms of myocardial ischemia in hypertrophic CM

Answer 5

supply/demand mismatch due to mass increase

icreased wall tension due to decreased relaxation

abnormal intramyocardial arteries

Question 6

Arrhythomgenic right ventricular cardiomyopathy, morphology

Answer 6

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?

Question 6

restrictive hemodynamics of amyloidosis

Answer 6

asymptomatic

pressure atrophy of fibers

depostion in regions of conduction system > arrhythmias

Question 7

clinical presentation dilated CM

Answer 7

Heart failure

angina

syncope

sudden cardiac death

Question 8

dilated cm gross morphology

Answer 8

four chamber dilation

variable wall thickness (hyper, normal, flabby)

**normal **valves

mitral or tricus regurg 2ndry two dilation

Question 9

heart morphology cardiomyopathy

Answer 9

progressive cardiac dilation

hypertrophy

enlarged, heavy, flabby heart

regurgitation (functional)

Question 9

pathovisiology hypertrophic CM (5 processes)

Answer 9

LV outflow tract obstruction

Mitral regurg

diastolic dsfxn

myocariial asichemia

cardiac arrhythmias

Question 10

histology restrictive CM

Answer 10

patch or diffuse interstitial fibrosis and diseases specific changes

amyloid fibers

Question 11

cardiotoxic drugs

Answer 11

lithium

pehnothiazines

chloroquine

cocaine

Question 12

histology hypertrophic CM

Answer 12

fibrosis, irregular organization

Question 13

gross morphology hypertrophic CM

Answer 13

banana ventricle

enlarged atrium

endocardial thickening

mural plaques in outflow tract

Question 15

Dilated cardiomyopathy genetics

Answer 15

genetic encoding cytoskeleton proteins

X-linked (often dystrophin)

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

Question 16

SAM of hypertropohic CM

Answer 16

anterior dispalcement of mital leaflets during systole

SAM - systolic anterior motion of mitral valve

Question 17

sarcoidosis

Answer 17

restriction

conduction system disease = arrhythmias

sudden cardiac death

Question 19

Acute viral myocarditis (dilated cardiomyopathy) infection and impact

Answer 19

Coxasacie B or echovirus

myocyte cell death and fibrosis

immune mediated injury

Question 20

Alcohol cardiomyopathy =

Answer 20

dilated (leads to beriberi heart disease)

Question 21

restrictive CM =

Answer 21

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

Question 23

increased risk for idiopathic dilated cardiomyopathy

Answer 23

male African American HTN chronic beta-agonist use

Question 24

heart wall of hypertrophic CM

Answer 24

thick, heavy, hypercontracting

Question 25

doxorubicin causes

Answer 25

dilated cardiomyopathy (dose-dependent)

Question 26

Restrictive CM clinical presentation

Answer 26

Right and left congestive HF (pulmonary congestion, hepatic congestion) pericardial+epicardial inflammation compressing the heart (dx with endomyocardial biopsy)

Question 28

non-pharm tx hypertrophic CM

Answer 28

surgical septal myectomy alcohol induced septal ablation dual chamber pacemaker

Question 29

cardiac effects of catecholamines (seen in pts of pheochromocytoma)

Answer 29

sudden intense emotional or physical stress leading to acute ventricular dysfxn takotsubo cardiomyopathy

Question 30

Hypertrophic CM pathogenesis

Answer 30

mutatio in sarcomeric proteins increase myofilament activation resulting in hypercontractility

Question 31

Senile cardiac amyloidosis

Answer 31

Transthyretin depostis in ventrilces and atria

Question 33

\_\_ dysfunction in dilated cardiomyopathy

Answer 33

systolic

Question 34

morphology of amyloiddosis

Answer 34

normal heart or firm and rubbery eosinophilic amyliodi depsits

Question 35

treatment hypertrophic CM

Answer 35

beta blockers (for negative ionotrope) Ca channel blockers Dispyramide (pts with resting gradient)

Question 37

dilated CM histology

Answer 37

myocyte hypertrophy deranged nuclei fibrosis between myocytes (interstitial and endocardial)

Question 38

morphology arrhythmogenic right ventricular cardiomyopathy

Answer 38

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

Question 39

clinical presentation hypertrophic CM

Answer 39

post puberty exertional dyspnea syncopes (LV outflow obstruction) Afib with mural thrombus Sudden death in young atheletes

Question 40

endocardio fibroelastosis =

Answer 40

focal or diffuse fibroelastic thiecnking usually involving mural of LV endocardium

Question 41

peripartum cardiomyopathy =

Answer 41

dilated

Question 42

hypertrophic cardiomyopathy may lead to ____ outflow obstruction

Answer 42

left ventricular

Question 43

iron overload from transfusion or hemochromatosis causes what type of cardiomyopathy

Answer 43

dilated