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CMT > Cardiomyopathy > Flashcards

Cardiomyopathy Flashcards

1
Q

3 types of cardiomyopathy

A
  1. dilated (most common)
  2. restrictive
  3. hypertrophic
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2
Q

describe dilated cardiomyopathy

A
  • dilation of LV
  • muscle is too stretched
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3
Q

how can dilated cardiomyopathy occur?

6

A
  1. ischemic
  2. chemo
  3. idiopathic
  4. viral
  5. familial
  6. tachy mediated
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4
Q

describe restrictive cardiomyopathy

A
  • impaired diastolic filling
  • muscle can’t move
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5
Q

how can restrictive cardiomyopathy occur?

3

A
  1. amyloid
  2. infiltrative disorders
  3. familial
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6
Q

describe hypertrophic cardiomyopathy

A

thickening of muscle impairs LV filling/movement

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7
Q

how can hypertrophic cardiomyopathy commonly occur?

A
  1. Genetic (most common, autosomal dominant)
  2. medications (tacrolimus)
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8
Q

CHF

Describe what happens with Right HF?

4 things

A
  1. congestion of peripheral arteries
  2. GI tract congestion (anorexia, GI distress, wt. loss)
  3. Liver congestion (impaired liver function)
  4. edema & ascites
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9
Q

CHF

describe what happens with left HF?

4 things

A
  1. decreased CO (activity intolerance, reduced tissue perfusion)
  2. Pulmonary congestion
  3. Impaired gas exchange (cyanosis & hypoxia)
  4. Pulmonary Edema (frothy sputum, cough, paroxysmal nocturnal dyspnea, orthopnea)
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10
Q

CHF

what are the “fantastic 4” of meds for tx?

A
  1. BB: carvedilol or metoprolol
  2. RAAS (ARNI/ACE/ARB)
  3. MRA (spironolactone)
  4. SGLT-2
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11
Q

CHF

what education to provide?

A
  1. diet
  2. wt
  3. sx to watch for
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12
Q

Dilated Cardiomyopathy

what is typical EF for dilated CM?

A

< 40%

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13
Q

Dilated Cardiomyopathy

mortality rate over 5 years?

A

50%

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14
Q

Dilated Cardiomyopathy

signs & sx

5

A
  1. gradual development of HF sx
  2. progressive dyspnea on exertion
  3. impaired exercise ability
  4. orthopnea
  5. peripheral edema
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15
Q

Dilated Cardiomyopathy

PE findings

8

A
  1. rales
  2. cardiomegaly
  3. S3 audible
  4. peipheral edema
  5. elevated JVP
  6. sinus tachy
  7. +/- mitral/tricuspid regurgitation
  8. +/- arrhythmias
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16
Q

Dilated Cardiomyopathy

Dx

A
  1. Labs: BNP, CMP, CBC, TSH
  2. Echo
  3. Heart Cath (+/-)
  4. CXR (+/-)
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17
Q

Dilated Cardiomyopathy

what is seen on echo?

3

A
  1. dilated LV
  2. decreased EF
  3. ventricular hypokinesis
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18
Q

Dilated Cardiomyopathy

what is seen on CXR?

3

A
  1. cardiomegaly
  2. pulm edema
  3. pleural effusion
19
Q

Dilated Cardiomyopathy

Tx

2- Always

A
  1. HF meds (BB, ARNI/ACE/ARB, spironolactone, SGLT-2)
  2. avoid cardiotoxic agents + CCB
20
Q

Dilated Cardiomyopathy

+/- Tx options

3

A
  1. ICD (EF < 35% 90d post QDMT)
  2. CRT (EF < 35% w/ wide QRS 90d post GDMT)
  3. Referral for LVAD/transplant
21
Q

Dilated Cardiomyopathy- Takotsubo

describe

A

broken heart syndrome, occurs after surge of catecholamines

22
Q

Dilated Cardiomyopathy- Takotsubo

common in who?

A

postmenopausal women

23
Q

Dilated Cardiomyopathy- Takotsubo

resovles after how long with GDMT?

