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SP: Cardiology Pearls (16%) > Cardiomyopathy > Flashcards

Cardiomyopathy Flashcards

1
Q

What is the definition of cardiomyopathy?

A

heart disease resulting from a primary abnormality in the myocardium

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2
Q

List two types of surgical procedures to correct HOCM.

A

Open heart and excision - Alcohol ablation done through cardiac cath

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3
Q

What heart sound will likely be present with HOCM?

A

S4

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4
Q

List three medications which may be used both to prevent arrhythmia and ease symptoms with HOCM.

A

Diuretics
Beta blockers
Non-dihydropyridine CCB (verapamil or diltiazem)

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5
Q

Once a patient is diagnosed with HOCM what family counseling must be done?

A

Entire family must be screened for HOCM

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6
Q

Angina syncope and heart failure in a child likely represents ____________.

A

HOCM (Hypertrophic Cardiomyopathy)

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7
Q

Constrictive Cardiomyopathy occurs by what mechanism?

A

Pericardial sac constricts

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8
Q

Restrictive Cardiomyopathy occurs by what mechanism?

A

Deposition into or between the myocardial cells

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9
Q

What causes the sudden cardiac death in a HOCM patient?

A

Ventricular tachycardia that degenerates into ventricular fibrillation

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10
Q

What maneuver makes the HOCM murmur louder?

A

Valsalva or standing

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11
Q

What are the signs of HOCM on exam?

A

Apical lift
S4 gallop
Ejection murmur medial to apex

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12
Q

What is the treatment for dilated cardiomyopathy?

A

Same as systolic heart failure

Beta blocker, Loop Diuretic, ACE inhibitor

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13
Q

What are the three categories of cardiomyopathy and which is the most common?

A

Dilated (90%)
Hypertrophic
Restrictive

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14
Q

What do low ejection fraction and hypertrophic (HOCM) heart have in common?

A

Sudden death due to VT

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15
Q

What is the ejection fraction in a cardiomyopathy?

A

less than 40% (in the presence of increased left ventricular dimension)

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16
Q

Which chamber is most affected in cardiomyopathies?

A

Left ventricle

17
Q

What chambers are affected (and how) in Dilated cardiomyopathy?

A

enlargement and dilation of all four chambers

18
Q

What is the most common cause of non-ischemic DCM in the US?

A

chronic alcoholism

19
Q

What is the second most common cause of non-ischemic cardiomyopathies? (#1 in other parts of the world)

A

viral myocarditis

20
Q

What is damaged in DCM and what does it result in?

A

myocytes are injured and necrosis occurs with myocardial fibrosis when muscle cells fail they dilate

21
Q

Does DCM have a systolic or diastolic dysfunction

A

systolic

22
Q

What is the number one specific cause of dilated cardiomyopathy overall?

A

Ischemic cardiomyopathy (more than 60% of patients with heart failure have this)

23
Q

What is seen histologically in DCM?

A

nonspecific abnormalities-variations in myocyte size\n-myocyte vacuolization-fibrosis and fat replace myocardium

24
Q

How does alcoholism lead to DCM?

A

alcohol destroys microvilli brush border and leads to nutritional deficits (thiamine in particular) (glutamine helps regenerate)
alcohol is toxic to cardiac tissue-> myocyte death

25
Q

What does the heart of someone with DCM resemble?

A

basketball

26
Q

In which chamber are changes seen in HCM?

A

LVH w/o ventricular chamber dilation

27
Q

What is HCM characterized by?

A

myocardial hypertrophy
abnormal diastolic filling
1/3 of cases
intermittent ventricular outflow obstruction

28
Q

Which wall of the ventricle is more hypertrophic in HCM?

A

the septum of the L ventricle is larger than the free wall

29
Q

What is seen histologically in HCM?

A

hypertrophy of myocardial fibers\n-interstitial fibrosis

30
Q

Where is the mutation that leads to HCM located?

A

any one of several genes that encode proteins within the sarcomere

31
Q

What is seen on an Echo for HCM?

A

hypertrophic septum and LV wall\n-small ejection fraction

32
Q

What happens to the myocardium in restricted cardiomyopathy?

A

The myocardium is infiltrated with abnormal tissue-> impaired ventricular wall motion and abnormal contraction and relaxation

33
Q

What are three causes of restrictive cardiomyopathy and which are the most common?

A

amyloidosis- most common\n \n-hemochromatosis-most common\niron overload(genetic)- kills cell\n \n-sarcoidosis

34
Q

What population is most susceptible to RCM?

A

men of northern European descent

35
Q

List 6 causes of restrictive cardiomyopathy

A 
Amyloidosis
Hemochromatosis
Sarcoidosis
Scleroderma
Fibrosis
Cancer

SP: Cardiology Pearls (16%) (12 decks)

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