Cardiomyopathy Disease States Flashcards
What is the most common CMO?
Dilated Cardiomyopathy
Dilated Cardiomyopathy is also referred to as _____
Congestive CMO
What is a disease that diffusely affects the myocardium, resulting in enlargement and/or ventricular dysfunction?
Cardiomyopathy
What are the three main categories of CMO?
Dilated CMO, Hypertrophic CMO (Obstructive & Non-Obstructive), and Restrictive/Infiltrative CMO.
Dilated CMO is known for its _____ and ______ systolic and diastolic function.
“Multi-Chamber” enlargement and “Decreased” systolic and diastolic function.
When evaluating 2-D echo of a patient with Dilated CMO what may be present due to the decreased flow pattern?
Spontaneous echo contrast
“Smoke”
What are the causes for Dilated CMO?
(Numerous)
-Idiopathic
-Ischemic; CAD
-Infections/viral- AIDS, others
-Toxic; Alcohol, cocaine
Chemo-Adriamycin, others
-Parasitic Diseases
-Pregnancy (peripartum)
-Hemochromatosis
-Ventricular noncompactionWhat are the clinical symptoms for Dilated CMO?
- Heart failure (pulmonary or systemic congestion)
- Low cardiac output/low BP
- Valvular regurgitation
- Arrythmias, afib
- Embolic events
What are the 2-D findings of DCM?
- Dilated chambers, increased volumes/mass, spherical shaped
- Normal to thinned wall thickness
- Reduced global systolic & diastolic function
- Reduced Co
- LV smoke
In M-Mode of DCM the increased EPSS is proportional to the _____
Reduced EF
On DCM M-Mode what does a B-Bump indicate?
Increased LVEDP
Typically >15 mmHg
With what CM is the double diamond pattern of MV on M-Mode associated with?
DCM
What are some other causes of DCM?
Long-standing HTN heart disease
LV non-compaction (honey comb apex; spongy)
(DCM) Aortic cusps that have a tapered appearance at closure vs. a crisp closure is due to what?
Reduced forward flow from poor systolic function; note reduced aortic root motion
Which CM is known for its hypertrophic, hyperdynamic, non-dilated left ventricle that is frequently, but not necessarily, associated with a left ventricular outflow tract obstruction (LVOTO)?
HCMO
What is an inherited autosomal dominant disease of the myocardium?
HCMO
Does HCMO primarily affect diastolic or systolic function?
Diastolic Function
ASH and SAM are hallmark findings of what CM?
HOCM
What is ASH?
asymmetric septal hypertrophy
What is SAM?
Systolic Anterior Motion of the mitral valve apparatus seen during systole.
With HOCM a LVOTO is created by ______
The small, hyperdynamic left ventricular cavity, ASH, and SAM.
Which CM presents a high risk of sudden death during exercise?
HOCM
What are the clinical symptoms of HCM?
- Asymptomatic (HCM)
- Dyspnea, PND, orthopnea
- Angina
- Arrythmias
- Exercise Intolerance
- Heart Failure
- Syncope
Myocardial fiber disarray is a hallmark finding for which CM?
HOCM
especially seen in IVS-speckling, ground glass reflection
Aortic valve notching (partial mid-systolic closure) of the aortic valve due to a sudden decrease in cardiac output is a M-Mode finding associated with which CM?
HOCM
A dagger shaped aortic flow profile is associated with which CM?
HOCM
Which CM is more common in Asian populations?
Asymmetic Apical Hypertrophy
Which CM has an “Ace of Spades” appearance of the LV at end diastole?
AAH
Asymmetric Apical Hypertrophy
Which CM presents with massive hypertrophy which only affects the apex?
AAH
No LVOT obstruction
Check for apical aneurysm
Which CMO involves the infiltration of the myocardium that results in stiff, rigid ventricular walls that impede diastolic fillinf?
Restrictive/Infiltrative
Which is the least common of all the CMO disease states?
RCMO
What are some 2-D findings associated with RCM?
Nml-small LV size Normal systolic function Bi-atrial enlargement Abnml texture; granular myocardium Concentric LVH possible
Which is the most common of the Restrictive/Infiltrative CMOs?
Amyloidosis
What is associated with Classic Amyloidosis?
Symmetric hypertrophied walls Abn myocardial texture Diffuse Valve thickening Bi-Atrial enlargement Restrictive Doppler pattern
RCM Doppler includes ____
- Short early filling, little atrial contribution Big E, little A
- Shortened Mdt
- Shortened IVRT
- E/A ratio >2.0
Which RCM is marked by abnormal inflammatory masses (granulomas) that infiltrate various organs?
Sarcoidosis
Which RCM is the most common iron overload disease that may result in multiple organ and tissue damage?
Hemochromatosis
What is a rare form of CM, which includes a fatty infiltration of RV muscle?
Arrythmogenic RV Dysplasia
ARVD (ACM)
ARVD
50% familial RV failure can result RVE, aneurysm,arrythmias Dilated RVOT RV wall motion abn's TR
Which CM is endemic to South & Central America?
Chagas’ Disease
Which CM is associated with a bite from a trypanosoma cruzi parasite?
Chagas’
What appearance does Chagas have on echo?
Apical aneurysm with a narrow neck
What are some treatments for CM’s?
Drug therapy of underlying cause Surgical myectomy/myotomy (HOCM) Bi-ventricular pacing Alcohol septal ablation Transplant
What presents as an acute infection with acute onset of LV systolic dysfx?
Acute myocarditis
