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Cardio Exam 2 Remediation > Cardiomyopathy > Flashcards

Cardiomyopathy Flashcards

1
Q

Cardiomyopathy

A

Any condition leading to an abnormally functional morphological abnormal myocardium

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2
Q

3 Cardiomyopathies

A

Dilated
Restrictive
Hypertrophic

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3
Q

How do most cardiomyopathies present?

A

Like heart failure

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4
Q

Best diagnostic modality for cardiomyopathy

A

ECHO!!!

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5
Q

Systolic dysfunction

A

Can’t contract the ventricles and empty them like we used to - ventricles pump harder - going to eventually have diatolic dysfunction

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6
Q

Diastolic dysfunction

A

LV can’t stretch - Ventricle made of glass

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7
Q

Myocarditis

A

Infectious or non-infectious process leads to necrosis. May lead to dilated cardiomyopathy

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8
Q

Two main mechanisms of cardiomyopathy

A

Autoimmune or infectious

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9
Q

Acute phase of myocarditis

A

Substernal, pleuritic chest pain
First 2 weeks
Fever

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10
Q

Chronic phase of myocarditis

A

Autoimmune - after the first two weeks

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11
Q

4 infectious causes of myocarditis

A

Adenovirus
COVID-19
Coxsackie virus
Cytomegalovirus

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12
Q

3 noninfectious causes of myocarditis

A

Alcohol
Cocaine
Anthracyclines

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13
Q

Myocarditis presentation

A

Acute febrile illness
SOB, Pleural chest pain, may present with HF, arrhythmias
No hx of heart problems

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14
Q

Best position to hear pericardial friction rub

A

Leaning forward

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15
Q

Four Initial tests for myocarditis

A

EKG - Sinus tachy, dysrhythmia, ST-T changes
Cardiac biomarkers - Elevated troponins (may have to cath)
CXR - Enlarged cardiac silloette
Increased/Reduced uptake of dye on cardiac MRI

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16
Q

Only true way to diagnose myocarditis -gold standard

A

A heart biopsy - only get if it will change presentation - patient decompensating rapidly and we have no idea what is going on

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17
Q

NSAIDs and IHD

A

NOT indicated

18
Q

Dilated cardiomyopathy

A

Big, dilated left ventricle with low ejection fraction, #1 reason for a heart transplant
Systolic dysfunction

19
Q

Presentation of dilated cardiomyopathy on PE

A

Valvular disorders
Arrhythmias
Pulsus alternans d/t limited emptying
S3 gallop
HF symptoms

20
Q

Etiologies of dilated cardiomyopathy

A

Pregnancy - usually go back to baseline
Lyme
Chagas
Alcohol
AF, SVT, AVNRT

21
Q

DCM etiolology mneumonic

A

Alcohol
Beri beri
Coxsackie
Cocaine
Chagas
Doxirubicin toxicity

22
Q

Diagnosis for DCM

A

Echo and BNP/pro-BMP

23
Q

Treatment for DCM

A

CHF management
Heart Transplant
Defibrillator

24
Q

Restrictive cardiomyopathy

A

Fibrosis leading to a DIASTOLIC dysfunction
Bi-atrial enlargement

25
Q

6 Etiologies of restrictive cardiomyopathy

A

Amyloidosis
Sarcoidosis
Hemochromatosis
Fabry disease
Radiation
Fatty infiltration

26
Q

Diagnosis and treatment for restrictive cardiomyopathy

A

Echo or MRI, may consider Biopsy
Treat HF and Underlying cause

27
Q

Hypertrophic cardiomyopathy

A

Typically a genetic issue
Septal buildup of myocytes - block the aortic valve
Worse with exercise, standing, valsalva
DIASTOLIC dysfunction

28
Q

Presentation of hypertrophic cardiomyopathy

A

Fatigue, chest pain, aortic stenosis like murmur - worse with valsalva, better with squatting
Sudden death

29
Q

Diagnostics of hypertrophic cardiomyopathy

A

LVH on EKG
ECHO with LV wall over 1.5 cm thick

30
Q

Management of hypertrophic CM non invasive

A

Activity restriction
BB or Verapamil
Avoid diuretics or vasodilators

31
Q

Invasive management of hypertrophic cardiomyopathy

A

Septal myectomy or alcohol septal ablation

32
Q

Screening of HTCM

A

Screen first degree relatives - annual echo until 20, then Q5 years

33
Q

MCC of HF in US

A

Ischemic cardiomyopathy

34
Q

Ischemic cardiomyopathy

A

Characterized by systolic dysfunction
Presentation - CHF
Usually LV dysfunction
Regional wall abnormality on Echo - akinetic

35
Q

Management of ischemic cardiomyopathy

A

Nuclear viability scan for hibernation
Revascularization
Manage CHF
ICD/Wearable defibrillator

36
Q

Arrhythmogenic right ventricular cardiomyopathy

A

RV free wall myocardium is replaced by fibrous/fatty tissue
Sudden death in YAs
More common in europe

37
Q

Left ventricular noncompaction

A

Congenital - CHF, etc. at birth
Heart wall looks like spongy bone
Usually need a heart transplant

38
Q

Stress induced/Takutsobu Cardiomyopathy

A

Broken heart syndrome
STEMI in the absence of CAD
Due to an intense psychological stressor

39
Q

MC patient for stress induced cardiomyopathy

A

Postmenopausal women

40
Q

Diagnosis and tx for stress induced cardiomyopathy

A

LV apical ballooning!!! on echo or LV angiography
Almost all patients recover in a few weeks - BB for 1 year

41
Q

Key sign for stress induced cardiomyopathy

A

LV apical ballooning

Cardio Exam 2 Remediation (7 decks)

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