Cardiomyopathies Flashcards
What is the main etiology of restrictive cardiomyopathy
amyloidosis
What other heart disease presents exactly the same as dilated cardiomyopathy?
Systolic heart failure
What is the gold standard for diagnosis of infectious dilated cardiomyopathy
endomyocardial biopsy
What are the two types of hypertrophic cardiomyopathy
- obstructive
2. non-obstructive
Which cardiovascular disease DO NOT cause dilated cardiomyopathy
- CAD
- valvular disease
- hypertension
Stress cardiomyopathy AKA
takotsubo cardiomyopathy
apical ballooning syndrome
broken heart syndrome
does the harsh crescendo-decrescendo systolic murmur in hypertrophic cardiomyopathy become louder or softer with valslva and standing
increases
What is the treatment of choice for dilated cardiomyopathy
take away offending agent
Would you want to do a stress test with someone who has hypertrophic cardiomyopathy?
yes
What is the leading cause of sudden cardiac death in young persons
hypertrophic cardiomyopathy
What other heart disease can restrictive cardiomyopathy resemble?
constrictive pericarditits
What type of dysfunction is hypertrophic cardiomyopathy
diastolic
What are non-medication treatment options for dilated cardiomyopathy?
implanted cardioverter defibrillator
cardiac transplantation
What does Stress cardiomyopathy look like on EKG?
ST segment elevation, deep anterior T wave inversion
What is the first line treatment for restrictive cardiomyopathy
treat underlying cause + low-dose loop diuretics
Which illicit drug is related to dilated cardiomyopathy
cocaine
What is the most common cause of infectious dilated cardiomyopathy (which is myocarditis secondary to infectious cause)
viral
What is the most definitive (but not always definitive) diagnostic test for dilated cardiomyopathy
echo
What is the most common etiology of dilated cardiomyopathy?
idiopathic
What does Stress cardiomyopathy look like on an echo?
decreased ejection fraction
What other heart disease does Stress cardiomyopathy present like?
acute coronary syndrome (like an MI)
In restrictive cardiomyopathy, what sided heart failure does the sxs usually resemble
right
edema, JVD, ascities
What is the definitive diagnostic test for cardiac amyloidosis (*restrictive cardiomyopathy )
What is another pretty good diagnostic test you should do but isn’t definitive
endomyocardial biopsy
echo— normal ejection fraction, abnormal filling
What is the difference in troponin levels between Stress cardiomyopathy and acute coronary syndrome (like an MI)
present, but much lower than an MI
What type of dysfuntion is dilated cardiomyopathy
systolic dysfunction
What type of dysfunction is restrictive cardiomyopathy
diastolic dysfunction
scarring and consequent loss of the normal elasticity of the pericardial sac leading to impaired ventricular filling is which cardiomyopathy
restrictive cardiomyopathy
Which is the least common cardiomyopathy
restrictive cardiomyopathy
transient LV systolic and diastolic dysfunction in the ansence of attributable coronary artery disease:
Stress cardiomyopathy
What is the most common type of cardiomyopathy
dilated
What is the drug of choice for dilated cardiomyopathy?
ACE inhibitor
Which heart sound (sound not a murmur) can be heard with hypertrophic cardiomyopathy
S4
What can you hear when auscultating the heart with hypertrophic cardiomyopathy
harsh crescendo-decrescendo systolic murmur
What kind of murmur can be heard with dilated cardiomyopathy
mitral/tricuspid regurgitation murmur
What is the mainstay diagnostic exam for hypertrophic cardiomyopathy
echo
You see a patient with periorbital purpura with heart failrue. What do you know
The patient has cardiac amyloidosis because periorbital purpura with heart failure is pathognomonic
*restrictive cardiomyopathy
What treatment is available for a patient that has hypertrophic cardiomyopathy and is at high risk for sudden cardiac death or has sustained ventricular tachyarrythmias
implanted cardioverter defibrillator
When is surgery for hypertrophic cardiomyopathy indicated?
symptomatic left ventricular outflow tract obstruction (LVOT) with advanced CHF refractory to medical therapy
does the harsh crescendo-decrescendo systolic murmur in hypertrophic cardiomyopathy become louder or softer with squatting and isometric handgrip
dereases
what medication can be used for a lot of cardiomyopathies but is contraindicated in amyloid restrictive cardiomyopathy
calcium channel blockers
Which is the only cardiomyopathy to have an abrupt onset
Stress cardiomyopathy
What other medication can be used if beta blockers are not working for hypertrophic cardiomyopathy
non-dihydropyridine calcium channel blockers
What is the first line treatment for hypertrophic cardiomyopathy
beta blockers
What is the treatment for Stress cardiomyopathy
send to cath lab, no blockage will be found
Asprin, beta blockers, ACE-I until LV recovery
if there is a thrombus, add warfarin for 3 months
Which chemotherapy drugs can cause chemo-therapy induced dilated cardiomyopathy
anthracyclines: adriamycin (Doxarubicin)
What is Kussmauls sign
increase in JVP with inspiration (jugular venous pressure)
restrictive cardiomyopathy
Which cardiomyopathy is associated with right and left atrial enlargement
restrictive cardiomyopathy
What storage diseases can lead to restrictive cardiomyopathy
hemochromatosis
glycogen storage disease
ACE inhibitors are the first line medication for dilated cardiomyopathy, what are other options?
- diuretics
- beta blockers
- digooxin
- amiodarone if afib
- anticoagulation
Which murmur is possible to hear with restrictive cardiomyopathy but not always
mitral regurgitation/ tricuspid regurgitation murmur
What is the main etiology for hypertrophic cardiomyopathy
familial
