Chapter 40: Cardiomyopathy Flashcards
Which type of cardiomyopathy is characterized by ventricular dilation and impaired systolic function?
A. Hypertrophic cardiomyopathy
B. Dilated cardiomyopathy
C. Restrictive cardiomyopathy
D. Arrhythmogenic right ventricular dysplasia
B. Dilated cardiomyopathy
Rationale: Dilated cardiomyopathy is characterized by ventricular dilation and impaired systolic function, often leading to heart failure.
A 45-year-old patient with a history of hypertension presents with a heart murmur, dyspnea, and chest pain. An echocardiogram reveals thickening of the ventricular walls. Which type of cardiomyopathy is most likely?
A. Dilated cardiomyopathy
B. Hypertrophic cardiomyopathy
C. Restrictive cardiomyopathy
D. Ischemic cardiomyopathy
B. Hypertrophic cardiomyopathy
Rationale: Hypertrophic cardiomyopathy is characterized by thickened ventricular walls, which can obstruct blood flow and cause symptoms like dyspnea and chest pain.
Which of the following is the most common cause of restrictive cardiomyopathy?
A. Coronary artery disease
B. Hypertension
C. Viral infections
D. Amyloidosis
D. Amyloidosis
Rationale: Restrictive cardiomyopathy is often caused by infiltrative diseases like amyloidosis, where abnormal proteins accumulate in the heart muscle.
A patient with dilated cardiomyopathy is prescribed ACE inhibitors and beta-blockers. Which of the following is the primary goal of this pharmacologic therapy?
A. To increase the heart rate and contractility
B. To correct electrolyte imbalances
C. To reduce fluid retention
D. To reduce preload and afterload
C. To reduce preload and afterload
Rationale: ACE inhibitors and beta-blockers are used to reduce preload and afterload in patients with dilated cardiomyopathy, improving heart function and reducing heart failure symptoms.
Which diagnostic test is considered the gold standard for diagnosing hypertrophic cardiomyopathy?
A. Electrocardiogram (ECG)
B. Chest X-ray
C. Echocardiogram
D. Cardiac MRI
C. Echocardiogram
Rationale: An echocardiogram is the gold standard for diagnosing hypertrophic cardiomyopathy, as it can detect ventricular wall thickening and assess for obstruction.
A 60-year-old patient with restrictive cardiomyopathy presents with fatigue and edema. Which diagnostic test is most likely to be ordered to assess myocardial stiffness?
A. Echocardiogram
B. Cardiac MRI
C. Electrocardiogram (ECG)
D. Biopsy of heart tissue
B. Cardiac MRI
Rationale: A cardiac MRI can help assess myocardial stiffness and evaluate the extent of restriction in restrictive cardiomyopathy.
Which clinical manifestation is most commonly associated with hypertrophic cardiomyopathy?
A. Peripheral edema
B. Chest pain and shortness of breath
C. Sudden cardiac death
D. Pitting edema
C. Sudden cardiac death
Rationale: Hypertrophic cardiomyopathy is associated with a risk of sudden cardiac death, often due to arrhythmias.
Which pharmacologic agent is most commonly prescribed to reduce the risk of arrhythmias in patients with hypertrophic cardiomyopathy?
A. Beta-blockers
B. ACE inhibitors
C. Diuretics
D. Calcium channel blockers
A. Beta-blockers
Rationale: Beta-blockers are commonly prescribed to control arrhythmias and improve exercise tolerance in patients with hypertrophic cardiomyopathy.
Which of the following is a common finding on a physical examination of a patient with dilated cardiomyopathy?
A. Systolic murmur
B. Loud S2 heart sound
C. JVD (jugular venous distention)
D. Normal heart sounds
C. JVD (jugular venous distention)
Rationale: Jugular venous distention is a common sign of heart failure seen in patients with dilated cardiomyopathy due to fluid retention.
Which surgical intervention is commonly used to treat hypertrophic cardiomyopathy with significant left ventricular outflow obstruction?
A. Valve replacement
B. Myomectomy
C. Coronary artery bypass grafting (CABG)
D. Aortic valve repair
B. Myomectomy
Rationale: Myomectomy involves surgical removal of a portion of the hypertrophied myocardium to relieve left ventricular outflow obstruction in hypertrophic cardiomyopathy.
A patient with dilated cardiomyopathy presents with severe fluid retention. Which pharmacologic agent is most appropriate to treat this condition?
A. Diuretics
B. Beta-blockers
C. ACE inhibitors
D. Calcium channel blockers
A. Diuretics
Rationale: Diuretics are used to manage fluid retention in patients with dilated cardiomyopathy, improving symptoms such as edema and shortness of breath.
