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CABS2: Cardiology > Cardiomyopathies > Flashcards

Cardiomyopathies Flashcards

1
Q

what is the endocardium

A

innermost layer of the heart muscle
both endothelium and CT - has protective anti-thrombic properties
contiguous with vasculature and covers valvular structures

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2
Q

what makes up the myocardium

A

striated cardiac muscle - oriented in a twisted formation for best squeeze and CO

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3
Q

what layer of the heart is made up of the visceral layer of the pericardium

A

epicardium

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4
Q

what layer are the coronaries underneath

A

the epicardium

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5
Q

What is the cardiac output

A

heart rate x stroke volume

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6
Q

what is the stroke volume

A

the amount of blood ejected from each ventricle with each contraction
usually about 70ml

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7
Q

what is the average Cardiac output

A

4000-5000mL

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8
Q

what is the preload

A

the venous return

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9
Q

what affects the stroke volume

A

venous return (preload)
blood volume
SNS (contractility)
Peripheral resistance (afterload)

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10
Q

what are factors that increase HR

A

SNS (norepi and epi)
increased thyroid
hypoxemia and acidosis
medications

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11
Q

What factors decrease HR

A

Parasympathetic (ach)
Medications
Athletes

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12
Q

What is ESV

A

end systolic volume
how much is left over after contraction
typically = 50mL

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13
Q

What is EDV

A

end diastolic volume
amount in ventricle right before contraction
typically = 120mL

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14
Q

What is the Ejection fraction equation

A

stroke volume / EDV

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15
Q

what increases in relation to the preload

A

ventricular output

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16
Q

what determines how much a myocyte can retract back to normal length, if this load is elevated, it will not be able to shorten adequately

A

afterload

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17
Q

what is the frank-starling curve

A

represents the relationship between stroke volume and end diastolic volume.
states that the stroke volume of the heart increases in response to an increase in the volume of blood in the ventricles, before contraction, when all other factors remain constant.

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18
Q

what is cardiomyopathy

A

disease process that changes the cardiac structure that affects the myocardium itself
m/c referencing disease process of the LV

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19
Q

what is impaired with cardiomyopathy

A

cardiac function and may also alter the cardiac electrical conduction

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20
Q

what are cardiomyopathies broken down into

A

hypertrophic
dilated (M/c)
arrhythmogenic
restrictive (least common)
unclassified

(genetic, mixed, acquired)

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21
Q

what are genetic cardiomyopathies

A

hypertrophic cardiomyopathy
arrhythmogenic cardiomyopathy
Left ventricular noncompaction
conduction defects
mitochondrial myopathies
ion channel disorders

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22
Q

what are acquired cardiomyopathies

A

takotsubo
myocarditis
peripartum
tachycardia induce

23
Q

what are mixed cardiomyopathies

A

dilated cardiomyopathies
restrictive cardiomyopathies

24
Q

What is MOGES classifcation

A

classification system gives information about the disease but also may be able to help risk stratify pts for potential future cardiovascular events

M: morphofunctional
O: Organ involvement
G: genetic predisposition
E: Etiological definition
S: functional status

25
Q

decreased contractility leading to reduced ejection fraction is caused by

A

systolic dysfunction

26
Q

what is systolic dysfunction

A

decreased contractility leading to reduced ejection fraction
causes: dilated cardiomyopathy

27
Q

the inability for the ventricle to completely relax to allow for appropriate passive filling is caused by

A

diastolic dysfunction

28
Q

what is disastolic dysfunction

A

inability for the ventricle to completely relax to allow for appropriate passive filling

29
Q

what are the causes of diastolic dysfunction

A

hypertrophic cardiomyopathy
restrictive cardiomyopathy

30
Q

what is the most common cardiomyopathy

A

dilated cardiomyopathy

31
Q

what is associated with an increase in filling volume

A

dilated cardiomyopathy

32
Q

what is increased with dilated cardiomyopathy

A

increased preload (EDV)
will cause increased atrial pressure
atrial dilation

33
Q

what is the most common cause of right sided heart failure

A

left sided heart failure

34
Q

what is activated within the body to increase the BP

A

renin-angiotensin-aldosterone system which is activated by decreased CO

35
Q

What is transient ballooning of the cardiac apex due to profound stress

A

Takotsubo - “broken heart”
classically seen in postmenopausal women

36
Q

what is thought to be associated with a huge catecholamine surge, microvascular dysfunction and spasm of the coronaries

A

Takotsubo

37
Q

what is the presentation of dilated cardiomyopathy

A

symptoms of left sided heart failure
S3 sounds
dilation can change annulus
can present with arrhythmia
may see right sided HF depending on severity

38
Q

what is the presentation of left sided heart failure

A

pulmonary concerns - pulmonary edema

39
Q

what is the presentation of right sided heart failure

A

more edema and ascites
fatigue, increased peripheral venous pressure
distended jugular veins, Anorexia & GI distress
weight gain

40
Q

what is hypertrophic cardiomyopathy

A

thickened myocardium leading to poor diastolic filling
may lead to outflow obstruction

41
Q

what can cause hypertrophic cardiomyopathy

A

genetics: inherited (autosomal dominant) or mutations
chronic HTN
Aortic stenosis
amyloidosis

42
Q

what presents with a more pronounced septum

A

hypertrophic cardiomyopathies

43
Q

What is HOCM

A

Hypertrophic Obstructive Cardiomyopathy
- often causes sudden cardiac death in athletes
occlusion of the outflow tract (aortic valve) which causes a vacuum with mitral valve and decreases CO

44
Q

what is the presentation of hypertrophic cardiomyopathy

A

systolic murmur
S4 heart sounds
HF
Arrhythmia
may also have findings of mitral regurgitation

45
Q

What is restrictive cardiomyopathy

A

fibrosis of the myocardium
infiltrative disease - decreased compliance

46
Q

what is the pathophysiology of restrictive cardiomyopathy

A

fibrotic changes within the myocardium which decreases compliance of the ventricles
this decreases ventricular filling capacity

47
Q

what can restrictive cardiomyopathy lead to

A

diastolic dysfunction
RV HF and LV HF secondary to decreased compliance
systolic murmur

48
Q

what are the causes of restrictive cardiomyopathy

A

endomyocardial fibrosis
radiation fibrosis: secondary to radiation to the mediastinum
amyloidosis
sarcoidosis
hemochromatosis

49
Q

What is endomyocardial fibrosis

A

autoimmune issue marked by eosinophilia which is an inflammatory reaction and fibrosis of the endocardial surfaces

50
Q

who are endomyocardial fibrosis most common in

A

children of developing countries

51
Q

What is amyloidosis

A

misfolded antibodies which are able to be deposited within the tissues
- genetic cause
leads to fibril deposition
deposition within the tissues - chronic inflammation

52
Q

What is sarcoidosis

A

autoimmune disease - exact pathophysiology not completely understood
hallmarked by non-caseating granuloma formation
deposits within heart, joints, eyes, skin, lungs

53
Q

what is the granuloma in sarcoidosis made up of

A

macrophages and fibrotic tissues, centrally contains epitheloid cells

54
Q

what is hemochromatosis

A

excess iron due to poor protein modulation within the liver
leads to increased absorption and release from the sleep
iron deposits within the myocardium

CABS2: Cardiology (11 decks)

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