Cardiomyopathies

Question 1

Define

Answer 1

refers to a disease of the heart muscle associated with cardiac dysfunction

Question 2

WHO definitions are based on what

Answer 2

ventricular morphology
Dilated CM
Hypertrophic CM
Restrictive CM

Question 3

Dilated CM
Cavity Size:
Wall thickness:
Systolic fx:
Diastolic fx:

Answer 3

enlarged
normal
severely reduced
abnormal

Question 4

Hypertrophic CM
Cavity Size:
Wall thickness:
Systolic fx:
Diastolic fx:

Answer 4

Small
Markedly thickened
Hyperdynamic
Abnormal (dec)

Question 5

Restrictive CM
Cavity Size:
Wall thickness:
Systolic fx:
Diastolic fx:

Answer 5

Normal
Normal
Normal or min. reduced
Abnormal (dec)

Question 6

Cause of dilated CM

Answer 6

Ischemic
Idiopathic
Viral
Genetic
Valvular dx
Alcoholic
From chemo
Metabolic disorders
Chagas
Nutritional 
Peripartum

Question 7

Hypertrophic CM - characterized by

Answer 7

thickened LV walls and reduced cardiac volume
Mutation of sarcomere proteins
Can be hereditary

Question 8

Hypertrophic CM - myocytes

Answer 8

are not arranged in an organized manner - high change of arrhythmias and fibrosis

Question 9

Presentation - Hypertrophic CM

Answer 9

Variable from asymptomatic to significant functional limitation
Typically - dyspnea on exertion, exertional angina, syncope/presyncope

Question 10

hypertrophic CM - septum

Answer 10

Gets thick too and can lead to outflow obstruction - can lead to immediate death

Question 11

Outflow tract obstruction is inc by

Answer 11

Hypovolemia
Inc contractility
Reduced afterload (peripheral VD)

Question 12

Murmus of outflow tract obstruction - how to make it worse

Answer 12

Standing, vasalva

Low venous return

Question 13

Murmurs of outflow tract obstruction - how to reduce

Answer 13

Leg raising, squatting, hand grip

Inc venous return with leg raise, other inc afterload

Question 14

What proves hypertrophic CM

Answer 14

ECG

Question 15

Management with Hypertrophic CM

Answer 15

Reduce LV outflow tract obstruction
Avoid hypovalemia or VD
Screen relatives
Avoid competitive athletics

Question 16

Therapy to reduce LV outflow tract obstruction

Answer 16

Beta blockers
Ca channel blockers
Pacemaker
Surgical myectomy
Alcohol septal ablation

Question 17

Risk factors for sudden cardiac death in those with hypertrophic cardiomyopathy

Answer 17

Young age (less than 30)
Family hx
Recurrent syncope
Nonsustained VT
Abnormal BP response to ex (dec)
Severe septal hypertrophy (more than 2.5cm)

Question 18

Restrictive CM define

Answer 18

Resulting in restricted ventricular filling and reduced diastolic volume with normal or near normal sys function AND wall thickness
RARE
Abnormal compliance of LV
Short relaxation time

Question 19

Etiology of Restrictive CM

Answer 19

Myocardial
Endomyocardial
(anything that will make your heart stiffer)

Question 20

Clinical manifestations of Restrictive CM

Answer 20

Sx of R and L heart failure
Jugular venous distension
Echo doppler abnormalities

Question 21

Amyloid heart disease

Answer 21

related to chronic conditions - infiltrates between myocytes

Question 22

Takotsubo CM AKA

Answer 22

apical ballooning syndrome
stress induced CM
broken heart syndrome

Question 23

What happens in Takotsubo CM

Answer 23

Distal tip does not contract

Question 24

Takotsubo CM - contributed to having

Answer 24

excess catecholamines

NE is elevated

Question 25

Takotsubo CM - triggers

Answer 25

death of loved one, catastrophic even, ICU