CVS Week 10

Question 1

Define cardiomyopathy.

Answer 1

A disease of the heart muscle that impairs the heart’s ability to pump blood effectively

Question 2

Define Dilated Cardiomyopathy (DCM).

Answer 2

A condition characterized by ventricular dilation and impaired systolic function (reduced ejection fraction). The heart chambers become enlarged and weakened.

Question 3

Describe the epidemiology of DCM.

Answer 3

Most common form of cardiomyopathy. Affects any age

Question 4

Identify the functional classes of cardiomyopathy.

Answer 4

New York Heart Association (NYHA) Functional Classification System: Class I (no limitation)

Question 5

Discuss the etiology of DCM.

Answer 5

Idiopathic (most common)

Question 6

Describe the clinical manifestations of DCM.

Answer 6

Symptoms of heart failure: Dyspnea (exertional

Question 7

Discuss the diagnosis of DCM.

Answer 7

Echocardiography (ventricular dilation

Question 8

Describe the morphological features of DCM (gross and microscopic).

Answer 8

Gross: Markedly enlarged

Question 9

Outline the pharmacological management of DCM.

Answer 9

ACE inhibitors/ARBs

Question 10

Outline the device therapy for DCM.

Answer 10

Implantable Cardioverter-Defibrillator (ICD) for SCD prevention. Cardiac Resynchronization Therapy (CRT) for LVEF ≤ 35% and wide QRS.

Question 11

Outline other management strategies for DCM.

Answer 11

Lifestyle modifications (sodium/fluid restriction

Question 12

Discuss the prognosis of DCM.

Answer 12

Variable. Can progress to severe heart failure. Improved with modern therapies

Question 13

Define Hypertrophic Cardiomyopathy (HCM).

Answer 13

A genetic disorder characterized by inappropriate and unexplained left ventricular hypertrophy (LVH) in absence of other causes. Typically asymmetric (septum more). Causes diastolic dysfunction and may result in LVOT obstruction.

Question 14

Describe the epidemiology of HCM.

Answer 14

Most common genetic heart disease (1 in 500). Leading cause of sudden cardiac death (SCD) in young athletes. Affects males and females equally.

Question 15

Discuss the etiology of HCM.

Answer 15

Genetic (most common): Autosomal dominant

Question 16

Describe the clinical manifestations of HCM.

Answer 16

Often asymptomatic. Symptoms: Dyspnea (most common)

Question 17

Discuss the diagnosis of HCM.

Answer 17

Echocardiography (unexplained LVH >15mm

Question 18

Describe the morphological features of HCM (gross and microscopic).

Answer 18

Gross: Markedly thickened

Question 19

Outline the pharmacological management of HCM.

Answer 19

Beta-blockers (first-line)

Question 20

Outline the management for SCD prevention in HCM.

Answer 20

Implantable Cardioverter-Defibrillator (ICD) for high-risk patients.

Question 21

Outline the management for LVOT obstruction in HCM.

Answer 21

Surgical Septal Myectomy (gold standard)

Question 22

Outline other management strategies for HCM.

Answer 22

Avoid strenuous competitive sports

Question 23

Discuss the prognosis of HCM.

Answer 23

Variable. Can be asymptomatic for life

Question 24

Define Restrictive Cardiomyopathy (RCM).

Answer 24

A cardiomyopathy characterized by abnormally rigid (stiff) ventricular walls that impair diastolic filling

Question 25

Describe the epidemiology of RCM.

Answer 25

Least common type of cardiomyopathy. Prevalence varies with underlying cause. Can occur at any age.

Question 26

Discuss the etiology of restrictive cardiomyopathy.

Answer 26

Infiltrative Diseases (Amyloidosis - most common

Question 27

Describe the clinical manifestations of restrictive cardiomyopathy.

Answer 27

Symptoms of diastolic heart failure: Dyspnea (exertional

Question 28

Discuss the diagnosis of restrictive cardiomyopathy.

