Myocardia and Pericradial Diseases Flashcards Preview

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Flashcards in Myocardia and Pericradial Diseases Deck (28):
1

types of cardiomyopaties

dilated

restrictive

hypertrophic

2

diseases that have to be excluded before diagnosis of cardiomyopathy

coronary artery disease

valvular heart disease

pericardial disease

hypertension

diseases of the greata vessels

3

common pathologic features of cardiomyopathies

elevated LV and ED pressures

reduced SV or CO

mitral regurgitation

supraventricular and ventricular arrhythmias

4

LV systolic function in cardiomyopathies

DCM - reduced

RCM - normal to reduced

HCM - normal to increased

5

etiologies for dilated cardiomyopathy

1. Post-viral

2. Post-partum

3. Inflammatory

4. Alcoholic

5. Infectious

6. Metabolic

7. Toxins

8. Chemotherapy

9. End-stag restrictive cardiomyopathy

**most cases are now known to be inherited

6

dilated cardiomyopathy

LV dilated, systolic pump function depressed

elevated LV ED pressure, LA pressure, and pulmonary venous pressure

reduced CO leads to hypertrophy, apoptosis, and fibrosis, and finally congestive heart failure

7

physical findings of DCM

displaced apical impulse

apical S3

systolic murmur

8

treatment for DCM

removing or treating primary precipitating causes

beta blockers

ACE inhibitors

drugs that antagonize aldosterone

implantable defibrillators for arrhythmias

9

cardiac resynchronization therapy

three leads in right atrium, right ventricle, and coronary sinus

used to ensure heart depolarizes in snyc

10

causes of restrictive cardiomyopathy

amyloidosis

hemochromatosis

eosinophilia

sarcoidosis

radiation

neoplastic

infiltrative

idiopathic/inherited

11

pathophysiologic mechanisms of RCM

impaired LV diastolic filling

LV systolic dysfunction (late)

arrhythmias

due to thickening and stiffening of the ventricular myocardium

 

12

treatment for RCM

no specific treatments

treat underlying cause

most treatment is nonspecific and tries to deal with adverse effects

13

causes of hypertrophic cardiomyopathy

geneticallt transmitted diseaes with chormosomal abnormalties involving the contractile proteins

14

pathophysiology of HCM

hypertrophy of the LV without dilation

increases stiffness and impairs ventricular illing in diastole

lowered EDV reduces stroke volume during exercise

MI is common due to the hypertrophy

may have dynamic obstruction of LV outflow

15

management of HCM

directed toward reducing heart rate and LV contractility to improve LV filling

beta blockers and calcium channel blockers

diuretics if dyspnea is present

monitor arrhythmias, ICD implantation

surgery to increase outflow tract

16

pericardial diseases

acute pericarditis

constrictive pericarditis

pericardial effusion

17

pathophysiology of acute pericarditis

acute inflammation of the visceral and parietal pericarium

results in chest pain, a pericardial friction rub, and ECG changes

if untreated, can progress to chronic constrictive pericarditis

18

causes of acute pericarditis

most common is idiopathic or viral infection

other causes include:

TB

bacteria

fungus

acute MI

uremia

neoplasia

surgery

radiation

autoimmune

drugs

trauma

aortic dissection

chylopericardium

myxedema

19

causes of chronic constrictive pericarditis

can arise from acute pericardial inflammation

viral, bacterial, TB, uremic, radiation, myxedema, and chylopericardium

surgery also may precipitate

20

pathophysiology of chornic constrictive pericarditis

impairment of RV and LV filling

elevation of filling pressures and reduced CO

21

physical findings of constrictive pericarditis

Kussmaul's Sign

jugular venous distension

pericardial knock

22

Kussmaul's sign

increase in jugular venous pressure upon inspiration

23

compliance relationship between DCM, RCM, and HCM

24

pericardial effusion and cardiac tamponade pathophysiology

marked effusions cause rapid increases of pressures

severely reduces ventricular filling and forward output

25

most common causes of pericardial effusions

neoplasia

idiopathic

uremia

infection

bacterial

iatrogenic cardiac perforation

TB

radiation

myxedema

acute aortic dissection

26

physical findings of pericardial effusions

jugular venous distension

pulsus paradoxicus

hypotension

27

treatment of pericardial effusion

pericardiocentesis

surgically placed pericardial window

28

pulsus paradoxicus

a greater than 10 mmHg drop in blood pressure upon inspiration