Cardiomyopathy/pericardial disease

Question 1

physical exam findings of tamponade?

Answer 1

pulsus paradoxus, x descent on JVW, distant heart sounds, bottle shaped heart

Question 2

complication of stress induced CM?

Answer 2

LVOT obstruction

Question 3

management for stress induced CM?

Answer 3

BB, volume, and if pressors needed use pure alpha

Question 4

treatment for resistant pericarditis?

Answer 4

immunosuppressants like azatioprine, anakinra

Question 5

things that can cause restrictive CM?

Answer 5

sarcoid and carcinoid

Question 6

constrictive pericardtisi JVW findings?

Answer 6

elevated JVP with prominent y descent

Question 7

what happens to JVP during diastole in constrictive pericarditis?

Answer 7

collapse, this is not seen in tamponade

Question 8

Kussmaul sign?

Answer 8

inc JVP with inspiration rather than expiration

Question 9

thickness of pericardium in constrictive pericarditis?

Answer 9

5mm

Question 10

diagnosis of cardiac amyloidosis?

Answer 10

serum light chains with monoclonal spike, biopsy, or bone scintography

Question 11

ejection systolic crescendo decrescndo murmur at left sternal border?

Answer 11

HOCM

Question 12

murmur of HOCM with squatting, handgrip?

Answer 12

squatting- inc, handgrip lessens

Question 13

what is the cause of risk of death with HOCM?

Answer 13

long QT- debrillator

Question 14

medications to treat HOCM?

Answer 14

BB or non dihydropyridine CCM like verapamil

Question 15

if patient is not a surgical candidate in HOCM then what intervention should they have?

Answer 15

dual chamber pacing

Question 16

what is the indication for surgery with HOCM?

Answer 16

outflow gradient of > 50 mmhg

Question 17

HOCM surgery for the young? old?

Answer 17

myomectomy, alcohol ablation

Question 18

pulsus paradoxus- what is it? what do you see it in?

Answer 18

decrease in systolic BP by 10 mmhg on inspiration/ tamponade

Question 19

becks triad of tamponade?

Answer 19

muffled or absent heart sounds, hypotension, inc JVP

Question 20

CVP waveform findings of tamponade?

Answer 20

prominent x descent and blunted y descent

Question 21

pathologic findings of viral myocarditis?

Answer 21

lymphocyte infiltration and myocyte necrosis

Question 22

management for pericarditis?

Answer 22

NSAID plus colchicine

Question 23

possible cause and tx for acute eosinophilic myocarditis?

Answer 23

phenytoin, immunlogics

Question 24

presentation of acute hypersensitivity eosinophilic myocarditis?

Answer 24

pink colored rash, eosinophilia, CHF,

Question 25

medical treatment for HOCM?

Answer 25

BB and NHD CCB like verapamil

Question 26

why not use ACE in HOCM?

Answer 26

reducing afterload will cause worsening outflow obstruction