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FA17 Cardio 2 > Cardiomyopathies > Flashcards

Cardiomyopathies Flashcards

1
Q

final common pathway of cardiomyopathy

A

CHF, arrhythmia, death

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2
Q

compensatory mechanisms of cardiomyopathy

A
  1. left ventricular enlargement
  2. Frank starling mechanism

eventually these are exceeded and cardiac output decreases = heart failure

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3
Q

diagnostic tools used to evaluate cardiomyopathy

A

clinical suspicion (FH, exam) + echocardiogram + cardiac MRI

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4
Q

test of choice for all cardiomyopathies

A

ECHOcardiogram

normal thickness of LV = <15 mm or 1.5 cm

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5
Q

types of primary cardiomyopathies

A

genetic
mixed (genetic v. non genetic)
acquired

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6
Q

types of genetic cardiomyopathies

A

hypertrophic cardiomyopathy

arrhythmogenic right ventricular cardiomyopathies

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7
Q

hypertrophic cardiomyopathy

genetic mutation

A

disorder of myocardium caused by mutations of sarcomere or sarcomere-associated proteins

autosomal dominant

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8
Q

Pathophys of hypertrophic cardiomyopathy

A

Septal hypertrophy = thickening of left ventricular septum

impaired relaxation, secondary to ventricular wall thickness, and loss of elasticity = DIASTOLIC issue

hard to fill the heart

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9
Q

abnormalities of hypertrophic cardiomyopathy

A

myocardial ischemia

mitral regurgitation

arrhythmias

MC CAUSE OF DEATH IN YOUNG ATHLETES

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10
Q

clinical features of hypertrophic cardiomyopathy

A

syncope, SOB, chest pain

S4 heart sound (atrial contraction against no complaint vent)

ventricular arrhythmias

sudden death

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11
Q

s4 heart sound

A

atrial diastolic gallop

“Tah” Lub Dub

found before S1

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12
Q

diagnostic eval of hypertrophic cardiomyopathy

A

clinical suspicion + ECG+ echocardiogram *** TOC + cardiac MRI

can genetic test

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13
Q

treatment of hypertrophic cardiomyopathy

A

activity restriction

Anti-arrhythmics

surgical tx

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14
Q

pharm treatment of hypertrophic cardiomyopathy

A

beta blockers - Metoprolol/Lopressor (sluggish)

avoid inotropes (digoxin, epinephrine, dopamine)

avoid vasodilators (CCB, nitrates, hydralazine)

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15
Q

hypertrophic cardiomyopathy surgical treatments

A

surgical septal myectomy

alcohol septal ablation

implantable cardio defibrillator

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16
Q

arrhythmogenic right ventricular cardiomyopathy pathophys

A

fibro-fatty infiltration of RIGHT ventricle

causes r. sided heart failure and various rhythm disturbances

precipitated by catecholamine release during exercise

second mc cause of death in young athletes

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17
Q

arrhythmogenic right ventricular cardiomyopathy

phases of presentation

A
  1. Concealed phase (asymptomatic)
  2. Electrical phase- palpitations or syncope
  3. diffuse phase - right sided heart failure
18
Q

diagnostics of arrhythmogenic right ventricular cardiomyopathy

A

EKG - suggestive

Echocardiogram (test of choice)

cardiac MRI

19
Q

arrhythmogenic right ventricular cardiomyopathy treatment

A

activity restriction

anti-arrhythmic drugs

implantable cardio defibrillator

20
Q

athletic ventricular hypertrophy

A

NOT cardiomyopathy

endurance training, increased thickness

can cause thickness but <14mm

21
Q

types of mixed cardiomyopathies

A

restrictive

dilated

22
Q

restrictive cardiomyopathies

A

rarest form

excessive rigidity of ventricle walls

diastolic dysfunction

23
Q

restrictive cardiomyopathies etiologies

A

infiltrative disease (amyloidosis, sarcoidosis)

inflammatory

24
Q

clinical features of restrictive cardiomyopathies

A

HF with normal sized heart

SOB (orthopnea, PND)

R. heart failure symptoms (JVD, periperhal edema, ascites, S4 heart sound)

SMALL STIFF heart

25
Q

pathogenic process of restrictive cardiomyopathy

A

BACKING UP ISSUE

one side backs up causes back up on other

i.e. pulmonary congestion causes RV to back up, then RA, and systemic congestion occurs

26
Q

restrictive cardiomyopathy

diagnostic

A

clinical suspicion + ECG + echocardiogram + cardiac MRI + Endomyocardial biopsy

27
Q

restrictive cardiomyopathy

treatment

A

no treatment of restrictive issue

can treat HF, arrhythmia

28
Q

dilated cardiomyopathy

A

poor contraction

low ejection fraction

heart dilates to compensate

MC form of cardiomyopathy

29
Q

etiologies of dilated cardiomyopathy

A

ETOH (mc cause)

genetics (chronic A Fib, DM, SLE, muscular dystrophy)

drugs/toxins (chemotherapy, anti=rheumatic)

30
Q

clinical presentation fo dilated cardiomyopathy

A

heart failure (SOB, crackles, S3)

mitral regurge, arrhythmia, death

peripheral edema

31
Q

S3 heart sound

A

ventricular diastolic gallop

found shortly after S2

32
Q

dilated cardiomyopathy diagnostics

A

CXR (infiltrates)

ECG

Echocardiogram (left vent. remodeling, ejection fraction <25%)

33
Q

dilated cardiomyopathy treatment

A

eliminate reversible causes

treat HF, thrombosis risk, or dysrhythmia

34
Q

pharm tx of dilated cardiomyopathy

A

beta blockers (decrease HR)

vast dilators (ace inhibitors, decrease after load + nitroglycerin, preload and after load decrease)

diuretics

antigoaculants

DIGOXIN

35
Q

types of acquired cardiomyopathies

A

myocarditis

permpartum cardiomyopathy

stress related, “Takotsubo”

36
Q

myocarditis

A

inflammatory process with necrosis of myocardium

can be asymptomatic, fever symptoms, to acute HF and death

37
Q

etiologies of myocarditis (BROAD)

A 
viruses
bacteria
fungus
parasties
protozoan 
autoimmune conditions

BASICALLY EVERYTHIng

38
Q

pathophysiology myocarditis

A

typically caused by viral infection

histologic hallmark - focal patchy, diffuse inflammatory infiltrate with adjacent myocyte injury

39
Q

myocarditis clinical presentation

A

asymptomatic

overshadowed or masked by symptoms of illness

typically come in after acute flu like syndrome

40
Q

myocarditis diagnostics

A

ECG
positive cardiac enzymes** (troponin elevated)
echocardiogram
endomyocardial biopsy

FA17 Cardio 2 (10 decks)

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