Cardiac path 5 (Cardiomyopathies)

Question 1

• A term that refers to heart disease resulting from a primary abnormality in the Myocardium.
• In response, heart might undergo dilation or hypertrophy

Answer 1

Cardiomyopathy

Question 2

long-standing pressure changes results in __________, and long-standing volume changes results in ______

Answer 2

Muscle hypertrophy (from pressure changes)

Dilation (from volume changes)

Question 3

What are the 3 types of cardiomyopathies?

Answer 3

1. Dilated cardiomyopathy
2. Hypertrophic cardiomyopathy
3. Restrictive cardiomyopathy

Question 4

Characteristics of which type of cardiomyopathy?

1. Progressive chamber dilation and systolic dysfunction, resulting in a reduction of the EF of <25%.
2. Most common cardiomyopathy

Answer 4

Dilated Cardiomyopathy

Question 5

Which type of Cardiomyopathy is the most common?

Answer 5

Dilated Cardiomyopathy

Question 6

Which type of cardiomyopathy has multiple secondary causes including:

1. Alcohol induced
2. Viral myocarditis
3. Anticancer drugs such as Adriamycin (cardiotoxic drug).

Answer 6

Dilated Cardiomyopathy

Question 7

Which condition?

Morphology reveals a heavy heart which is large and flabby with dilation of all chambers

Answer 7

Dilated Cardiomyopathy

Question 8

Gross and microscopic findings of what condition?

1. Walls are thin, partially replaced by fibrous tissue.
2. Heart size is 2-3x normal, there is impaired contractility and eventual CHF
3. The coronary arteries are usually normal.

Question 9

Can there be a primary or genetic cause of dilated cardiomyopathy?

Answer 9

Can also be Primary (idiopathic or genetic)

Question 10

The genetic form of ________ is transmitted by:

• Most familial cases are transmitted as an autosomal dominant trait
• autosomal and sex-linked recessive cases have also been seen.

Answer 10

Idiopathic dilated cardiomyopathy

Question 11

Causes of __________:

1. Toxic with ethanol being MC identifiable cause in the U.S., followed by Adriamycin and Cytoxin (Anticancer drugs) and long-standing Cocaine use and Cobalt exposure
2. Viral Myocarditis
3. Pregnancy
4. High Catecholamines (pheochromocytoma)

Answer 11

Dilated Cardiomyopathy

Question 12

_________ is characterized by:

1. extensive hypertrophy of the left ventricular myocardium.

Also known as IHSS (idiopathic hypertrophic subaortic stenosis) where the heart is enlarged, heavy and muscular, exceeding 1200 gms, with or without chamber dilation.

Answer 12

Hypertrophic Cardiomyopathy

Question 13

What condition is also known as hypertrophic obstructive cardiomyopathy b/c of the possible left ventricular outflow tract obstruction.

Answer 13

Hypertrophic Cardiomyopathy

Question 14

Which condition is also known as IHSS (Idiopathic Hypertrophic Subaortic Stenosis) where heart is enlarged, heavy and muscular, exceeding 1200g +/- chamber dilation

Answer 14

Hypertrophic Cardiomyopathy

Question 15

Which condition has the following gross findings:

1. asymmetrical thickening of the ventricular septum as compared to the left ventricular free wall.
2. Septum has a “banana-shaped” appearance.
3. +/- endocardial thickening with mural plaque formation of the outflow tract.

Answer 15

Hypertrophic Cardiomyopathy

Question 16

Which condition is grossly described as having a “Banana-Septum”

Answer 16

Hypertrophic cardiomyopathy

Question 17

_________ has the following characteristics:

1. Decrease in ventricular compliance –> results in impaired ventricular filling during diastole with normal systolic function.
2. The heart can’t expand adequately to receive the inflowing blood.

Answer 17

Restrictive Cardiomyopathy

Question 18

The cause of ______ can be:

1. idiopathic
2. Can be associated w/ an abnormal infiltrate such as Amyloid, Sarcoidosis, or metastatic tumor.
3. Radiation fibrosis

Answer 18

Restrictive Cardiomyopathy

Question 19

Gross findings of ________=

1. The ventricles are normal in size or slightly enlarged
2. Chambers usually aren’t dilated
3. myocardium is firm.

Answer 19

Restrictive Cardiomyopathy

Question 20

Which condition?

Histologically, there is patchy or diffuse interstitial fibrosis

Answer 20

Restrictive cardiomyopathy

Question 21

________ are diagnosed by:

1. Non-invasive procedures such as ECG’s and echocardiograms are useful.
2. Definitive diagnosis= endomyocardial biopsy

Answer 21

How to diagnose cardiomyopathies

Question 22

The following is describing what procedure:

obtained by inserting a catheter through the groin (femoral artery or vein) or neck (jugular vein) into the left or right side of the heart to obtain 3 or 4 small pieces for the pathologist

Answer 22

Endomyocardial biopsy (definititive dx for cardiomyopathies)