Cardiomyopathy

Question 1

cardiomyopathy

Answer 1

Contraction and relaxation of the myocardial muscle fibers are impaired

Question 2

primary causes of cardiomyopathy

Answer 2

Pathological process in heart muscle

Question 3

Secondary causes of cardiomyopathy

Answer 3

result of systemic disease processes

Hypertension, valve disease, amyloidosis, toxicity, inflammatory

Question 4

types of cardiomyopathies

Answer 4

Dilated- dilation of ventricles/ backing up of fluid (cardiomegaly)

Hypertrophic- increased wall thickness/ impaired filling, impaired ventricular diastolic pressure, increased left atrial pressure

Restrictive- stiff heart, cant relax, replaced with scar tissue, decreased output, S4

Question 5

What is the most common cause of congestive heart failure?

Answer 5

CMD
Cardiac muscle dysfunction

Question 6

cause of CMD

Answer 6

Abnormality of cardiac structure or function

Question 7

CMD

Answer 7

Impaired aerobic capacity
Impaired endurance due to cardiovascular pump dysfunction or failure

Question 8

Etiology of CMD

Answer 8

hypertension, heart failure, CAD, cardiac arrhythmias

Renal insufficiency, heart valve abnormalities, acquired heart disease

Pericardial effusion , myocarditis, spinal cord injury, pulmonary embolism

Pulmonary hypertension , age related changes

Question 9

heart failure and CMD

Answer 9

Left ventricular hypertrophy

Question 10

Hypertension and CMD

Answer 10

increased arterial pressure leads to ventricular hypertrophy

Leads to overstretched contractile fibers, and less effective pump

Question 11

Coronary artery disease and CMD

Answer 11

myocardial infarction ischemia

Second most common cause

Dysfunction of left or right ventricle or both from MI

Question 12

Renal insufficiency and CMD

Answer 12

acute or chronic insufficiency produces fluid overload on the heart

Primary treatment is to decrease reabsorption of fluid from kidneys

Diuretics Lasix
Dialysis

Question 13

Heart valve abnormalities, and CMD

Answer 13

blocked valve or incompetent valves, cause heart muscle to contract more forcefully

Associated with myocardial, dilation, and hypertrophy

Surgeries include valve replacement, valvuloplasty valvulotomy

Question 14

congenital or acquired heart disease and CMD

Answer 14

Altered embryonic development of normal structure, or failure of structure to develop

Most common abnormalities are congenital bicuspid, aortic valve and leaflet abnormality associated with mitral valve prolapse

Question 15

Pericardial effusion or myocarditis and CMD

Answer 15

injury to pericardium inflammation of pericardial sac
Pericarditis leads to pericardial effusion

Cardiac tamponade, elevated cardiac pressures, limited ventricular diastolic filling, reduced stroke volume

Medical management nonsteroidal, anti-inflammatory agents or cortical steroids pericardiocentesis

Question 16

Spinal cord injury, and CMD

Answer 16

typical in cervical spine injuries

Causes imbalance in parasympathetic and sympathetic control

Lack cardiovascular adaptations

Neurogenic edema in lungs

Cardiac filling pressures must be monitored

Question 17

pulmonary embolism and CMD

Answer 17

elevated pulmonary artery pressures increase right ventricular work

Potentially life threatening

Medical management
rapidly acting fibrinolytic agent like heparin
Sedative to decrease anxiety and pain
Oxygen
Embolectomy

Question 18

pulmonary hypertension and CMD

Answer 18

Defined by mean pulmonary artery pressure

Abnormal if greater than 25 mm Hg
in patients with COPD if greater than 20 mm Hg

Question 19

age Related changes and CMB

Answer 19

Aging decreases cardiac output by altering contraction and relaxation of cardiac muscle

Higher prevalence of heart, disease, hypertension, and other pathological processes in older population

increase systolic arterial pressure
Decreased aortic distensibility
Develop left ventricular hypertrophy
Selective decrease in beta adrenergic receptor
Increase pericardial and myocardial stiffness and delayed relaxation