Cardiomyopathies and pericardial Flashcards
Hypertrophic cardiomyopathy symptoms
Syncope, Chest pain, Dyspnea
Worse with exertion
Same as aortic stenosis, just younger athlete is in question stem
Hypetrophic cardiomyopathy physical exam
Question from Q bank
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
Tx hypertrophic cardiomyopathy
Filling heart more decreases the symptoms of the septum being in the way
Beta blocker increases filling
Avoid volume depletion
Dilated cardiomyopathy H and P
Fatigue, dyspnea, systolic dysfunction, S3
Globular heart on CXR
Tx of cardiomyopathy
Like failure
Diuretics
ACE i
Beta blockers
Restrictive cardiomyoapthy causes less compliance. Causes?
Hemochromatosis (though more commonly causes dilated)
amyloidosis
Sarcoidosis
Dx of restrictive cardiomyopathy?
Tx?
Biopsy
Treat like heart failure
Pericarditis is 4 star topic
ok
Pleuritic chest pain
Pulsus paradoxes happens b/c right heart fills and limited room for left to fill so pressure decreases a bit
Lowers by 10 mm Hg of blood pressure
Global ST elevation?
Pericarditis
But still rule it out
Exudative pericardial effusion from what?
Tb, fibrotic disease, neoplasm
Kussmaul sign is what?
JVD with inspiration
Decreased capacity of RV
With constrictive pericarditis more than pericarditis
Tx of restrictive pericarditis?
NSAID, Colchicine, steroid, surgery
What is electrical alternans?
Alternating amplitude of QRS with tamponade
Distended enck veins, instant heart sound and hypotension you do what?
TAMPONADE AND DO PERICARDIOCENTESIS
It is beck triad
Common causes of dilated cardiomyopathy?
Ischemic heart disease
Chronic alcohol
Doxorubicin
Peripartum cardiomyopathy
Hypertrophic cardiomyopathy is what genetically?
dominant. IT IS CRAZY WOVENNESS ON BIOPSY
Viruses that cause myocarditis?
Coxsackie! Echovirus, adeno, ebv, cmv, influ
Trypanosoma cruz can cause what?
chagas diseaes (south american). Myocarditis or big things
Cardiomegaly, megacolon or megaesophagus (BIG THINGS)
Myocarditis helpful study?
Echo
Dx of rheumatic fever? mnemonic
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
Tx of rheumatic fever?
NSAID, Corticosteroid, Ongoing infection tx (although usually gone by then)
Endocarditis prophylaxis?
NO LONGER rheumatic
Prosthetic valve
history of endocarditis
Congen heart disease
Valvulopathy with transplant
What is libman sacks endocarditis?
Lupus with non-infective endocarditis!!
Duke crieteria?
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
NEw endocarditis
Regurg
Endocarditis tx
IV antibiotics 4-6 weeks
Ceftriaxone with gentamicin
Van may be added
Prophylactic antibiotics 30 minutes before surgery
Valve replacement if super damaged later
HTN dx?
Need 3 readings of 140/90 or more