Cardiomyopathies and pericardial

Question 1

Hypertrophic cardiomyopathy symptoms

Answer 1

Syncope, Chest pain, Dyspnea

Worse with exertion

Same as aortic stenosis, just younger athlete is in question stem

Question 2

Hypetrophic cardiomyopathy physical exam

Question from Q bank

Answer 2

S4, systolic murmur (regurg)

Louder with valsalva b/c septum is closer to lateral wall so sound will be louder

Squatting increases after load and opens it

Question 3

Tx hypertrophic cardiomyopathy

Answer 3

Filling heart more decreases the symptoms of the septum being in the way

Beta blocker increases filling
Avoid volume depletion

Question 4

Dilated cardiomyopathy H and P

Answer 4

Fatigue, dyspnea, systolic dysfunction, S3

Globular heart on CXR

Question 5

Tx of cardiomyopathy

Answer 5

Like failure

Diuretics
ACE i
Beta blockers

Question 6

Restrictive cardiomyoapthy causes less compliance. Causes?

Answer 6

Hemochromatosis (though more commonly causes dilated)

amyloidosis

Sarcoidosis

Question 7

Dx of restrictive cardiomyopathy?

Tx?

Answer 7

Biopsy

Treat like heart failure

Question 8

Pericarditis is 4 star topic

Answer 8

ok

Pleuritic chest pain

Question 9

Pulsus paradoxes happens b/c right heart fills and limited room for left to fill so pressure decreases a bit

Answer 9

Lowers by 10 mm Hg of blood pressure

Question 10

Global ST elevation?

Answer 10

Pericarditis

But still rule it out

Question 11

Exudative pericardial effusion from what?

Answer 11

Tb, fibrotic disease, neoplasm

Question 12

Kussmaul sign is what?

Answer 12

JVD with inspiration

Decreased capacity of RV

With constrictive pericarditis more than pericarditis

Question 13

Tx of restrictive pericarditis?

Answer 13

NSAID, Colchicine, steroid, surgery

Question 14

What is electrical alternans?

Answer 14

Alternating amplitude of QRS with tamponade

Question 15

Distended enck veins, instant heart sound and hypotension you do what?

Answer 15

TAMPONADE AND DO PERICARDIOCENTESIS

It is beck triad

Question 16

Common causes of dilated cardiomyopathy?

Answer 16

Ischemic heart disease
Chronic alcohol
Doxorubicin
Peripartum cardiomyopathy

Question 17

Hypertrophic cardiomyopathy is what genetically?

Answer 17

dominant. IT IS CRAZY WOVENNESS ON BIOPSY

Question 18

Viruses that cause myocarditis?

Answer 18

Coxsackie! Echovirus, adeno, ebv, cmv, influ

Question 19

Trypanosoma cruz can cause what?

Answer 19

chagas diseaes (south american). Myocarditis or big things

Cardiomegaly, megacolon or megaesophagus (BIG THINGS)

Question 20

Myocarditis helpful study?

Answer 20

Echo

Question 21

Dx of rheumatic fever? mnemonic

Answer 21

JONES Criteria

Jones is major, PEACE is minor
2 major or 1 major and 2 minor

Joints
Heart (pancarditis)
Nodules (subcu)
Erythema marginatum (painless rash)
Sydenham corea

PEACE
Previous rheumatic
ECG with PR prolongation
Arthralga
CRP and ESR
Elevated temp

Question 22

Tx of rheumatic fever?

Answer 22

NSAID, Corticosteroid, Ongoing infection tx (although usually gone by then)

Question 23

Endocarditis prophylaxis?

Answer 23

NO LONGER rheumatic

Prosthetic valve
history of endocarditis
Congen heart disease
Valvulopathy with transplant

Question 24

What is libman sacks endocarditis?

Answer 24

Lupus with non-infective endocarditis!!

Question 25

Duke crieteria?

Answer 25

Major types
Serial blood cultures for organism
Echocardiogram showing vegetations
New valve regurg
Blood culture for coxiella burnetii

Minor (not as important)
Janeway
Predisposed
Vasc phenomenon
Immunologic phenomenon

Question 26

NEw endocarditis

Answer 26

Regurg

Question 27

Endocarditis tx

Answer 27

IV antibiotics 4-6 weeks
Ceftriaxone with gentamicin

Van may be added

Prophylactic antibiotics 30 minutes before surgery

Valve replacement if super damaged later

Question 28

HTN dx?

Answer 28

Need 3 readings of 140/90 or more