Which diagnostic finding is most commonly seen in patients with restrictive cardiomyopathy?
A. Dilated ventricles
B. Thickened heart walls
C. Normal-sized heart with stiff walls
D. Increased left ventricular ejection fraction
C. Normal-sized heart with stiff walls
Rationale: Restrictive cardiomyopathy typically presents with a normal-sized heart but stiff ventricular walls, leading to impaired diastolic filling.
Which of the following interventions is appropriate for a patient with dilated cardiomyopathy who is experiencing heart failure?
A. Administering anticoagulants to prevent clot formation
B. Prescribing high-dose diuretics to manage fluid overload
C. Encouraging the patient to engage in vigorous exercise
D. Starting long-term oral corticosteroids for inflammation
B. Prescribing high-dose diuretics to manage fluid overload
Rationale: High-dose diuretics are commonly used in heart failure management to relieve fluid overload and reduce symptoms in patients with dilated cardiomyopathy.
Which clinical finding would be most concerning in a patient with hypertrophic cardiomyopathy?
A. Decreased heart rate during exercise
B. Systolic murmur with an increase in intensity with Valsalva maneuver
C. Increased jugular venous pressure
D. Absence of chest pain on exertion
B. Systolic murmur with an increase in intensity with Valsalva maneuver
Rationale: A systolic murmur that increases in intensity with the Valsalva maneuver suggests obstruction of the left ventricular outflow tract, a hallmark of hypertrophic cardiomyopathy.
Which of the following is an indication for heart transplantation in patients with cardiomyopathy?
A. Uncontrolled hypertension despite treatment
B. Persistent fluid retention despite diuretics
C. End-stage heart failure with poor quality of life
D. Acute pericarditis with symptoms of chest pain
C. End-stage heart failure with poor quality of life
Rationale: Heart transplantation is considered for patients with end-stage heart failure who have a poor quality of life and no other treatment options.
Which of the following pharmacologic treatments is contraindicated in patients with hypertrophic cardiomyopathy?
A. Beta-blockers
B. Calcium channel blockers
C. Diuretics
D. Digoxin
D. Digoxin
Rationale: Digoxin is contraindicated in hypertrophic cardiomyopathy as it can increase contractility, worsening the outflow obstruction.
A patient with dilated cardiomyopathy is prescribed a beta-blocker. What is the primary purpose of this medication in the management of dilated cardiomyopathy?
A. To increase the heart rate and contractility
B. To decrease myocardial oxygen demand and prevent arrhythmias
C. To reduce fluid retention
D. To improve diastolic function
B. To decrease myocardial oxygen demand and prevent arrhythmias
Rationale: Beta-blockers help reduce myocardial oxygen demand and prevent arrhythmias, improving heart function in dilated cardiomyopathy.
Which of the following is a common complication of restrictive cardiomyopathy?
A. Severe mitral regurgitation
B. Left ventricular outflow obstruction
C. Right-sided heart failure
D. Pulmonary embolism
C. Right-sided heart failure
Rationale: Restrictive cardiomyopathy commonly leads to right-sided heart failure due to impaired ventricular filling and increased right heart pressures.
What is the first-line diagnostic test for assessing heart function in a patient suspected of having cardiomyopathy?
A. Echocardiogram
B. Electrocardiogram (ECG)
C. Chest X-ray
D. Cardiac catheterization
A. Echocardiogram
Rationale: The echocardiogram is the first-line diagnostic test for cardiomyopathy, as it provides information about heart structure, function, and ventricular dilation or thickening.
Which statement by a patient undergoing treatment for hypertrophic cardiomyopathy indicates a need for further education regarding activity restrictions?
A. “I can engage in moderate physical activity like walking and light cycling.”
B. “I should avoid high-intensity workouts that may strain my heart.”
C. “I am allowed to run marathons, as long as I feel okay.”
D. “I should call my doctor if I feel dizzy or faint during exercise.”
C. “I am allowed to run marathons, as long as I feel okay.”
Rationale: Patients with hypertrophic cardiomyopathy should avoid strenuous physical activities, including running marathons, as it may worsen symptoms and increase the risk of sudden cardiac death.
Which of the following is a characteristic feature of restrictive cardiomyopathy on an echocardiogram?
A. Increased left ventricular mass
B. Normal left ventricular wall thickness
C. Dilated ventricles
D. Impaired diastolic filling with preserved systolic function
D. Impaired diastolic filling with preserved systolic function
Rationale: In restrictive cardiomyopathy, there is impaired diastolic filling of the ventricles with preserved systolic function.
