Cardiomyopathy

Question 1

Cardiomyopathy

Answer 1

• a group of conditions of the myocardium.
• myocardium becomes enlarged, thick, or rigid.
• In rare cases, it can be replaced with scar tissue

Question 2

What happens as the myocardium progresses?

Answer 2

myocardium is weakened

Question 3

What happens when myocardium gets weakened?

Answer 3

• The heart pumps less effectively, leading to heart failure.
• has difficulty maintaining normal electrical conduction, leading to arrhythmias.
• valvular disorders can develop.

Question 4

What 3 groups are Cardiomyopathies classified into?

Answer 4

• dilated
• hypertrophic
• restrictive

Question 5

What is Dilated Cardiomyopathy?

Answer 5

• Develops when the ventricles become enlarged and weakened

Question 6

What heart chamber does Dilated Cardiomyopathy usually start?

Answer 6

-In the left ventricle and eventually affects the right ventricle

Question 7

Describe what happens to the ventricle and wall thickness (of the heart)

Answer 7

The ventricles are enlarged (dilated) as a whole, but the wall thickness is normal or thin.

**Enlarged Ventricle

Question 8

When the ventricle walls are stretched what happens to the contractility?

Answer 8

Cardiac contractility is weaker, resulting in systolic dysfunction.

Question 9

What happens to the cardiac output when there is a systolic dysfunction?

Answer 9

• The cardiac output decreases

- Blood backs up into the pulmonary system

Question 10

When cardiac output decreases and blood backs up into the pulmonary system, what can happen to the blood in the heart?

Answer 10

Blood can stagnate in the heart, causing thrombi to develop.

Question 11

What is the risk for developing dilated cardiomyopathy?

Answer 11

• increases with age
• most common form of cardiomyopathy in children
• more common in African Americans and men
• idiopathic (most cases)

Question 12

Dilated cardiomyopathy can be inherited, but secondary causes include?

Answer 12

• Chemotherapy (specifically doxorubicin and daunorubicin)
• Alcoholism
• Cocaine and amphetamine abuse
• Pregnancy, specifically the last trimester
• Infections, especially viral
• Thyrotoxicosis (hypermetabolic syndrome resulting from increased levels of thyroid hormones)
• Diabetes mellitus
• Neuromuscular diseases (e.g., muscular dystrophy)
• Hypertension
• Coronary artery disease
• Viral hepatitis
• Human immunodeficiency virus (HIV)
• Hypersensitivity to medications
• Certain toxins (e.g., poisons and heavy metals)

Question 13

As dilated cardiomyopathy develops, the SNS and which organ attempts to compensate for the falling cardiac output?

Answer 13

• Kidneys

Question 14

How do the SNS and kidneys compensate for the falling cardiac output (during the development of cardiomyopathy?

Answer 14

Increasing both the heart rate and the blood volume

Question 15

The following clinical manifestations of dilated cardiomyopathy often develop insidiously:

Answer 15

Dyspnea
Fatigue
Nonproductive cough
Orthopnea (difficulty breathing while lying down)
Paroxysmal nocturnal dyspnea (difficulty breathing at night)
Dysrhythmias
Angina (cardiac chest pain that often occurs with exertion)
Dizziness
Activity intolerance
Blood pressure changes
Tachycardia
Murmurs
Abnormal lung sounds (e.g., crackles and wheezes)
Tachypnea
Peripheral edema
Ascites (fluid in the peritoneal cavity)
Weak pedal pulses
Cool, pale extremities
Poor capillary refill
Hepatomegaly
Jugular vein distention

Question 16

Dilated cardiomyopathy affects only?

Answer 16

Systolic Function

Question 17

Diagnostic procedures for dilated cardiomyopathy include?

Answer 17

echocardiogram
EKG
chest X-ray
heart catheterization
 nuclear studies

Question 18

Hypertrophic cardiomyopathy affects both

Answer 18

systolic and diastolic function

Question 19

What increases the risk for developing Hypertrophic Cardiomyopathy?

Answer 19

• Hypertension
• obstructive valvular disease
• thyroid disease

Question 20

With hypertrophic cardiomyopathy what part of the heart is most frequently affected?

Answer 20

The septum between the ventricles

***Enlarged Stiff Septum

Question 21

During hypertrophic cardiomyopathy, what happens to the hypertrophied ventricle wall?

Answer 21

The hypertrophied ventricle wall becomes:

• Stiff
• Unable to relax during ventricular filling

Question 22

What happens to the cardiac output when there is a reduction in ventricular filling?

Answer 22

• cardiac output decreases

Question 23

With a reduction in ventricular filling, cardiac output decreases. What happens to the atrial and pulmonary pressures

Answer 23

atrial and pulmonary pressures increase

Question 24

The hypertrophied myocardium compresses blood vessels, reducing?

Answer 24

• tissue perfusion

- causing ischemia

Question 25

In addition to hypertrophy, the myocardium becomes ?

Answer 25

• Fibrotic

- Forms scars

Question 26

When the myocardium forms scars, what happens to the electrical impulses of the heart?

Answer 26

They do not conduct electrical impulses properly, Arrhythmias can develop

Question 27

Which population does Hypertrophic Cardiomyopathy

cause sudden cardiac death?

Answer 27

Young people, especially young athletes

Question 28

Clinical manifestations of hypertrophic cardiomyopathy are similar to those associated with dilated cardiomyopathy:

Answer 28

• Dyspnea on exertion
• Fatigue
• Syncope
• Orthopnea
• Angina
• Activity intolerance
• Dysrhythmias
• Left ventricular failure
• Myocardial infarction

Question 29

Hypertrophic Cardiomyopathy Treatment goals include?

Answer 29

• reducing ventricular stiffness
• improving ventricular filling
• enhancing cardiac output
• Beta-adrenergic blocking agents and calcium-channel blocking agents are often included in the medication regimen.
• Surgical removal of excess myocardium may be necessary for those patients who do not respond well to medications.
• Treatment of any dysrhythmias and hypertension may also be warranted.

Question 30

What type of activity should be avoided to prevent sudden death that could be associated with hypertrophic cardiomyopathy?

Answer 30

strenuous activity (e.g., running)

Question 31

Restrictive Cardiomyopathy (least common) is?

Answer 31

characterized by rigidity of the ventricles, but the myocardium does not thicken.

*****Walls of Ventricles become stiff

Question 32

In Restrictive Cardiomyopathy what happens to the ventricles as a result of rigidity of the ventricles?

Answer 32

ventricles do not relax and fill

Question 33

In Restrictive Cardiomyopathy when the ventricles do not relax and fill, what type of dysfunction does it lead to?

Answer 33

Diastolic Dysfunction

Question 34

As restrictive cardiomyopathy progresses, what happens to the myocardium and the cardiac contractility?

Answer 34

• myocardium weakens

- cardiac contractility becomes ineffective

Question 35

Causes of restrictive cardiomyopathy include the following conditions:

Answer 35

• Amyloidosis (buildup of fat and proteins in the heart muscle)
• Hemochromatosis (excessive amounts of iron in the heart)
• Radiation exposure to the chest
• Connective tissue diseases
• Buildup of scar tissue after a myocardial infarction
• Sarcoidosis (cellular growths on various organs)
• Cardiac neoplasms

Question 36

Many cases are asymptomatic, but the following clinical manifestations may also appear with restrictive cardiomyopathy:

Answer 36

• Fatigue
• Dyspnea
• Orthopnea
• Abnormal lung sounds
• Angina
• Hepatomegaly
• Jugular vein distention
• Ascites
• Murmurs
• Peripheral cyanosis
• Pallor