Know It Pt.9 Flashcards
(126 cards)
1
Q
The etiology of HCM is ______but may be transmitted by an __________ with ____ penetrance
A
Idiopathic; autosomal dominant gene; variable
2
Q
ASH stands for?
A
Asymmetric septal hyper trophy
3
Q
SAM stands for?
A
Systolic anterior motion
4
Q
IHSS stands for?
A
Idiopathic hypertrophic subaortic stenosis
5
Q
HOCM stands for?
A
Hypertrophic obstructive cardiomyopathy
6
Q
IHSS is?
A) SAM & HCM
B)SAM
C)ASH
D)SAM & ASH
A
D
7
Q
HOCM is?
A) SAM & HCM
B)SAM
C)ASH
D)SAM & ASH
A
A
8
Q
Which cardiomyopathy is autosomal dominant?
A) dialated
B) Infiltrative
C)Hypertrophic
D)restrictive
A
C
9
Q
HCM has _____ dysfunction
A
Diastolic
10
Q
HCM had a myocardial ______ disarray
A
Fiber
11
Q
With HCM there’s increased LV hypertorphy and _______load. This causes _____issues and results in _____ dysfunction which results in _____ enlargement.
A
Afterload; filling; diastolic; LAE
12
Q
Why does HCM result in LAE?
A
Because the LV is hypertrophied, unable to relax and fill and is noncompliant. This results in the LA enlarging and LA not filling properly
13
Q
Due to HCM causing LAE, this can also result in ____
A
MR
14
Q
Which is the most common?
A) HOCM
B)HCM
C)SAM
D) ASH
A
D
15
Q
IHSSS has what 2 things?
A
SAM & ASH
16
Q
HOCM has what 2 things ?
A
SAM & HCM
17
Q
With HOCM it has the thickened ___ which causes the AMVL to ?
A
Septum ; to hit the septum causing an obstruction
18
Q
MV thickening and scarring may result from?
A
The MV leaflets constantly striking the thick IVS and obstruction
19
Q
_____ and fibrosis may be present with HCM
A
MAC
20
Q
What are some symptoms of HCM?
A
-syncope
-sudden death
-arrhythmias
-angina
-DOE
21
Q
Valsalva or amyl nitrate will ___ the murmur/sound of HCM
A
Increase
22
Q
What’s the murmur associated with HCM?
A
Crescendo descendo -systolic murmur
23
Q
What are the 4 variants of HCM?
A
-Sigmoidal
-Reverse curve
-Apical
-Neutral
24
Q
Which HCM variation is the most common?
A)Apical
B)Neutral
C)Sigmoid
D)Revers curve
A
C
25
Describe the Sigmoid HCM variant
The septum is thicker- caused AMVL to hit it
26
Describe reverse Curve HCM variant
Entire IVS curves downward into LV
27
Describe apical HCM variant
Apex is thicker than the rest of the walls
28
Describe Neutral HCM variant
Concentric LVH
29
How common is the sigmoid HCM variant?
40-50% most common!
30
How common is the Reverse curve HCM?
30-40%
31
How common is the apical and neutral HCM?
10%
32
Apical HCM is more common what country?
Japan
33
What is the etiology of apical HOCM?
Genetic
34
With apical HCM on Doppler you will typically see flow ____in mid ____
Acceleration ; LV
35
With apical HCM you will see increased ___ voltage on EKG. And giant negative ___ wave
QRS; T
36
The “ace is spades sign” is?
Apical HCM
37
With HCM the myocardium may a ___ appearance from the ____ disarray
Bright; fiber
38
With HCM will you have a small LV cavity or thick LV cavity
Small
39
Pt. With HCM usually have ____ LV contraction or _____ LV contraction
Hyperdyanmic ; normal
40
Thickness of ventricular walls with HCM may be ____ or ____
Asymmetric or symmetric
41
If the HCM is asymmetric what is the septal to PW ratio?
A) >1.3-2
B)<1.3-1
C)>1.3 to 1
D)<1.2-2
C) >1.3-1
42
Duration of septal contact with the AMVL will increase with ___ or ____ of the pt. Is NOT on beta blockers
Valsalva or amyl nitrate
43
If the pt. Is on beta blockers will valsalva or amyl nitrate increase the septal contact sound?