Answer 28

Echocardiography (normal/increased ventricular wall thickness

Question 29

Outline the management of restrictive cardiomyopathy.

Answer 29

Primarily supportive and aimed at treating the underlying cause. Diuretics (cautious use). Arrhythmia management (rate control for AF

Question 30

Discuss the prognosis of restrictive cardiomyopathy.

Answer 30

Generally poor

Question 31

Define Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC).

Answer 31

A genetic heart muscle disease characterized by progressive replacement of right ventricular (RV) myocardium by fibrofatty tissue. Leads to RV dysfunction

Question 32

Describe the epidemiology of ARVC.

Answer 32

Relatively rare (1 in 2

Question 33

Discuss the etiology of ARVC.

Answer 33

Genetic (primary): Autosomal dominant

Question 34

Describe the clinical manifestations of ARVC.

Answer 34

Arrhythmias (most common): Ventricular Tachycardia (VT) from RV (LBBB morphology)

Question 35

Discuss the diagnosis of ARVC.

Answer 35

Modified Task Force Criteria. Echocardiography (RV dilation/dysfunction

Question 36

Describe the morphological features of ARVC (gross and microscopic).

Answer 36

Gross: RV dilation

Question 37

Outline the management of ARVC.

Answer 37

Activity Restriction (avoid strenuous exercise). Pharmacological: Beta-blockers

Question 38

Discuss the prognosis of ARVC.

Answer 38

Variable. Depends on genetic mutation

Question 39

Define pericardial effusion.

Answer 39

An abnormal accumulation of fluid in the pericardial space

Question 40

Enumerate the causes of pericardial effusion.

Answer 40

Inflammatory/Infectious (Pericarditis - viral

Question 41

Discuss the clinical manifestations of pericardial effusion.

Answer 41

Depend on fluid amount and accumulation rate. Small/slow: Asymptomatic. Large/rapid: Symptoms of cardiac compression/tamponade (Dyspnea

Question 42

Discuss the diagnosis of pericardial effusion.

Answer 42

Echocardiography (gold standard - visualizes fluid

Question 43

Outline the management of pericardial effusion.

Answer 43

Observation (small

Question 44

Discuss the complications and prognosis of pericardial effusion.

Answer 44

Complications: Cardiac Tamponade

Question 45

Define cardiac tamponade.

Answer 45

A life-threatening condition caused by rapid or excessive fluid accumulation in the pericardial sac

Question 46

Discuss hemodynamic changes in cardiac tamponade.

Answer 46

Increased Intrapericardial Pressure

Question 47

Discuss the clinical features of cardiac tamponade.

Answer 47

Beck's Triad (Hypotension

Question 48

Distinguish between symptoms of rapidly accumulating and slowly accumulating effusion leading to tamponade.

Answer 48

Rapid: Severe

Question 49

Describe pericardiocentesis.

Answer 49

A medical procedure involving insertion of a needle (typically under ultrasound guidance) into the pericardial sac to aspirate (drain) accumulated fluid. Life-saving emergency procedure to relieve cardiac compression.

Question 50

Discuss the prognosis of cardiac tamponade.

Answer 50

Fatal if untreated. With prompt diagnosis and effective pericardiocentesis

Question 51

Define constrictive pericarditis.

Answer 51

A rare

Question 52

Enumerate the causes of constrictive pericarditis.

Answer 52

Idiopathic (most common in developed countries)

Question 53

Discuss the clinical manifestations of constrictive pericarditis.

Answer 53

Symptoms of chronic right-sided heart failure: Progressive Dyspnea on Exertion

Question 54

Discuss the diagnosis of constrictive pericarditis.

Answer 54

Clinical Suspicion (chronic right heart failure

Question 55

Enumerate the differences between constrictive pericarditis and restrictive cardiomyopathy.

Answer 55

Constrictive Pericarditis: Stiff

Question 56

Outline the management of constrictive pericarditis.

Answer 56

Pericardiectomy (Surgical - definitive treatment). Medical Management (supportive