Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio final > Cardiomyopathy and Pericardial Disease Large Group-Silverstien > Flashcards

Cardiomyopathy and Pericardial Disease Large Group-Silverstien Flashcards

1
Q

What is responsible for Chagas Disease? Where is this most common?

A

Parasite Trypanosoma cruzi

transmission by leaving feces on skin and biting–> get into circulation

common in Central and South America

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When will the titer be high in Chagas Disease? What are the symptoms at this stage and can it be cured?

A

Acute phase

usually asymptomatic but can cause myocarditis.

can cure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does chronic Chagas Disease often cause?

A

inflammation leading to chronic multifocal fibrosing myocarditis –> conduction problems

hard to treat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What EKG changes are classic for Chagas? Presentation?

A

Classic : RBBB +/- LAFB , Multiform PVCs, Ventricular tachycardia

often presents as a young person who travelled to central/south america

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What findings are associated with chronic Chagas?

A

apical aneurysm

progressive biventricular systolic dysfunction

thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Who should you treat for Chagas? What is the treatment? (3)

A

those under 50 yo with chronic infection without end-stage cardiac disease

acute infection

congenital infeciton

chronic in children

immunosuppressed

Treatment:
Benznidazole, nifurtimox and amiodarone (anti-trypanosomal activity, NOT anti-arrhythmic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the potential causes for dilated cardiomyopathy?

A
  • idiopathic
  • familial
  • inflammatory (inc. CT diseases and sarcoidosis)
  • toxic (chronic EtOH and chemo drugs)
  • metabolic: hypothyroid and chronic hypocalcemia
  • neuromuscular: muscular or myotonic dystrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the hallmark finding in hypertrophic cardiomyopathy?

A

asymmetric septal hypertrophy in the absence of chronic pressure overload (HTN or aortic stenosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common cause of sudden cardiac death in young athletes in the US?

A

hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the genetic mutation in hypertrophic cardiomyopathy?

A

genes for sarcomere proteins (beta myosin heavy chain, myosin binding protein C are the most common)

autosomal dominant but not 100% penetrance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes sudden death in pts with hypertrophic cardiomyopathy?

A

monomorphic V tach due to fibrosis and myofibrillar disarray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What PE findings will there be in association with hypertrophic cardiomyopathy?

A

Crescendo-decrescendo murmur at LLSB that increases with Valsalva (enlargement of the septum can cause sub aortic stenosis that will worsen with decreased preload)

May have accompanying MR murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What ECG findings are seen in hypertrophic cardiomyopathy?

A

Giant, “dagger like” Q waves in the lateral leads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the pharmacological treatment of hypertrophic cardiomyopathy? What should be avoided?

A

Treatment:

  • beta blockers
  • Ca2+ channel blockers
  • DIsopyramide (dec contractility)

AVOID nitrates–> cause decrease preload=BAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the only thing that reduces the mortality risk in hypertrophic cardiomyopathy? Who should receive this treatment?

A

AICD (defibrillator)

indications:

  • family hx of sudden death
  • wall thickness >30 mm
  • unexplained syncope
  • hx of ventricular arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Kussmaul’s sign? What can cause it?

A

JVP rises with inspiration

Restrictive and Constrictive Pericarditis

17
Q

What is the most likely diagnosis in a pt with SEVERE bi-atrial enlargement?

A

restrictive pericarditis/cardiomyopathy

this is a diastolic heart failure–> ventricles are non-compliant and require high P in the atria to fill –> cause the atria to enlarge

18
Q

What is the disease associated with ventricular thickening without systolic dysfunction but low voltage on an EKG?

A

amyloidosis

19
Q

What is the number one cause of Restrictive Cardiomyopathy? How is this diagnosed?

A

amyloidosis –> misfolded fibrils deposit in the tissue

can be caused by a plasma cell tumor –> multiple myeloma

  • consider with renal, neuropathy, macroglossia and easy bruising in weird places (nasal folds)
  • diagnose with congo red stain-green birefringence
20
Q

What heart sound is associated with pericarditis?

A

Friction rub with 3 phases (heard best with the pt leaning forward and exhaling)

21
Q

What is the treatment for pericarditis? What should be avoided?

A

NSAIDS and high dose Aspirin –> normally self-limited 1-3 weeks

AVOID steroids (inc likelihood of recurrent pain)

22
Q

What is the number one cause of constrictive pericarditis? What are some other causes?

A

Tuberculosis–> pericardial thickening and blood fluid

malignant (lung, breast, lymphoma), bacterial, post-MI, Uremic, radiation, rheumatologic, drug induced (procainamide)

23
Q

If tamponade is suspected, what test should be done immediately?

A

Echo

should see early diastolic RV collapse and late diastolic RA collapse

-respiratory variation in output >25%

24
Q

What is Beck’s Triad for Cardiac Tamponade?

A
  1. tachycardia and hypotension
  2. muffled heart sounds
  3. Jugular venous distension
25
Q

What is pulses paradoxus?

What is associated with a wide pulsus?

A

pulsus=fall in systemic Pressure >10 mmHg during inspiration

Take BP. at first, hear sounds in expiration only and then measure until you hear constant sounds and measure the difference. >10-12 is significant

*cardiac tamponade

26
Q

What can cause a rapid pericardial effusion? A slow?

Which type will be able to hold more volume before the pt experiences tamponade?

A

Rapid: punctures of the wall, aortic dissection –> bleeding into the pericardial space

slow: heart failure, lupus, renal failure

slow can accommodate more volume

27
Q

What ECG finding is associated with cardiac tamponade?

A

changes in the appearance (height) of the QRS from the heart swinging.

Low voltage
limb leads <10

28
Q

What chest x-ray finding is associated with cardiac tamponade?

A

Enlarged cardiac silhouette
Globular
“Water bottle”

29
Q

What is the gold standard for cardiac tamponade?

A

Right heart cath

BLUNTED Y descent in RA

(Y descent is ventricular filling)

30
Q

What is the treatment of cardiac tamponade?

A

pericardiocentesis (removal of the fluid)

31
Q

Will pulsus or Kussmaul be seen in constrictive pericarditis?

A

Kussmaul will (blood will pool in the veins and distend them in inspiration)

not pulsus because the stiff pericardium does not respond to the change in intrathoracic pressure well

32
Q

What disease has a RA STEEP Y descent? Why?

A

constrictive pericarditis because the ventricles will be allowed to fill rapidly and then shut off quickly by the rigid pericardium

Cardio final (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions