Cardiomyopathies Exam #4 Questions

Question 1

angina is more common in this cardiomyopathy although it exists in both

Answer 1

more common in Hypertrophic Cardiomyopathy than in Dilated

Question 2

Auscultation for DCMP

Answer 2

muffled heart sound, accentuated pulmonic component of S2, S4, and S3 gallop or summation gallop. MR or TR murmur (when annulus is dilated)

Question 3

An athlete may have what’s called athletes heart. This could be confused with a type of cardiomyopathy. Which one?

Answer 3

Hypertrophic Cardiomyopathy (HCM)

Question 4

In what cardiomyopathy is thrombus common?

Answer 4

Dilated

Question 5

Treatment for dilated cardiomyopathy

Answer 5

weight reduction
sodium restriction
absence from alcohol/tobacco
diuretics
vasodilators
anticoagulants
antiarrhythmias
cardiac transplant

Question 6

2 types of surgical techniques for heart transplant (DCMP)

Answer 6

orthotopic: donor heart replaces patient’s heart
heterotopic: donor is placed alongside patient’s heart - 2 HEARTS!

Question 7

Heart transplant rejection signs

Answer 7

increasing wall thickness >4mm (IVS and LVPW)
increased myocardial echogenicity
increase pericardial effusion
decrease of 10% or more: EF
20% decrease or more in PHT @ MV
20% decrease in IVRT

Question 8

What is IVRT

Answer 8

time it takes LV to relax before the MV opens

Question 9

What does IVRT stand for

Question 10

Takosubo aka (4)

Answer 10

apical ballooning syndrome
ampulla cardiomyopathy
stress cardiomyopathy
broken heart syndrome

Question 11

Takosubo characterized by

Answer 11

Reversible LV function
Absence of coronary disease and myocardial infarcts
associated with emotional distress
Elevation of serum markers like CK, CK-MB and troponin
affects females more
97% recovery

Question 12

restrictive cardiomyopathy associated with elevation in MULTIPLE pressures

Answer 12

elevated ventricular diastolic pressures AND increased atrial pressure

Question 13

This type of cardiomyopathy includes myocardial fibrosis and Loefler’s cardiomyopathy

Answer 13

Restrictive cardiomyopathy (infiltrative)

Question 14

Cavity obliteration of LV is seen in advanced cases of this cardiomyopathy

Answer 14

Restrictive

Question 15

Sudden death is an outcome for this type of cardiomyopathy

Answer 15

Restrictive

Question 16

EKG shows complete heart block… this might be what cardiomyopathy

Answer 16

Restrictive

Question 17

What is an echo feature seen in restrictive cardiomyopathy that can distinguish the patient from having constrictive pericarditis?

Answer 17

abrupt elevation of early diastolic pressures at rest and with exercise
respiratory variation on E and A velocities through MV and TV during first beat of inspiration and expiration

Question 18

most common cause of infiltrative (restrictive) cardiomyopathy is what

Answer 18

AMYLOIDOSIS

Question 19

infiltrative cardiomyopathy amyloidosis, what is

Answer 19

multiple valve thickening
small lv cavity
wall hypokinesis
pericardial effusion

Question 20

Other cardiomyopathies

Answer 20

ARVD
arrhythmogenic RV dysplasia
-genetic
-caused by fatty infiltrative process involving RV free wall (poorly contracting RV)

Isolated LV noncompaction
-congenital
-trabeculations in LV myocardium with deep spaces due to compaction of LV wall

Question 21

primary hemodynamic problem with HCM (2)

Answer 21

1. Sub aortic obstructions
2. LV diastolic dysfunction