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Luis Foundations 2 > Myocarditis > Flashcards

Myocarditis Flashcards

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1
Q

what heart disease is charaterized by abnormal heart muscle not from CAD, HTN, Valve disease, or CHD?

A

cardiomyopathies

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2
Q

what is the most common cardiomyopathy, and its cause

A

dilated, idiopathic

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3
Q

inability to contract and expel blood is a ____ side heart problem, while cor pulmonale is a ____ side heart problem

A

Left, Right

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4
Q

heart disease associated with enlarged atria

A

Cardiomyopathy

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5
Q

what disease has LV cavity increases with not HTN or Hypertrophy and has endocardial fibrosis

A

Cardiomyopathy

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6
Q

what are the ABCDPIG causes of Dilated CM

A

Alcohol, beri beri, Cox, Drugs, Pregs, Idiopathic, genetic

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7
Q

Most common cause of dilated cardiomyopathy, and thus most common cause of HF due to systolic dysfunction. LVEF<35% from CAD

A

Ischemic CM

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8
Q

Treat this disease with ASA, statins, beta blockers, ACE, Loops, and K-sparring diuretics

A

Ischemic CM

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9
Q

associated with Acetaldehyde damage, leads to prolonged QT.

A

alcoholic CM, abstain

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10
Q

what disease has HF late in pregnancy (within 1 month of birth)

A

Peripartum Cardiomyopathy

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11
Q

when can you wean a patient with perpartum CM off therapy

A

LVEF>50%

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12
Q

Broken heart syndrome with systolic apical ballooning

A

Takotsubo

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13
Q

what CM leads to a troponin level 7x elevated, ST elevation, and with apical ballooning pattern

A

Takotsubo

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14
Q

Which CM has SXS of both LHF and RHF, with heaves and a shifted PMI

A

Dilated cardiomyopathy

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15
Q

What can you see in a CBC & CMP in Dilated CM?

A 
CBC = anemia (high output state)
CMP = hyponatriemia, LFTs, electrolyte inbalance
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16
Q

What can you see in a CXR, EKG, Cardiac Cath in DCM?

A

CXR = cardiomegaly, pulm congestion, Kerley B lines,
EKG = LVH, conduction delay, arrythmias.
Cardiac Cath = exclude ischemia

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17
Q

What disease do you treat like HF (Ace/Arbs, Beta blockers, aldostrone ant, Diuretics, Nitro, Sacubitril-valsartan)?

A

Dilated Cardiomyopathy.

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18
Q

If your patients has ischemic dilated CM what do you do?

A

Revascularization

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19
Q

How do ACE-I help DCM

A

reduce preload, afterload by vasodilation. Prevent cardiac remodeling.

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20
Q

What are the side effects of an ACE?

A

CHAA, Cough, hyperK, angio edema, acute nephritis

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21
Q

How do Beta blockers help DCM

A

In EF<40%, can reduce catecholamine effects and slow HR = increased filling time, while decreasing afterload. This allows better coronary perfussion.

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22
Q

When should you not give beta blockers to a patient with DCM

A

HR< 50, 2/3 degree heart block, asthma, COPD

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23
Q

What are surgical options for DCM

A

LVAD, cardiac resynchronization therapy if EF<35% or Bundle branch block on EKG.