No
44
With HOCM there will a _____ closure of Av
Mid systolic
45
If HCM is obstructive what occurs to the AV?
Mid systolic closure of AV due to obstruction shutting the AV early
46
LVOT obstruction causes the AV to?
A) flutter in systole
B)close mid systole
C)flutter in systole
D)close late systole
B
47
Another name for SAM is?
IHSS
48
HCM will show what kind of MV diastolic dysfunction filling pattern?
A) Restrictive
B) Pseudo normal
C)Abnormal relaxation
D) none of the above
C
49
The IVRT will be right before the?
E wave
50
What is the Doppler spectrum of a HCM look like?
Dagger shaped (late peaking jet)
51
With HCM have a decreased or increased E/A ratio?
Increased
52
The ____ peaking ___ jet often seen with ____ is also called
Late; systolic; HCM; dagger shaped
53
A late peaking Doppler jet (dagger shape) goes with?
A)ASH & HOCM
B) HOCM & IHSS
C) IHSS
D) ASH & SAM
B
54
What is the drug Inderal?
Best blocker
55
Beat blockers will ____ SAM with excercise. Hence why we ask patients to ___ take their beta blockers before a stress echo
Decrease; not
56
With HOCM or IHSS you get a mid_____ or subaortic gradient due to the _____
Ventricular; obstruction
57
What are 2 treatments for HCM?
-ETOH -Ethanol alcohol septal ablation
-Surgical Septal Myectomy
58
Surgical Septal Myectomy involves?
Open heart surgery to remove thickened
myocardium
59
ETOH ablation treatment involves?
Non surgical procedure
A catheter put into the groin up into the aorta then into the vessel that feeds that IVS.
Doctor injects alcohol into thick area to kill the area causing the thickness to shrink due to alcohol toxicity
60
What is a contradiction to amyl nitrate?
Allergic to nitrates
Severe fixed AS
Recent CVA
Hemodynamic instability
61
Strain measures the?
Deformation within the myocardium
62
What is the acoustic signature in tissue what strain software tracks called?
Speckle
63
Strain is a ____ number
Unitless
64
Normal GLS is?
-16- to -20% or more
65
GLS with HOCM is typically?
A)+20%
B)-10%
C)-20%
D)+16%
B
66
People think strain changes before the ____ does
EF
67
HOCM pt. Have lower strain pattern of -____ to -____ % typically
-8 to -10
68
Dilated cardiomyopathy is also called?
Congestive
69
What are some etiologies of Dilated cardiomyopathy ?
-idiopathic
-Ischemic
-Peripartum
-Toxic
-Infective (viral, bacterial, fungal Chagas)
-metabolic (thiamine deficiency)
70
What are some infectious etiologies of dilated Cardiomyopathy?
Fungal
Parasitic
Bacteria
Viral
Chagas
71
What are some toxic etiologies of dialated cardiomyopathy?
Alcohol, lead, cobalt or adriamycin poisoning
72
What is adriamycin poisoning? And which cardiomyopathy is it consistent with
A cancer drugs that is toxic, associated with dilated cardiomyopathy
73
What is Chagas’ disease?
Tropical parasite that causes posterior and apical thinning of the septum
74
What affect does Chagas’ disease have on the heart?
Tropical parasite that causes posterior and apical thinning of the septum
75
What Tropical parasite that causes posterior and apical thinning of the septum associated with dilated cardiomyopathy)
Chagas’ disease
76
Chagas’ disease is associated with which cardiomyopathy?
Dilated
77
What is a thiamin deficiency?
A vitamin found in food that can reduce systemic vascular clearance decreasing cardiac function
78
Dilated cardiomyopathy have increased LV ____
Mass
79
What is thin walled by has dilated chamber?
Dilated cardiomyopathy
80
Dilated cardiomyopathy has ____ dysfunction due to multi chamber ___
Systolic ; dilation
81
What are some symptoms of dilated cardiomyopathy?
-edema
-fatigue
-Dyspena
82
Murmurs of the ___ valve and ___ valve are usually present with dilated cardiomyopathy
MV & TV
83
True or false- pt. With dilated cardiomyopathy usually have bradycardia
False! Tachycardia
84
What is pulses alternans?