Which complication is most commonly seen in patients with dilated cardiomyopathy?
A. Valvular regurgitation
B. Heart failure
C. Sudden cardiac death
D. Coronary artery disease
B. Heart failure
Rationale: Heart failure is the most common complication of dilated cardiomyopathy due to the heart’s inability to pump effectively because of ventricular dilation.
Which type of cardiomyopathy is most likely to cause arrhythmias and sudden cardiac death in young athletes?
A. Hypertrophic cardiomyopathy
B. Dilated cardiomyopathy
C. Restrictive cardiomyopathy
D. Peripartum cardiomyopathy
A. Hypertrophic cardiomyopathy
Rationale: Hypertrophic cardiomyopathy is the leading cause of sudden cardiac death in young athletes due to its potential to cause life-threatening arrhythmias.
In a patient with hypertrophic cardiomyopathy, which of the following interventions is essential to reduce the risk of sudden cardiac death?
A. Heart transplantation
B. Implantable cardioverter-defibrillator (ICD)
C. Coronary artery bypass grafting (CABG)
D. Myomectomy
B. Implantable cardioverter-defibrillator (ICD)
Rationale: An ICD is recommended for patients with hypertrophic cardiomyopathy at high risk for arrhythmias and sudden cardiac death.
Which drug is most commonly prescribed for a patient with dilated cardiomyopathy to reduce the workload on the heart?
A. Diuretics
B. Anticoagulants
C. ACE inhibitors
D. Calcium channel blockers
C. ACE inhibitors
Rationale: ACE inhibitors are commonly prescribed to reduce afterload and improve cardiac output in patients with dilated cardiomyopathy.
A patient with restrictive cardiomyopathy is prescribed diuretics. Which of the following is a priority nursing consideration?
A. Monitor for signs of fluid overload
B. Assess for hypokalemia
C. Encourage the patient to exercise regularly
D. Administer blood pressure medications as prescribed
B. Assess for hypokalemia
Rationale: Diuretics can cause electrolyte imbalances, including hypokalemia. Monitoring potassium levels is important to prevent complications such as arrhythmias.
Which of the following is a key difference between hypertrophic and dilated cardiomyopathy?
A. Hypertrophic cardiomyopathy involves a dilated left ventricle, while dilated cardiomyopathy involves thickened walls.
B. Hypertrophic cardiomyopathy causes left ventricular hypertrophy, while dilated cardiomyopathy involves systolic dysfunction.
C. Dilated cardiomyopathy is often seen in older adults, while hypertrophic cardiomyopathy is typically diagnosed in young adults.
D. Dilated cardiomyopathy is associated with a high risk of sudden cardiac death, while hypertrophic cardiomyopathy has a low risk.
B. Hypertrophic cardiomyopathy causes left ventricular hypertrophy, while dilated cardiomyopathy involves systolic dysfunction.
Rationale: Hypertrophic cardiomyopathy is characterized by ventricular hypertrophy and impaired diastolic filling, whereas dilated cardiomyopathy involves systolic dysfunction with a dilated heart.
A patient with cardiomyopathy is being educated about the importance of avoiding alcohol. Which of the following is the primary reason for this recommendation?
A. Alcohol is a vasodilator and can worsen heart failure symptoms.
B. Alcohol interacts with many heart medications, reducing their effectiveness.
C. Alcohol increases the risk of developing arrhythmias.
D. Alcohol is a stimulant that can increase heart rate excessively.
C. Alcohol increases the risk of developing arrhythmias.
Rationale: Alcohol increases the risk of arrhythmias, which can be particularly dangerous for patients with cardiomyopathy.
Which diagnostic test is used to evaluate the presence of emboli in patients with cardiomyopathy?
A. Cardiac MRI
B. Electrocardiogram (ECG)
C. Echocardiogram with Doppler
D. Pulmonary function test
C. Echocardiogram with Doppler
Rationale: An echocardiogram with Doppler can help identify emboli that may have originated from the heart, a common concern in patients with dilated cardiomyopathy due to stasis of blood.
In a patient who has undergone a myomectomy for hypertrophic cardiomyopathy, which of the following is the most important post-operative nursing consideration?
A. Encouraging early mobilization to prevent blood clots
B. Instructing the patient to avoid all physical activity for 6 months
C. Providing high-sodium meals to prevent fluid retention
D. Monitoring for signs of infection and bleeding
D. Monitoring for signs of infection and bleeding
Rationale: Post-operative monitoring for infection and bleeding is critical after myomectomy to ensure proper healing and prevent complications.
