Heart Failure, Myocarditis, Cardiomyopathies, and Pulmonary HTN I

Question 1

CHF

Answer 1

SYNDROME NOT DISEASE

same syndrome can occur with different diseases

Question 2

abnormality of cardiac structure or function responsible for inability of heart to eject or fill with blood at rate sufficient to meet demands of metabolizing tissues

Answer 2

congestive heart failure

Question 3

HR and heart failure

Answer 3

too slow - decreased CO

too fast - not enough time to fill

Question 4

impaired relaxation and compliance

Answer 4

diastolic dysfunction

Question 5

normal heart function with increased metabolic demand or increased peripheral blood flow from decreased PVR

Answer 5

high output failure

Question 6

pulmonary edema

Answer 6

increased LA pressure

Question 7

JVP, hepatomegaly, intestinal edema

Answer 7

increased RA pressure

Question 8

CO = ?

Answer 8

HR x SV

Question 9

SV = ?

Answer 9

EDV - ESV

Question 10

EF = ?

Answer 10

SV/EDV

Question 11

failure to eject

Answer 11

forward failure

-decreased perfusion of organs/tissues down-stream from heart

Question 12

congestion

Answer 12

backward failure
-backing up of blood into organs upstream

increasing hydrostatic pressure, leads to congestion/edema

Question 13

forward failure Sx in left sided failure

Answer 13

systemic circulation

Question 14

backward failure Sx in left sided failure

Answer 14

congestion in lungs

Question 15

backward failure Sx in right sided failure

Answer 15

systemic venous circulation

-upstream

Question 16

acute heart failure

Answer 16

forward failure**

flash pulmonary edema

massive MI, chorda rupture, large PE

Question 17

chronic heart failure

Answer 17

slow, exacerbations

predominantly backward failure**

Question 18

hypertrophic cardiomyopathy

Answer 18

diastolic left heart failure

Question 19

dilated cardiomyopathy

Answer 19

systolic left heart failure

Question 20

valvular regurg

Answer 20

increased preload

systolic left heart failure

Question 21

valvular stenosis

Answer 21

increased afterload

systolic left heart failure

Question 22

thyrotoxicosis

Answer 22

metabolic disorder

-high output heart failure

Question 23

anemia, AV fistula, beriberi

Answer 23

excessive blood flow high output failure

Question 24

aortic stenosis

Answer 24

hypertrophic cardiomyopathy

Question 25

toxins

Answer 25

alcohol, cocaine, radiation dilated cardiomyopathy

Question 26

myocarditis

Answer 26

dialted cardiomyopathy

Question 27

SLE, scleroderma, RA, polyarteritis nodosa, dermato-myositis

Answer 27

dilated cardiomyopathy

Question 28

CAD/MI

Answer 28

dilated cardiomyopathy

Question 29

HTN

Answer 29

dilated cardiomyopathy HTN > LVH > diastolic dysfunction > ventricular dilation > systolic dysfunction

Question 30

aortic regurg

Answer 30

dilated cardiomyopathy increased EDV/preload >increased cardiac workload > LVH > LV dilation > systolic dysfunction

Question 31

myocarditis

Answer 31

dilated cardiomyopathy viral, bacterial, fungal, helminth

Question 32

febrile illness or URI

Answer 32

can lead to myocarditis

Question 33

doxorubicin

Answer 33

chemotherapy | can cause myocarditis

Question 34

toxic myocarditis causes

Answer 34

``` chemo drugs heavy metals lithium malaria drugs radiation ```

Question 35

autoimmune myocarditis

Answer 35

giant cell myocarditis | PM

Question 36

alcoholic cardiomyopathy

Answer 36

prolonged exposure -10 years toxic effects on myocardium

Question 37

pregnancy cardiomyopathy

Answer 37

dilated

Question 38

takotsubo cardiomyopathy

Answer 38

dilated - triggered by stress - majority women aka stress, broken heart syndrome, apical ballooning syndrome

Question 39

myosin heavy chain mutation

Answer 39

hypertrophic cardiomyopathy autosomal dominant IV septum - often disproportionately involved majority diastolic dysfunction

Question 40

valsalva increases what murmur

Answer 40

hypertrophic cardiomyopathy decreased venous return - walls closer together - louder murmur

Question 41

restrictive cardiomyopathy

Answer 41

impaired filling | -diastolic dysfunction

Question 42

amyloidosis, sarcoidosis, hemochromatosos, glycogen storage diseases, metabolic disorders, radiation, scleroderma, lofflers

Answer 42

restrictive cardiomyopathy

Question 43

idiopathic pulmonary HTN

Answer 43

primary females age 30-50yo autosomal dominant survival - 2-3 yrs from Dx

Question 44

left to right shunt

Answer 44

pulmonary HTN

Question 45

drugs with pulmonary HTN

Answer 45

fenflumarine -weight loss pill amphetamines cocaine

Question 46

most common cause of pulmonary HTN

Answer 46

cor pulmonale ``` pulmonary Dx > pulmonary HTN > increase RV afterload > RV hypertrophy > RV failure ```

Question 47

pulmonary embolism

Answer 47

from lower extremities increased pulmonary artery pressure increased aferload for right ventricle right ventricular failure