Alternating strong and weak pulses
85
Alternating strong and weak pulses is called?
Pulses alternans
86
Pulses alter and is commonly seen with what cardiomyopathy?
Dilated
87
What is the B-notch or B-bump on MV m-mode?
After the E/A MV has a little extra wave known as a b-bump.
It’s a sign of increased LVEDP
88
The B-notch is a sign of?
Increased LVEDP
89
What cardiomyopathy is the B-notch sign on m-mode associated with?
Dilated cardiomyopathy
90
A EPSS of > ____ is an increased EPSS
>7mm
91
What is the double diamond sign on m-mode a sign of?
A sign of reduced MV excursion or moment
92
What does the double diamond m-mode sign look like ?
Increased echoes of the AMVL to the PMVL creating a double diamond
93
What cardiomyopathy is a double diamond sign typically seen with ?
Dilated cardiomyopathy
94
2D post cardiac transplant has what famous ?
Double atria or bi atrial enlargement
95
What is Takotsubo cardiomyopathy?
A stress cardiomyopathy
96
Takotsubo is known as?
Broken heart syndrome
97
Takotsubo commonly affects ___ and is a ___ CM
Middle aged women; stress
98
Takotsubo usually presents with ?
Apical ballooning
99
Takotsbuo usually resolves in?
A few weeks
100
What is the stress cardiomyopathy called?
Takotsubo
101
What is the most common cause restrictive cardiomyopathy?
Amyloidosis
102
Restrictive CM is also known as ?
Infiltrative
103
Amyloid and Sarcoidosis are what kind of abnormalities?
A) congestive
B)hypertrophic
C)Restrictive
D)Infiltrative
D
104
____ is a form of infiltrative cardiomyopathy
Sarcoidosis
105
What is Pompes disease?
Glycogen storage issue
106
Pompes disease affects what cardiomyopathy?
Infiltrative(restrictive)
107
What is the name for excess iron?
Hemochromatosis
108
Hemochromatosis is associated with what cardiomyopathy?
Infiltrative (restrictive)
109
Endomyocardical fibrosis is associated with what CM?
Infiltrative (restrictive)
110
With infiltrative (restrictive) cardiomyopathy there’s a ____ of myocardium that results in ____ ventricular walls what impeded____ filing
Infiltration ; rigid ; diastolic
111
Infiltrative (restrictive) cardiomyopathy has ____ dysfunction
Diastolic
112
Infiltrative (restrictive) cardiomyopathy has ____ dysfunction
Diastolic
113
There’s ___ enlargement with infiltrate (restrictive ) cardiomyopathy. Why so?
Bi atrial
Because the ventricles are stiff and rigid (like in HCM) and don’t allow filling so both atria gets backed up
114
What are some symptoms of infiltrative CM
-Dyspena
-fatigue
-angina
115
With infiltrative (restrictive) cardiomyopathy there’s a ____ appearance of the myocardium
Ground glass
116
Sarcoidosis may infiltrative _____ system leading to a ____ block
Conduction ; AV
117
Amyloidosis is described as ?
Translucent waxy substance that builds up in the myofibrils
118
With Endomyocardical fibrous the endocardium appears ___ or ____and the ___ valves may been involved
Echogenic or scarred ; atrioventricular
119
With Endomyocardical fibrous the endocardium appears ___ or ____and the ___ valves may been involved
Echogenic or scarred ; atrioventricular
120
The term “ground glass” appearance id associated with which CM?
Infiltrative (restrictive)
121
A restrictive CM has which of the following?
A)increased afterload
B)decreased LV compliance
C) increased preload
D)decreased LA pressure
B
122
With infiltrative(restrictive) cardiomyopathy there will be abnormal ____ filling patterns.
Diastolic
123
With infiltrative CM the pulmonary vein flow will have a decreased ____ wave
s
124
With infiltrative(restrictive) cardiomyopathy there will be abnormal ____ filling patterns.
Diastolic
125
With infiltrative CM the MV inflow will have a low ___ wave/velocity
A wave
126
What disease processes heard with the pericardial knock versus a friction rub?
Friction rub= pericardial effusion
Pericardial knock= constrictive pericarditis
