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Cardiovascular II > Myocardium diseases > Flashcards

Myocardium diseases Flashcards

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1
Q

LVEF in dilated cardiomyopathy

A

<40%

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2
Q

LVEF in hypertrophic cardiomyopathy

A

50-80%

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3
Q

LVEF in restrictive cardiomyopathy

A

45-90%

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4
Q

Mechanism of HF in dilated cardiomyopathy

A

Impairment of contractility –> systolic dysfunction

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5
Q

Mechanism of HF in hypertrophic cardiomyopathy

A

Impairment of compliance –> diastolic dysfunction

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6
Q

Mechanism of HF in restrictive cardiomyopathy

A

Impairment of compliance –> diastolic dysfunction

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7
Q

Causes of dilated cardiomyopathy

A

Genetic
Alcohol
Peripartum
Myocarditis
Hemochromatosis
Chronic anemia
Doxorubicin (Adriamycin) toxicity
Sarcoidosis
Idiopathic

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8
Q

Causes of hypertrophic cardiomyopathy

A

Genetic
Friedreich ataxia
Storage disease
Infants of diabetic mother

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9
Q

Causes of restrictive cardiomyopathy

A

Amyloidosis
Radiation-induced fibrosis
Idiopathic

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10
Q

Indirect myocardial dysfunctions in dilated cardiomyopathy

A

IHD
Valvular heart disease
HTN heart disease
Congenital heart disease

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11
Q

Indirect myocardial dysfunctions in hypertrophic cardiomyopathy

A

HTN heart disease
Aortic stenosis

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12
Q

Indirect myocardial dysfunction in restrictive cardiomyopathy

A

Pericardial constriction

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13
Q

Characterized by ventricular chamber enlargement with impaired systolic contractile function.

A

Dilated cardiomyopathy

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14
Q

Genetic mutations that cause dilated cardiomyopathy

A

Mutations in proteins for sarcolemma, cytoskeleton, and nuclear envelope (laminin)

Mutation in TTN –> encodes titin

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15
Q

Inheritance of genetic dilated cardiomyopathy

A

Autosomal dominant

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16
Q

Takotsubo cardiomyopathy falls under what cardiomyopathy type?

A

Dilated

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17
Q

Causes of excess catecholamine production that can result in dilated cardiomyopathy

A

Pheochromocytoma
Cocaine or dopamine use
Intense autonomic stimulation
Emotional duress –> Takotsubo

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18
Q

Complications of dilated cardiomyopathy

A

Secondary mitral regurgitation
Abnormal cardiac rhythms
Embolism from intracardiac thrombi

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19
Q

Microscopy of heart in dilated cardiomyopathy

A

Hypertrophied with enlarged nuclei
Interstitial and endocardial fibrosis of a variable degree

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20
Q

Abnormally thickened ventricular wall with abnormal diastolic relaxation. Due to sarcomeric alterations, defective energy transfer, and/or exaggerated response of myocardial fibroblasts.

A

Hypertrophic cardiomyopathy

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21
Q

Inheritance of genetic causes of hypertrophic cardiomyopathy

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A

Autosomal dominant with variable penetrance

22
Q

Genetic mutations associated with hypertrophic cardiomyopathy

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A

Sarcomeric proteins –> missense
Beta-myosin heavy chain
Cardiac TnT
Alpha-tropomyosin
Myosin binding protein C (MYBP-C)

23
Q

Affect of sarcomeric alterations in hypertrophic cardiomyopathy

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A

Abnormal cardiac contraction causing a secondary compensatory hypertrophy

24
Q

Affect of myofiber disarray in HOCM without outflow obstruction

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A

Ventricular arrhythmias
Myocyte hypertrophy

25
Complications of ventricular arrhythmias in HOCM without outflow obstruction
Syncope Sudden cardiac death
26
Complications of myocyte hypertrophy in HOCM without outflow obstruction
Ventricular hypertrophy Increased stiffness and impaired relaxation --> diastolic dysfunction Elevated LVEDP Dyspnea, exertional
27
Cause of outflow obstruction of blood flow to aorta in HOCM with obstruction
Abnormal motional of anterior mitral valve leaflet to cover the LV outflow tract Also results in mitral regurgitation
28
Harsh systolic ejection murmur heard best at the L lower sternal border. Intensity increases with decreased preload and decreases with increased preload and increased afterload.
HOCM
29
Major clinical complications in hypertrophic cardiomyopathy (HOCM)
A fib Mural thrombi embolization Intractable cardiac failure Ventricular arrhythmias Sudden death
30
One of the most common causes of sudden, otherwise unexplained, death in young athletes
HOCM
31
Transthoracic echo findings in hypertrophic cardiomyopathy (HOCM)
Reduced LV cavity size LA enlargement Normal or increased LVEF Overall increase in LV mass Asymmetric LV wall thickness
32
Microscopy of heart in hypertrophic cardiomyopathy
Massive myocyte hypertrophy Asymmetric septal hypertrophy --> septum to free wall ratio of 3:1 Myofiber disarray --> irregular myofibers with surrounding collagen Interstitial and replacement fibrosis
33
Abnormally stiffened myocardium, because of fibrosis or infiltrative process, leading to impaired diastolic relaxation. Causing a primary decrease in ventricular compliance resulting in impaired ventricle filling.
Restrictive cardiomyopathy
34
Peripheral eosinophilia and eosinophilic infiltrates in multiple organs, including heart, release major basic protein. Causes endomyocardial necrosis in the heart. May develop in restrictive cardiomyopathy.
Loeffler endomyocarditis
35
Fibrosis of the ventricular endocardium and subendocardium that primary affects children and young adults in Africa and other tropical areas. May result in restrictive cardiomyopathy.
Endomyocardial fibrosis
36
Fibroelastic thickening of the LV endocardium, most comment in first 2 years of life. A complication of mumps exposure in utero. May develop into restrictive cardiomyopathy
Endocardial fibroelastosis
37
Most common recognized cause of restrictive cardiomyopathy in non-tropical countries
Cardiac amyloidosis
38
Small, semi-translucent nodules (resembling drips of wax) may be seen on the atrial endocardial surfaces.
Cardiac amyloidosis
39
Stain for amyloid fibrils that causes them to appear apple-green under polarized light
Congo red stain
40
Effect of rigid myocardium in restrictive cardiomyopathy
Increased diastolic ventricular pressure --> venous congestion Decreased ventricle filling --> decreased CO
41
Major viral causes of myocarditis
Coxsackie virus B Adenovirus Parvovirus B19 HIV HHV-6
42
Major parasitic causes of myocarditis
Trypanosoma cruzi --> Chagas Toxoplasma gondii
43
Major bacterial causes of myocarditis
Borrelia burgdoferi Mycoplasma pneumoniae
44
Major toxins causing myocarditis
CO poisoning Black widow venom
45
Drugs that can cause myocarditis
Doxorubicin Cocaine
46
Autoimmune disease that can cause myocarditis
SLE Kawasaki disease
47
Complications of myocarditis
Sudden death Arrhythmias Heart block DCM Mural thrombi with embolization
48
Microscopy finding in myocarditis caused by Chagas disease
Myofiber distended with trypanosomes
49
Microscopy findings in myocarditis caused by toxoplasma
Toxoplasma pseudocyst in myocardial cell that contains bradyzoites
50

Cardiovascular II (29 decks)

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