Cardiology

Question 1

3 types of cardiomyopathy

Answer 1

1. Dilated
2. Hypertrophic
3. Restrictive

Question 2

Etiology of dilated cardiomyopathy

Answer 2

Idiopathic, alcoholism (thiamine deficiency), genetics, myocarditis, chemo (doxorubicin), cocaine, heroin, glue sniffing, peripartum (last trimester or within 6 mo PP)

Question 3

Clinical features of dilated cardiomyopathy

Answer 3

• Massive enlargement of heart with all chambers dilated
• Mitral & tricuspid valve regurgitation
• L and R sided S3 and S4 sounds
• Narrow pulse pressure due to decreased stroke vol
• Arrythmias (block in bundle of His, leading to atrial and ventricular arrythmias)
• **Sudden death **

Question 4

Etiology of hypertrophic cardiomyopathy

Answer 4

Autosomal dominant inheritance (chromo 14 missense mutation that codes for cardiac sarcomere protiens)

Question 5

Clinical features of hypertrophic cardiomyopathy

Answer 5

• Palpitations
• Dizziness
• Angina w exercise
• SOB/DOE, CHF, arrhythmias
• Split S2, S4, harsh systolic ejection (crescendo-decrescendo) murmur best hear along lower L sternal border or apex
• Murmur best heard during valsalva
• Palpable souble apical impulse

Question 6

Eitology of restrictive cardiomyopathy

Answer 6

• Amyloydosis, sarcoidosis
• Myocardial finrosis post open-heart surgery
• Radiation

Question 7

Clinical features of restrictive cardiomyopathy

Answer 7

• Worsening SOB
• Progressive exercise intolerance
• Fatigue
• CHF w normal L ventricular systolic function
• Arrhythmias
• Elevated JVP
• Loud early diastolic filling sounds (S3) may be present
• Murmurs due to mitral and tricuspid regurg may be heard, but are secondary to the disease

Question 8

Investigations of cardiomyopathy (all 3)

Answer 8

1. Dilated: CBC, electrolytes, BNP, troponin, CK, CK-MB, nonspecific ST-T and Q wave changes, CXR (enlarged heart, plural effusion).
2. Hypertrophic: Prominent Q wave, short PR, 2D echocardiography is diagnostic, cardiac MRI to assess severity.
3. Restrictive: Normal ECG or nonsepcific ST-T wave changes, low QRS volatage, CXR mild cardiac enlargement, ventricular biopsy can determine etiology

Question 10

ACS/MI

Question 11

Dilated Cardiomyopathy

Question 12

Hypertrophic/Obstructive Cardiomyopathy

Question 13

Restrictive Cardiomyopathy

Question 14

CHF (Right sided)

Question 15

CHF (Left sided)

Question 16

Endocarditis

Question 17

Pericarditis

Question 18

Rheumatic Heart Disease

Question 19

Afib

Question 20

Atrial flutter

Question 21

Heart Block

Question 22

Premature Atrial Contractions (PACs)

Question 23

Premature Ventricular Contractions (PVCs)

Question 24

Sinus Bradycardia

Question 25

Supraventricular Tachycardia

Question 26

Ventricular Fibrillation

Question 27

Aortic Regurgitation

Question 28

Mitral Regurgitation

Question 29

Mitral Valve Prolapse

Question 30

Pulmonic Regurgitation

Question 31

Tricuspid Regurgitation

Question 32

Aortic Stenosis

Question 33

Mitral Stenosis

Question 34

Pulmonic Stenosis

Question 35

Tricuspid Stenosis

Question 36

Hypertension

Question 37

Hypertensive Crisis

Question 38

Hypotension

Question 39

Aortic Aneurysm

Question 40

Chronic Venus Insufficiency

Question 41

Gangrene

Question 42

Hypovolemic Shock

Question 43

Phlebitis

Question 44

Raynaud Phenomenon

Question 45

Stasis Dermatitis

Question 46

Atherosclerosis

Question 47

Coronary Microvascular Disease

Question 48

Peripheral Artery Disease

Question 49

Thormboangiitis Obliterans

Question 50

Embolism

Question 51

Thrombosis

Question 52

Thrombophlebitis

Question 53

Chest Injuries