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Clin Med 2 - CARDS > Cardiomyopathies > Flashcards

Cardiomyopathies Flashcards

1
Q

what are the subtypes of cardiomyopathies

A

dilated
hypertrophic
restrictive

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2
Q

what is the most common cardiomyopathy

A

dilated cardiomyopathy
seen in M>F (3:1)
black patients at her risk

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3
Q

what are the causes of dilated cardiomyopathies

A

50% idiopathic
Genetic
infection
autoimmune (sarcoidosis)
toxic and overload (alcohol + cirrohosis)
drugs (chemo)
endocrine/metabolic (DM)
peripartum

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4
Q

what characterizes dilated cardiomyopathy

A

ventricular enlargement (LV>RV>Atria)
NO associated hypertrophy (normal wall thickness)
impaired systolic function (reduced contractility)

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5
Q

what are the common causes of infective dilated cardiomyopathy

A

enteroviruses and adenoviruses

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6
Q

what is the equation for stroke volume

A

EDV (preload) - ESV (afterload)

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7
Q

what is the equation for cardiac output

A

CO= HR x SV

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8
Q

what are symptoms of left sided HF

A

dyspnea on exertion
orthopnea
paroxysmal nocturnal dyspnea
cough
fatigue
AMS

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9
Q

what is paroxysmal nocturnal dyspnea

A

SOB that awakens patient from sleep, relieved with sitting up)

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10
Q

what are the signs of left sided HF

A

tachycardia
tachypnea
cyanosis
cardiomegaly
RALES
WHEEZES
S3 or S4 HEART SOUNDS
VALVULAR REGURGITATION

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11
Q

what are the symptoms of right sided HF

A

peripheral edema
RUQ pain (hepatic congestion)
Anorexia or reduced appetite
Bloating/weight
fatigue

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12
Q

what are signs of Right sided HF

A

peripheral edema
elevated JVP
Hepatomegaly
anasarca
ascites
weight gain

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13
Q

what is present on Chest XR with CHF

A

cardiomegaly
pulmonary congestion
- hilar fullness, cephalization, Kerley B lines
pleural effusion
widened mediastinum

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14
Q

what is the treatment for dilated cardiomyopathy

A

treat it like heart failure
control modifiable risk factors
diet and lifestyle change
daily weight monitoring
intensive case management
regular activity to preserve functional status
pharmacologic tx of HF
consider surgical interventions for end stage HF

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15
Q

how do you treat acute heart failrue

A

diuretics
- furosemide (lasix)
- bumetanide
- Torsemide

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16
Q

what is the pharmacologic treatment of heart failure

A

All should get a BB + ACEi
ARBs as second line option

17
Q

what is the #1 cause of sudden cardiac death in young patients

A

HOCM (hypertrophic Obstructive Cardiomyopathy)
M>F
Genetic

18
Q

what characterizes HOCM

A

myocyte disarray
LVH
impaired diastolic function
LV outflow obstruction

19
Q

what is the presentation of HOCM

A

dsypnea - especially on exertion
angina (without CAD)
syncope
orthostatic hypotension
arrhythmias

20
Q

what are exam abnormalities with HOCM

A

S4 heart sound (atrial kick)
double apical impulse (atrial kick)
exaggerated PMI
systolic crescendo-decrescendo murmur at left lower sternal border
mitral regurgitation murmur (improved with squatting, worse with valsalva, standing)
bifid carotid pulse (pulsus bisferiens)

21
Q

what is the treatment for HOCM

A

Avoid strenuous exercise - SCD risk!
CCB (Verapamil or dilt)
BB
Avoid diuretics and nitrates

22
Q

what is the treatment for refractory HOCM

A

surgical intervention
septal myectomy, ETOH ablation

23
Q

what type of cardiomyopathy has the worse prognosis

A

restrictive cardiomyopahty
2-5 year average survival
highest rate of SCD

24
Q

what is restrictive cardiomyopathy secondary to

A

either fibrosis or infiltrative process
- myocardium or endocardium

25
Q

what are the causes of restrictive cardiomyopathy

A

idiopathic
scleroderma (fibrosis)
AMYLOIDOSIS (INFILTRATIVE)
Sarcoidosis (infiltrative)
hemochromatosis (infiltrative)
Hypereosinophilic syndrome(infiltrative)
tumors
radiation

26
Q

what is restrictive cardiomyopathies characterized by

A

atrial enlargement
ventricular stiffness
MINIMAL ventricular hypertrophy
impaired diastolic dysfunction

27
Q

what is the best diagnostic study for restrictive cardiomyopathies

A

Biopsy
congo red stain for amyloidosis
looking for infiltrative process or fibrosis

28
Q

what is the treatment for restrictive cardiomyopathies

A

targeted at underling cause
salt restriction
diuretics PRN for pulmonary congestion or fluid overload
vasodilators less helpful (minimal systolic dysfunction)
manage arrhythmias - NSR
consider anticoagulation
treatmentof amyloidosis

29
Q

what is the treatment of amyloidosis

A

immunomodulators
molecular/gene-targeted drugs
chemotherapy
stem cell or liver transplant

Clin Med 2 - CARDS (11 decks)

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