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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
pathogenic process of restrictive cardiomyopathy
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
restrictive cardiomyopathy diagnostic
clinical suspicion + ECG + echocardiogram + cardiac MRI + Endomyocardial biopsy
27
restrictive cardiomyopathy treatment
no treatment of restrictive issue can treat HF, arrhythmia
28
dilated cardiomyopathy
poor contraction low ejection fraction heart dilates to compensate MC form of cardiomyopathy
29
etiologies of dilated cardiomyopathy
ETOH (mc cause) genetics (chronic A Fib, DM, SLE, muscular dystrophy) drugs/toxins (chemotherapy, anti=rheumatic)
30
clinical presentation fo dilated cardiomyopathy
heart failure (SOB, crackles, S3) mitral regurge, arrhythmia, death peripheral edema
31
S3 heart sound
ventricular diastolic gallop found shortly after S2
32
dilated cardiomyopathy diagnostics
CXR (infiltrates) ECG Echocardiogram (left vent. remodeling, ejection fraction <25%)
33
dilated cardiomyopathy treatment
eliminate reversible causes | treat HF, thrombosis risk, or dysrhythmia
34
pharm tx of dilated cardiomyopathy
beta blockers (decrease HR) vast dilators (ace inhibitors, decrease after load + nitroglycerin, preload and after load decrease) diuretics antigoaculants DIGOXIN
35
types of acquired cardiomyopathies
myocarditis permpartum cardiomyopathy stress related, "Takotsubo"
36
myocarditis
inflammatory process with necrosis of myocardium can be asymptomatic, fever symptoms, to acute HF and death
37
etiologies of myocarditis (BROAD)
``` viruses bacteria fungus parasties protozoan autoimmune conditions ``` BASICALLY EVERYTHIng
38
pathophysiology myocarditis
typically caused by viral infection histologic hallmark - focal patchy, diffuse inflammatory infiltrate with adjacent myocyte injury
39
myocarditis clinical presentation
asymptomatic overshadowed or masked by symptoms of illness typically come in after acute flu like syndrome
40
myocarditis diagnostics
ECG positive cardiac enzymes** (troponin elevated) echocardiogram endomyocardial biopsy

FA17 Cardio 2 (10 decks)

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