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Cardiology > Cardiomyopathy and Obstructive Sleep Apnea > Flashcards

Cardiomyopathy and Obstructive Sleep Apnea Flashcards

1
Q

What is the most important thing to control in HF?

A

Blood Pressure

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2
Q

Cardiomyopathy can lead to what?

A

Heart failure

Arrhythmias

Conduction Abnormalities

Thromboembolic strokes

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3
Q

Clinical forms of cardiomyopathy

A

Dilated MC

Hypertrophic

Restrictive (diastolic)

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4
Q

Dilated Cardiomyopathy etiologies and general characteristics

A

Common etiologies

  • Post Viral (MC)
  • EtOH
  • Cocaine
  • Familial
  • Post partum

4 Chamber cardiac enlargement

CO may be normal at rest, but does not adequately increase with exertion

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5
Q

Dilated Cardiomyopathy Physiology

A

EF <30% may improve with time and tx

RIsk for ventricular tachyarrhythmias and sudden death

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6
Q

Dilated Cardiomyopathy sxs

A

Non-specific non-ischemic CP

Syncope

Sxs of HF (DOE, PND, orthopnea, peripheral edema)

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7
Q

Dilated Cardiomyopathy PE

A

Cardiomegaly

Signs of L sided HF

  • Rales
  • Wheezing

Signs of R Sided HF

  • Edema
  • HJR
  • Concurrent signs of L sided HF
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8
Q

Dilated Cardiomyopathy Tx

A

Treat underlying cause

Tx HF

Tx arrhythmias and conduction disturbances

Prevent thromboembolic complications

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9
Q

Hypertrophic Cardiomyopathy Etiology

A

Genetic heterogenous autosomal dominant mutation in genes coding for sarcomeres

Lead to thickening of L ventricle and septum

Presents between ages 20-40

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10
Q

Hypertrophic Cardiomyopathy Physiology

A

EF >60%

L ventricular volume decreased (doesn’t eject as much blood)

Sxs: DOE, CP, syncope, palpitations

Risk for ventricular tacchyarrhythmias and A Fib

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11
Q

Common cause of sudden death in athletes

A

Hypertrophic cardiomyopathy

Syncopal episode during exercise is a warning sign of HD and requires cardio evaluation

EKG (makes Dx), Echo, Exercise stress test

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12
Q

Hypertrophic Cardiomyopic PE

A

Prominent L Ventricular Impulse

S4 gallop

Murmur along L sternal border that increases on expiration, increases going from squatting to standing

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13
Q

Etiology of Restrictive Cardiomyopathy

A

Infiltrative diseases: amyloidosis, sarcoidosis

Restrictive pericarditis

Chemo

Radiation

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14
Q

Restrictive Cardiomyopathy Physiology

A

Diastolic and systolic dysfunction

EF dec’d 25-50%

LV internal dimension decreased

Sxs: exertional intolerance

Risk for arrhythmia: ventricular, conduction block, A fib

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15
Q

Restrictive Cardiomyopathy PE

A

May be normal

May be signs of L sided HF

A fib may be present

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16
Q

Evaluation of Restrictive Cardiomyopathy

A

CXR

EKG

Echo

17
Q

Systolic dysfunction (Causes HF)

A

Inability of heart to contract strongly enough to supply blood to periphery

Primarily in dilated cardiomyopathy

18
Q

Diastolic Dysfunction (Causees HF)

A

Associated with reduced filling of the ventricle because heart cannot relax properly

Hypertrophic or Restrictive Cardiomyopathy

19
Q

Left Ventricular Failure

A

Acute MI

Papillary muscle rupture secondary to AMI

CAD

Cardiomyopathy

20
Q

Right Ventricular Failure

A

PE

Pumonary HTN

RV Infarct

Cardiomyopathy

21
Q

Can have L, R or Biventricular failure

True or False?

A

True

22
Q

High Output Failure

A

Heart is unable to meet abnormally high metabolic demands of peripheral tissue

Anemia, thiamine deficiency (EtOH, Refeeding Syndrome), Thyroid disorders

23
Q

Low Output Failure

A

insufficient forward output at rest or with increasing metabolic demands

Dilated, restrictive, ischemic cardiomyopathy

24
Q

Acute vs. Chronic Heart Failure

A

Previously normaly, develops HF because of AMI, papillary muscle rupture or PE

Pre-existing heart disease, can be compensated and then have decompensation

25
Q

HF/Cardiomyopathy Evaluation

A

H&P

EKG

CXR

Echo

MRI

Cardiac Cath

Lab Tests

Genetic Tests

26
Q

Left Sided HF PE

A

Rales & Wheezes

27
Q

R Sided HF PE

A

Distended neck veins, HJR

Peripheral Edema

28
Q

EKG Findings

A

LVH

Sum V1 + V5 or V6 >35mm

29
Q

Cardiomyopathy Cardiac Cath

A

Chamber size

EF

Valvular Function

Coronary Artery Anatomy

30
Q

Cardiomyopathy Labs

A

**BNP **

  • secreted by ventricles in setting of volume expansion and pressure overload
  • >100 indicates HF

Maybe also:

  • Thyroid function (TSH)
  • Drug screenings
  • Viral titers
  • Renal and liver function
31
Q

Pathophys of Sleep Apnea (2 kinds)

A

Obstructive–narrowing or collapse of upper airway (MC)

Central–absent drive to breathe

32
Q

Obstructive Sleep Apnea Sxs

A

Snoring

Nocturnal arousal

excessive daytime sleepiness

personality changes

intellectual deterioration

morning HAs

chronic fatigue

33
Q

Associated Disorders of Sleep Apnea

A

Obesity
Nasal obstruction
Adenoidal or tonsillar hypertrophy
Small jaw (micrognathia)
Macroglossia
Hypothyroidism

Neuromuscular disease

34
Q

Associated Cardio Disorders with Sleep Apnea

A

Systemic HTN

HF

Stroke

DM

Metabolic Syndrome

35
Q

Diagnosis of Sleep Apnea

A

Epworth Sleepiness Scale (normal 1-10)

H&P

Gold Standard–Sleep Study

36
Q

Treatment of Sleep Apnea

A

Weight loss

CPAP

Surgery

Treatment results in cardiac remodeling, improving cardiac function, improves metabolic syndrome, better sleep and decreased daytime sleepiness

Cardiology (12 decks)

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