Cardio: Cardiomypathies Flashcards
Normal ejection fraction %
> 55%
EF in Dilated CM
<30%
EF in Restrictive CM
25-50%
EF in Hypertrophic CM
> 60%
normal LV diastolic dimension in mm
<55mm
Dilated CM LV diastolic dimension in mm
> = 60mm
Restrictive CM LV diastolic dimension in mm
<60mm, may be decreased
Hypertrophic CM LV diastolic dimension in mm
often decreased
LV wall thickness in hypertrophic CM
Markedly increased
LV wall thickness in dilated CM
decreased
LV wall thickness in restrictive CM
normal or increased
Atrial Size in Dilated CM
Increased
Atrial Size in restrictive CM
Increased, may be massive
Atrial size in Hypertrophic CM
Increased
Valvular regurgitation in Dilated CM
Related to annular dilation
Valvular regurgitation in Restrictive CM
Related to endocardial involvement
Valvular regurgitation in Hypertrophic CM
Related to valve-septum interaction; MR
Common first symptome in Hypertrophic CM
Exertional intolerance; may have chest pain
Common first symptom in restrictive CM
Exertional intolerance, fluid retention early
Common first symptoms Dilated CM
Exertional intolerance
Congestive symptoms in dilated CM
Left before right, except right prominent in young adults
Congestive symptoms of hyertrophic CM
left sided congestion may develop late
Congestive symptoms restrictive CM
Exertional intolerance, fluid retention early
Arrhythmia in Dilated CM
Ventricular tacharrhythmial conduction block in Chagas’ disease, atrial fibrillation
Arrhythmia in restrictive CM
Ventricular uncommon except in sarcoidosis conduction block in sarcoidosis and amyloidosis. Atrial fibrillation
Arrhythmia in hypertrophic CM
Ventricular tachyarrhythmias; atrial fbrillation
T/F alcohol can cause Dilated Cardiomyopathy
T
Antineoplastic agents that cause Dilated Cardiomyopathy
Doxorubicin, transtuzumab, imatinib mesylate
TID
Muscular dystrophies cause what type of cardiomyopathy
A. Hypertrophic
B. Dilated
C. Restrictive
B
Symptoms of Dilated Cardiomyopathy
PTC
Peripheral emboli
Congestive Heart Failure
Tachyarrhythmias
PE findings in Dilated Cardiomyopathy
JVD rales diffuse and dyskenetic LV apex S3 hepatomegaly Peripheral edema murmurs of mitral and tricuspid regurgitation
Lab findings for ECG in Dilated Cardiomyopathy
LBBB and ST-T wave abnormalities
CXR findings in dilated cardiomyopathy
Cardiomegaly,
Pulmonary vascular redistribution
Pulmonary effusions
Regional wall motion abnormalities suggest
A. Coronary artery disease
B. Primary Cardiomyopathy
A
BNP in Cardiomyopathy
A. Elevated
B. Normal
A
Tx in dilated cardiomyopathy:
What is the preferred Drug for vasodilation therapy?
ACEi
Chronic anticoagulation tx with warfarin is considered in dilated cardiomyopathy if with….
Atrial fibrillation
Prior embolism
Recent or large anterior MI
Implanted Cardioverter Defibrillator is recommended for patients with DCM if with
> = Class III heart failure, LVEF <35% and QRS duration >120ms
PE for Restrictive Cardiomyopathy
R sided heart failure JVD hepatomegaly peripheral edema murmur of tricuspid regurgitaion Left sided S4
ECG findings for Restrictive Cardiomyopathy
Low limb lead voltage, sinus tachycardia
ST-T wave abnormalities
CXR findings for restrictive cardiomyopathy
Mild LV enlargement
Anticoagulation is often indicated in restrictive cardiomyopathy especially patients with __________
eosinophilic endomyocarditis
T/F Hypertrophic cardiomyopathy is never asymmetric
F; often asymmetric
PE findings in hypertrophic cardiomyopathy
Brisk carotid upstroke with pulsus bisfriens
S4,
harsh systolic murmur along left sternal border
murmur changes with valsalva and other manuevers
Hypertrophic CM Septal Q waves can be found in which ECG leads
I, aVL, V5-6
Recommended drug classes for Hypertrophic cardiomyopathy treatment
Beta Blockers, Verapamil, Disopyramide to reduce symptoms
Contraindicated drug classes for hypertophic cardiomyopathy
Digoxin
Inotropes
Diuretics
Vasodilators