Cardiomyopathies and Selected non-coronary heart disease Flashcards

1
Q

What are the major causes of dilated cardiomyopathy?

A
  1. myocarditis
  2. ischemic heart disease
  3. peripartum
  4. hypertensive
  5. valvular
  6. infectious
  7. systemic
  8. toxic (drugs/alcohol)
  9. metabolic
  10. neuromuscular
  11. familial
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2
Q

What are the treatment of cardiomyopathy?

A
  1. ACE inhibitor
  2. beta blockers
  3. diuretics
  4. digoxin/vasipressin antagonist
  5. antiarrhythmic drugs
  6. anticoagulants
  7. Pacemaker - severe
  8. Heart transplant - very severe
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3
Q

Diagnostic tools for cardiomyopathy?

A

TTE
EKG - non-specific change or LBBB or AFIB

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4
Q

What are the three unfavourable features of dilated cardiomyopathy?

A
  1. significant LV enlargement
  2. Lower EF
  3. LBBB
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5
Q

Hypertrophic cardiomyopathy is characterized by what?

A

Myocardiac hypertrophy; hypertrophy is thickening of the heart muscle, primarily left ventricle.

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6
Q

LV outflow tract can be obstructed due to anterior mitral leaflet impinging on the hypertrophied septum, what are these cases referred to?

A

Hypertrophic obstructive cardiomyopathy/HOCM.

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7
Q

What differentiate athlete heart to HCM in diagnostic?

A

Athletic heart has an LV wall thickness that exceeds 13mm, and systolic anterior motion of the mitral apparatus is confirmatory for HCM.

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8
Q

Treatment for HCM?

A
  1. beta blocker/calcium channels
  2. Anticoagulant
  3. Surgery
  4. Alcohol injection into septal artery
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9
Q

EKG abnormalities in HCM?

A
  1. LVH by voltage criteria
  2. Major St-T changes in the absence of known causes.
  3. abnormal Q waves
  4. large negative T waves
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10
Q

High Risk Characteristic of HCM?

A

symptomatic
fhx of sudden death
septal thickness of 25mm
outflow gradient over 30 mmHg
arrhythmias/AF
Ventricular tachycardia
Low exercise capacity/fall in BP with exercise

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11
Q

More favourable prognosis with HCM?

A

over 40
no progression in echocardio
no symptoms
no fhx of sudden death
intraventricular septum less than 16mm
no outflow gradient less than 10mmHg
no hx or arrhythmia
no strenuous exercise

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12
Q

EKG changes in athlete’s heart?

A
  1. sinus bradycardia
  2. first-degree atrioventricular block/PR interval prolongation
  3. Wenckeback 2AV block
  4. early repolarization, ST elevation
  5. primary T wave inversion
  6. complete RBBB or LBBB
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13
Q

In Athlete’s heart, an echocardiogram can show?

A
  1. Heart diamete increased by 5-10% max
  2. increased LV posterior wall and septum thickness.
  3. heart volume index/mass index 25% above normal values.
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14
Q

What is restrictive cardiomyopathy?

A

Heart disease in which the heart chambers are unable to properly fill with blood due to heart stiffness.

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15
Q

What is Arrhythmogenic right ventricular cardiomyopathy?

A

rare disorder characterize by replacement of the right ventricular free wall with fiber and fat

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16
Q

What is left ventricular non-compaction cardiomyopathy?

A

myocardial wall alteration with prominent trabeculae and deep inter-trabecular recesses.

17
Q

What is pericarditis?

A

Inflammation of the pericardium

18
Q

What is pericardial Effusion?

A

Abnormal collection of fluid in the pericardial space.

19
Q

What is constrictive pericarditis?

A

Occurs when a thickened pericardium restricts diastolic filing of the heart.

20
Q

What is endocarditis?

A

Inflammation of the endocardium.

21
Q

Endocarditis is usually caused by?

A

Basteria and fungus

22
Q

Infective endocarditis usually occurs in what?

A

Heart abnormalities.

23
Q

What is congestive heart failure?

A

Clinical diagnosis based on the findings of lung congestion, edema and liver enlargement.

24
Q

What is a major consideration for congestive heart failure?

A

Age (over 65)

25
Q

Myocardial disorder that can damage the myocardium and result in heart failure includes?

A

CAD/MI
Cardiomyopathy
Myocarditis
Neuromuscular disease
Infiltrative disorders
Drugs/Chemical
Postpartum heart failure

26
Q

Conditions that can cause cardiac overload resulting in heart failure?

A

pressure overload
valvular heart disease with regurgitation and volume overload
iatrogenic volume overload
severe anemia
peripheral arteriovenous shunts with high cardiac output
Chronic tachycardia
pregnancy
endocrine disorders
excessive physical activity

27
Q

Tools to diagnosed CHF?

A

Chest xray
echocardiogram
heart catheterization
BNP levels

28
Q

What is diastolic dysfunction?

A

Impaired filling of the heart during diastole.

29
Q

Which cases of heart failure can be underwritten?

A
  1. Correction of severe mitral and/or aortic valve regurgitation.
  2. Correction of chronic tachyarrhythmias
  3. Correction of overload caused by arterio-venous fistulae/severe anemia/iatrogenic fluid overload.