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Cardiology 2 > Clin Med - Cardiomyopathy > Flashcards

Clin Med - Cardiomyopathy Flashcards

1
Q

Cardiomyopathy definition

A

diseases of the myocardium associated with mechanical and/or electrical dysfunction

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2
Q

Primary cardiomyopathy

A

genetic, mixed, acquired

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3
Q

Secondary cardiomyopathy

A

Multi-organ

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4
Q

Hypertrophic Cardiomyopathy

A
  • Autosomal dominant (MYH7, MYBPC3, TNNT2, TNNI3)
  • Septal hypertrophy
  • Blood that normally goes into aorta is compromised because the septum covers it
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5
Q

Septal hypertrophy causes:

A
  • Decrease in cardiac output

- Left ventricle becomes stiff

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6
Q

Sudden death in hypertrophic cardiomyopathy

A

Symptoms appear mainly during exercise d/t myocardial oxygen demand (often seen in young athletes)

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7
Q

Hypertrophic Cardiomyopathy Symptoms

A
  1. Dyspnea
  2. Chest pain
  3. Palpitations
    - -Excitement of myocardium due to PVCs
    - -Enough PVCs in a row gets you Vtach
  4. Syncope* - most significant
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8
Q

Hypertrophic Cardiomyopathy Signs

A
  1. Systolic ejection murmur
    - -Murmur increased with Valsalva/squatting
    - -Murmur decreased with hand grip
  2. Prominent, nondisplaced point of maximal impulse
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9
Q

Hypertrophic Cardiomyopathy diagnostic gold standard

A

Echocardiogram

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10
Q

Hypertrophic cardiomyopathy ECHO

A
  • Increased septum to LV wall thickness (greater than 1.3 to 1)
  • EKG – LV hypertrophy
  • Genetic test – cardiac muscle biopsy (myofibril disarray) muscle fibers are not lined up parallel
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11
Q

Hypertrophic cardiomyopathy prognosis & treatment

A

Prognosis: 1-3% mortality

Treatment: 
-Slow HR, allow more time for diastolic filling
-Increase cardiac output  
beta blockers and calcium channel blockers
-Implantable Cardioverter Device (ICD)
-Patient’s die from fibrillation
-Cardiac surgery
-Heart transplantation
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12
Q

Hypertrophic cardiomyopathy patient education

A
  • No competitive sports
  • Screening of family members
  • Healthy diet
  • Immunizations
  • Medical bracelet

Referral – needs to be followed by a cardiologist

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13
Q

Dilated Cardiomyopathy Physiology

A
  • Dysfunction in the ability of the heart to contract
  • Decreased EF
  • Heart chambers “dilate” to compensate
  • Dilation gets progressively worse, ventricles first, atrium second
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14
Q

Dilated cardiomyopathy etiology

A
  • Genetic: protein in muscles cells that do not allow muscles to contract
  • Myocarditis
  • Pregnancy
  • Idiopathic
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15
Q

Dilated cardiomyopathy S&S

A

Symptoms
-Fatigue, DOE, Swelling, Edema, Ascites

Signs
-Tachycardia, Tachypnea, HTN

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16
Q

Dilated cardiomyopathy signs when disease is in later stages

A
  • Cyanosis/clubbing
  • Jugular venous distention
  • Pulmonary edema (crackles or wheezes)
  • S3 gallop
  • Hepatomegaly
17
Q

Dilated Cardiomyopathy Labs and Diagnostic Findings

A
  1. BNP – elevated in conditions with “stretching” of the heart – not specific
  2. EKG – abnormal, non-specific
  3. CXR – cardiomegaly
  4. Echocardiogram – dilation of chambers and decreased EF
18
Q

Dilated Cardiomyopathy Treatment

A

Treat the same as for CHF (ACE, B-blocker, Diuretics, etc)

19
Q

Dilated Cardiomyopathy Patient Education

A
  • Exercise
  • Quit smoking
  • No alcohol/drug use
  • Maintain healthy weight
  • Eat heart healthy diet

Refer to cardiologist

20
Q

Primary Restrictive Cardiomyopathy Etiology

A
  • Rare, only 5% of world population
  • Disease of the heart muscle
  • Fibrosis or scarring of muscles (via radiation, idiopathic)
21
Q

Primary Restrictive Cardiomyopathy Infiltration (4)

A
  1. Amyloidosis – protein
  2. Sarcoidosis – granulomas
  3. Genetic diseases where metabolites are deposited
  4. Hemochromatosis – excessive iron in the parenchyma tissue (lungs or heart)
22
Q

Primary Restrictive Cardiomyopathy characteristics (4)

A
  1. Ventricles fail to relax (dilate)
  2. Muscle stays the same size and the heart can not fill properly
  3. Decreased filling = decrease volume of blood leaving heart
  4. Diastolic heart failure
23
Q

Primary Restrictive Cardiomyopathy Clinical Manifestations

A
  • Shortness of breath
  • Weakness
  • Fatigue
  • Edema
  • Ascites
24
Q

Primary Restrictive Cardiomyopathy Diagnostic Tests

A
  1. CXR – pulmonary congestion +/- with NORMAL heart size
  2. EKG – low voltage QRS complexes
  3. Echocardiogram – increased ventricular thickness and maybe atrial enlargement
25
Q

Primary Restrictive Cardiomyopathy Prognosis

A
  • Usually fatal when diagnosed in infancy
  • Progressively worse
  • Heart transplant

Cardiology 2 (13 decks)

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