02.13 Cardiomyopathy and Myocarditis

Question 1

Disease of heart muscle that results from myriad insults, not the result of congenital, acquired valvular, hypertensive, coronary arterial or pericardial abnormalities

Answer 1

Cardiomyopathy

Question 2

Consisting of heart muscle disease predominantly involving the myocardium and/or unknown cause

Answer 2

Primary type of cardiomyopathy

Question 3

Consisting of myocardial disease of known cause or associated with a systemic disease such as amyloidosis or chronic alcohol use

Answer 3

Secondary type

Question 4

Primary type of cardiomyopathy

Answer 4

Dilated
Hypertrophic
Restrictive
Unclassified

Question 5

Secondary type of cardiomyopathy

Answer 5

Infective
Metabolic
Systemic disease
Heredofamilial
Sensitivity
Toxic

Question 6

Dilatation
Reduction in ventricular contractile function
Large volume heart
Systolic dysfunction

Answer 6

Dilated cardiomyopathy

Question 7

Thick myocardium
LV outflow tract obstruction
Diastolic dysfunction

Answer 7

Hypertrophic cardiomyopathy

Question 8

Rigid myocardium

Diastolic dysfunction

Answer 8

Restrictive cardiomyopathy

Question 9

Most common cause of systolic dysfunction

Answer 9

Coronary artery disease

Question 10

Most common form of CM

Answer 10

Dilated CM

Question 11

Diastolic dysfunction
Ischemia
Arrhythmias
Outflow obstruction
Syncope, chest pain, sudden cardiac death

Answer 11

Hypertrophic CM

Question 12

ICD is indicated when

Answer 12

Previous cardiac arrest
Spontaneous sustained ventricular tachycardia
Non-sustained spontaneous ventricular tachycardia
Unexplained syncope
Blunted increase/decrease in systolic BP with exercise
Left ventricular wall thickness >/= 30 mm
1st degree relative with sudden death
Dilated cardiomyopathy with ejection fraction

Question 13

Rare condition
Ventricular filling is impaired because ventricles are stiff
Leads to high atrial pressure with atrial hypertrophy, dilatation, and later atrial fibillation

Answer 13

Restrictive CM

Question 14

Most common cause of restrictive CM

Answer 14

Amyloidosis

Question 15

Rigid myocardium leads to ____ diastolic ventricular pressure, ___ ventricular filling

Answer 15

Increased

Decreased

Question 16

Holiday heart syndrome
Consumption of large quantities of alcohol
Consistently drinking

Answer 16

Alcoholic CMP

Question 17

Occurs during last trimester or within 6 months after delivery

Answer 17

Peripartum CMP

Question 18

Anthracycline derivatives
Cyclophosphamide
Cocaine abuse

Answer 18

Drug-induced CMP

Question 19

Unusual, often familial, condition characterized by the replacement of myocardial tissue by fat and fibrous tissue

Answer 19

Arrhythmogenic right ventricle dysplasia (ARVC)

Question 20

Most common location for tissue transformation in ARVC is referred to as

Answer 20

Triangle of dysplasia (between the anterior infundibulum, RV apex, and inferior or diaphragmatic aspect of the RV)

Question 21

Diagnostic modality of choice of ARVC

Answer 21

MRI

Question 22

Apical ballooning syndrome
Abrupt onset of severe chest discomfort preceded by very stressful emotional or physical event
Common among . 50 years of age

Answer 22

Takotsubo/stress-induced CM

Question 23

Trigger massive catecholamine release causing multi-vessel apicardial spasm, microvascular dysfunction, myocardial stunning and minor injury

Answer 23

Takotsubo/stress-induced CM

Question 24

Mayo Clinic criteria for diagnosis of Takotsubo

Answer 24

Transient reversible akinesis of LV apical and mid-ventricular segments
Absence of obstruction coronary artery stenosis
New electrocardiographic abnormalities consisting of ST-elevation or T-wave inversion
Absence of recent head trauma, intracranial bleeding, pheochromocytoma, obstructive epicardial coronary artery disease, myocarditis, hypertrophic CM

Question 25

Characterized by myocardial inflammation, necrosis, fibrosis

Cardiomegaly and diminished systolic function occur due to myocardial damage

Answer 25

Myocarditis

Question 26

ECG changes are nonspecific
In CXR, cardiomegaly, pulmonary vascular prominence, pulmonary edema or pleural effusions
Inflammatory cell infiltrates

Answer 26

Myocarditis

Question 27

Primary therapy for acute myocarditis

Answer 27

Supportive

Question 28

Accepted therapy for myocarditis

Answer 28

Conventional heart failure therapy