A

6 mo- is transient

24
Q

Dilated Cardiomyopathy- Takotsubo

Management & Disposition

4

A
  1. repeat echo
  2. BB
  3. ACE/ARB/ARNI
  4. Spironolactone
25
Q

Hypertrophic Cardiomyopathy

signs & sx

4

A
  1. dyspnea
  2. chest pain
  3. post-exertional syncope
  4. sudden cardiac death
26
Q

Hypertrophic Cardiomyopathy

PE findings

A
  1. harsh systolic murmur on S4
  2. bisferiens carotid pulse
  3. enlarged PMI
27
Q

Hypertrophic Cardiomyopathy

what increases/decreases murmur?

2 then 4

A
  1. valsalva, standing (decreased venous return)
  2. squatting, supine, leg raise, hand grip (increased venous return)
28
Q

Hypertrophic Cardiomyopathy

Dx

4

A
  1. echo
  2. EKG
  3. Genetic testing
  4. preg counseling
29
Q

Hypertrophic Cardiomyopathy

what is seen on EKG?

A

LVH

30
Q

Hypertrophic Cardiomyopathy

what is seen on echo?

3

A
  1. repeat w/ exercise, valsalva
  2. asymmetric septal wall thickening (> 1.5 cm)
  3. systolic anterior motion of mitral valve w/ small LV chamber
31
Q

Hypertrophic Cardiomyopathy

Tx

6

A
  1. BB, CCB, disopyramide
  2. Avoid dehydration
  3. maintain NSR
  4. surgical myectomy
  5. alcohol ablation
  6. +/- ICD/DDD pacing
32
Q

Hypertrophic Cardiomyopathy

Rec for athletic activity

A
  1. avoid most competitive sports
  2. low-risk older pts can participate given certain factors are absent
33
Q

Restrictive Cardiomyopathy

characterized by?

A

nondilated, rigid ventricles with impaired ventricular filling (diastolic dysfunction)

34
Q

Restrictive Cardiomyopathy

which side HF is more common? what is seen with it?

A
  1. R > L
  2. pulm HTN, decline in activity tolerance
35
Q

Restrictive Cardiomyopathy

signs & sx

6

A
  1. dyspnea
  2. peripheral edema
  3. palpitations
  4. fatigue
  5. weakness
  6. exercise intolerance
36
Q

Restrictive Cardiomyopathy

what must be ruled out?

A

constrictive pericarditis

37
Q

Restrictive Cardiomyopathy

if caused by amyloidosis, what signs/sx can be expected? which organs are involved?

5 sx, 2 organs

A
  1. periorbital purpura
  2. thickened tongue
  3. hepatomegaly
  4. diarrhea
  5. wt loss
  6. kidney & heart most commonly involved
38
Q

Restrictive Cardiomyopathy

Physical Exam Findings

6

A
  1. R sided failure
  2. elevated JVP
  3. ascites
  4. edema
  5. S3 audible
  6. Kussmaul’s sign pos
39
Q

Restrictive Cardiomyopathy

what is kussmaul’s sign?

A

increase in jugular venous pressure w/ inspiration

40
Q

Restrictive Cardiomyopathy

dx

A
  1. EKG- low voltage
  2. Echo
  3. Cardiac MRI
  4. Pulmonary HTN
  5. Biopsy (amyloidosis)
41
Q

Restrictive Cardiomyopathy

Echo findings

5

A
  1. thickened LV and RV walls
  2. biatrial enlargement
  3. elevated atrial pressure
  4. normal systolic function
  5. poor diastolic function
42
Q

Restrictive Cardiomyopathy

cardiac MRI findings

1

A

diffuse hyper enhancement

43
Q

Restrictive Cardiomyopathy

what is associated with amyloidosis on biopsy?

A

apple-green birefringence w/ congo-red staining

44
Q

Restrictive Cardiomyopathy

Tx

4

A
  1. treat underlying disorder
  2. +/- diuretics
  3. Amyloidosis- chemo, +/- stem cell transplant
  4. cardiac transplant

CMT (78 decks)

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