CARDIO- CMP Flashcards
Pt has enlargement of all chambers, HTN and PMH of arrythmias. What is the DX
Dilated CARDIOMYOPATHY (CMP)
SYS AND DYS DFX
MC** HF-post MI/ischemia
What is anatomic and physiologic of Dilated CMP causes?
○ Myocarditis (viral) ○ Alcohol ○ Chemotherapy ○ Pregnancy ○ Connective tissue disease ○ Sepsis
On Echo the person has LV thickening, palpitation, fatigue, SOB? What are the concerns?
Hypertrophic CMP (HCM) MC athletes - SCD** S/S/CP SOB orthopnea angina fatigue syncompe palpitattions S4 (ten..nese)
Ms. Choo 65yo smoker has dyspnea and fatigue. Last echo showed cardiomegaly. What EKG finding are MC?
NSSTC- no specifif ST changes
AV blocks
Ventricul Ectopy
Ms. Choo 65yo smoker has dyspnea and fatigue. Last echo showed cardiomegaly. What EHCO finding are MC?
Dilated LV, LOW CO
BOTH HFpEF and HFrEF
Enlarged Atria
MV regurgitation
Ms. Choo 65yo smoker has dyspnea and fatgiue. Last echo showed cardiomegaly. What other workups labs?
CXR- emergent only. Pulmonary edema, cardiomegaly
Stress Echo
Angiogam
BNP enxymes-Find cause
What is first line of TX for Ms. choo dyspnea and fatigue d/t Dilated CMP?
find the cause
Tx sx of HF- ACEI,ARB,
AVOID- alcohol, Na
IF severe-consider implants ICD (high risk), LVAD, surgery
Mr. Lewis, former MLB has CP SOB, angina, syncope during exercise. What is DX?
HYPERTROPHIC CMP - HCM
Thick LV muscle
DEC BLOOD FLOW
CP- SOB, orthopnea, angina, fatigue, syncope, palpitation, ankle edema, S4 (ten…ne.se)
Mr. Lewis, former MLB has CP SOB, angina, syncope during exercise. What is cardio test is next?
EKG
LVH
NSST
Q-waves- old MI, scar tissue
Mr. Lewis, former MLB has CP SOB, angina, syncope during exercise. What are MC ECHO results?
MC-LVH
Asym septal hypertrophy
Small LV volume
DIASTOLIC DYSFX-filling defect
Mr. Lewis, former MLB has CP SOB, angina, syncope during exercise. What are other workup?
NO CXR bc will not show much
Cardiac MRI ideal
Mr. Uptight has major diastolic dsyfx on echo with rigid walls movement?
RESTRICTVE CMP strained R&L wall LC type Worst prognosis IMPAIRE FILLING FH R/t- amyloidosis, sarcoidosis, hemacrhomatosis, scleroderma
Mr. Uptite begins to feel dyspnea, fatigue after ECHO showed major filling defect. What other maybe present
RESTRICTIVE CMP CP
PE- S3+S4 sounds
Mitral valve regurg
RHF- rare
Mr. Uptite begins to feel dyspnea, fatigue after ECHO showed major filling defect. What are EKG findings?
LOW voltage-non specific
Mr. Uptite begins to feel dyspnea, fatigue after ECHO showed major filling defect. What are other ECHO findings
LARGE RV
Stage 4 Diastolic dysfx
LASt endomysial biopsy
IF Mr. Uptite has a filling defect, what TX is ideal?
Diuretics- dec work load
PAH- sildenafil, floven
Transplant
Mr. Lewis, former MLB has CP SOB, angina, syncope/dizzy during exercise at risk for? What is best TX?
BB or CCB
Surgery- ablation, myoectomy
ICD- implanted defibrillator
Valve replacement
What and why is Mr. Lewis, former MLB has CP SOB, angina, syncope/dizzy during exercise at risk for?
SCD- d/t ventricula tacyarrhythmi/tachycardia
LV outflow obstruction- not rare surgery helpful
Genetic**
MC of sudden death in young athletes
any age
What is hallmark cause of syncope in athletes/ HCM r/t SCD?
d/t LV outflow tract obstruction leading to decreased cerebral perfusion
MC-no symptoms
Occurs in sleep to exercise
BK#1 highest risk
FB
Soccer in Eruope
Sarah, a 13 yo swimmer has had syncope in the last race, he MOM had similar experiences? What is the DDX and who else is at risk?
SCD d/ HCOM PMH of Cardiac arrest (VF-ventricular fibrillation) ○ Spontaneous sustained VT ○ FH of premature sudden death ○ Unexplained syncope ○ LV thickness ≥ 30 mm ○ Abnormal exercise BP ○ Non-sustained spontaneous VT
What are individual risk outside FH?
Possible in individual patients
○ AF-Atrial fibrillation
○ Myocardial ischemia
○ LVOTO-Left ventricular outflow tract obstruction
○ High-risk mutation
○ Intense (competitive) physical exertion
Has athlete sudden death rates DEC even
participation screening strategies?
NO. Evidence does not show significant changes
Screening strategy: family and personal history, physical examination, and 12-lead ECG Questions: CP, SOB DOE syncope, fatigue Marfan QT syndrome
Sarah received 12 ECG with postive findings of LVH, NSSTC, septal Q waves? What is next step to determine her activity
ECHO Stress test 24 Holter cardia MRI Angio/EMB. EPS
Mrs. Presley is in clinic w/ c/c of chest pain? Her EKG showed ST-segment elevation. What are her DDX
Takosubo/ Broken heart syndrome/Stress-induced cardiomyopathy
PMP Women 1-2%
Reverislbe CMP mimics acute coronary syndrome ACS
d/t emotional/physical stressors
LABS- EKG, Troponin
Echo- wall-motion abnormalities, absence of obstructive coronary lesions. apical ballooning.
TX- spontaneous, rapid recovery within weeks.
