Myocardial and Pericardial Disease

Question 1

cardiomyopathy

Answer 1

priamry disorder that is not a disease of other cardia structures (ie mi, htn, valve stenosis)

Question 2

Primary cardiomyopathies

Answer 2

1. Dilated (congestive)
2. Hypertrophic
3. Restrictive/constrictive

Question 3

Hypertrophic Cardiomyopathy

Answer 3

Hypertrophy w/o dilation of LV
Myofiber disarray
endocardial and interstitial fibrosis
Impaired diastolic fxn
Assymetrical septal hypertrophy
systolic anterior motion of mitral valve leaflet

Question 4

Restrictive vs constrictive disease

Answer 4

constrictive is pericardial, restrictive is infiltrative

Question 5

Familial HCM

Answer 5

Autosomal Dominant
Most common cause of sudden death in athletes
many mutations

Question 6

effect of isotonic exercise on heart

Answer 6

mass-volume ratio unchanged

Question 7

isometric exercise effect on heart

Answer 7

mass-volume ration increases

resolves w/in weeks of discontinuing exertion

Question 8

Most common causes of Sudden cardiac death (SCD)

Answer 8

1. coronary atherosclerosis

2. cardiomyopathies

Question 9

diltiazem

Answer 9

prevents cardiomyopathy in mouse

Question 10

Idiopathic Dilated Cardiomyopathy

Answer 10

unknown etiology

LV dilation, normal wall thickness

Question 11

Dilated Cardiomyopathy genetics

Answer 11

20-30% familial occurrence

Question 12

Hallmark of restrictive cardiomyopathies

Answer 12

abnormal diastolic fxn (in addition to hypertrophic) , heart failure R>L, in HCM and DMC L>R

Question 13

restrictive cardiomyopathy

Answer 13

infiltration of things which cause wall to become less compliance

Question 14

cardiac amyloidosis

Answer 14

interstitial depostion of eosinophils

agglutination of myocytes

Question 15

sarcoidosis

Answer 15

non caseating granulomas,

cause conduction and valve abnormalities

Question 16

alcoholic cardiolmyopathy

Answer 16

causes DCM and increased risk SVT

Question 17

Myocarditis

Answer 17

inflammatory infiltrate of myocardium with necrosis (less damage than ischemia)

Question 18

Myocarditis can be caused by

Answer 18

infection (including flu, cold, etc), toxic, hypersensitiviy

Question 19

Coxsackie (A,B)

Answer 19

tropism for heart
lead to DCM
also cause pericarditis

Question 20

Cytomegalovirus

Answer 20

can cause myocarditis

Question 21

Chagas Disease

Answer 21

most common cause of CHF in the world

Question 22

When do you get toxoplasmosis

Answer 22

following cardiac transplantation

Question 23

ways to get pericardial inflammation

Answer 23

contiguous spread form lungs, etc
hematogenous spread
lyphmphatic spread
trauma or irradiation

Question 24

acute pericarditis common causes TUMOR

Answer 24

trauma, uremia, MI/medication, Other infections, Rheumatoid/radiation

Question 25

dresslers syndrome

Answer 25

fever, pericarditis, pleuritis

In weeks following MI/heart surgery

Question 26

Cardiac Tamponade

Answer 26

limits diastolic filling

Question 27

becks triad

Answer 27

3 features of tamponade:
decline in systemic arterial pressure
elevation in systemic venous pressure
small, quiet heart

Question 28

differentiate rapid vs slow onset tamponade

Answer 28

you get more diastolic problems at lower pressures with rapid onset