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24
Q

most common cause of DCM

A

idiopathic

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25
most common cause of HCM
Genetics, athlete that had SCD
26
What disease has abnormal thickening of the intramural coronarys
HCM
27
A hypercontractile LVH with a small cavity is
HCM
28
what disease is associated with coronary compression during systole, and impaired filling in diastole, and with SAM (mital valve sytolic anterior motion)
HCM
29
How does LVOTO affect preload, afterload, and inotropy in HCM
decrease preload & afterload but increased inotrophy
30
what disease leads to SCD from venticular arryhthmias?
HCM
31
How thick can the septal wall get in HCM
>30 m, which leads to hypoperfusion, and syncope
32
what disease do you see a double apical impulse (S4), and S2, and a crescendo-decrescendo murmur.
HCM
33
TTE is used to diagnose what disease
HCM
34
What are the first line meds for sxs arrythmias with HCM
beta blockers or anti-arrythmics (sotalol, amiodarone)
35
what do you give a patient with A-fib and HCM
anticoagulants
36
how does a beta blocker help in HCM
reduces inotrophy, 02 demands, and increases LV fill time
37
if a Beta blocker doesnt work for HCM, whats next?
discontinue BB and give CCM like verapamil
38
If a beta blocker or a CCM didnt help a patient with HCM, whats next
give Disopyramide (antiarrhythmic), strong anticholinergic effect & prolonged QT
39
what are the surgical treatments for HCM
Surgical septal myectomy (needs cardiopulm bypass) | Alcohol ablation: ablate SAM (mitral valve systolic anterior motion)
40
What type of murmur do you see in HCM
crescendo-descendo in LLD position
41
What CM is associated with non-dilation, non-hypertrophic disease but has amyloidosis
RCM - with bi-atrial enlargement (from impaired LV filling)
42
What are some main causes of RCM
1st = idopathic (associated with Loefflers Eosinophilia) | Amyloidosis, Sarcoidosis, cancer, radiation induced, hemochromatosis.
43
What is the most common worldwide cause of RCM
Leofflers eosinophiliac endocarditis
44
What disease shows RHF sxs (LE pitting, edema, hepatomegaly, ascites, JCD), Cardiac cachexia, and periorbital purpura
RCM
45
What disease gives a positive Kussmaul's sign
Kussmauls = JVD during inspiration. | RCM
46
What is the front line daignosis test for RCM
Echo: with infiltrate disease, you can see concentric LVH, and specific strain patterns. without amyloids, see dilated atria
47
What type of pattern can be seen in a Cardiac MR with RCM
Late Gadolinium Enhancement (LGE)
48
What lab tests can show that a patient has RCM?
``` CBC = eosinophilia smearing CMP = LFTs and Fe conc. BNP = elevated in RCM not in restrictive pericarditis EKG = ST changes in 90% of patients and low voltage ```
49
What tests will differentiate between RCM and restrictive pericarditis
Cardiac cath Ventricular biopsy: see infiltrates, BNP: elevated in RCM CBC = Leofflers eosiniophilia
50
What are the medical goals and tx for RCM
Goal: reduce LV filling pressure w/o losing CO Meds = beta blockers and CCB (increase LV filling time) Diuretics (reduce preload) ACE/ARB (poorly tolerated> Anticoag - if A-fib
51
How do you treat amyloids, sarcoidosis, or hemochromatosis in RCM
``` Amyloids = chemo Sarcoidosis = corticosteroids Hemochrom = phlebotomy ```
52
What disease is associated with Periorbital purpura
RCM
53
What disease is associated with cardiac cachexia
Amyloidosis of RCM
54
Inflammatory infiltrate of myocardium with necrosis not from ischemia or CAD
Dallas Criteria
55
Causes of Myocarditis
Idiopathic or viral | Chagas, HIV, autoimmune
56
what percentage of Myocarditis leads to DCM
1/3
57
What disease presents with Flu like or URI sxs?
Myocarditis
58
what are the acute signs of decompensated HF in myocarditis
S3, edema, tachy | Pericardial friction rub with pericarditis
59
What is the Gold stnd for diagnosing Myocarditis
Endomyocardial Biopsy
60
Why do you do an Echo and Cardiac MR when suspecting Myocarditis
Echo = rule out HF | Cardiac MR = rule out ischemic CM
61
What disease can be diagnosed with serum viral titers
Myocarditis
62
What is the common tx for Myocarditis
Supportive, most recover.

Luis Foundations 2 (5 decks)

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