Dilated And Hypertrophic CMO Flashcards by Julianna Small

All cariomyopathies are classified according to what 2 things

Physiology (1st)

Ethology (2nd)

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Primary disease of the myocardium excluding myocardial dysfunction due to ischemia or chronic valvular disease

cadiomyopathy

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Cardiomyopathy where all four chambers of the heart are enlarged

Dilated cardiomyopathy

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They impaired LV and RV systolic function in DCMO will cause what

Reduced CO

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The diastolic dysfunction in DCMO will cause what

Elevated end diastolic LV pressure

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Infectious causes of DCMO

Viral myocarditis
Parasites
AIDS

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Toxic causes of DCMO

Alcohol
Chemo
Drugs

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Endocrine causes of DCMO

Hypothyroidism
Hyperthyroidism
Phenochromocytoma

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8 causes of DCMO

Infectious
Toxic
Peripartum
Metabolic
Genetic
Endocrine
Idiopathic
Stress induced

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What will the QRS complex look like with DCMO

Large

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What will you see on the ECG with DCMO

Sinus tachycardia

Conduction defects

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What dietary changes can you make when you have DCMO

Restrict salt

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What two things need to be ruled out when looking for causes of LV and RV dysfunction with DCMO

Valvular disease

Ischemic disease

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The B bump is caused by what in a M-mode tracing

High LVEDP

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What is a abnormal EPSS

> 7mm

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A >20mm EPSS with = what EF

<30%

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What is a abnormal sphericity index

> 0.76

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EF, FS, and CO will be increased of decreased with DCMO

Decreased

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What MV abnormality will be seen with DCMO

MV tenting

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Quantitative assessment of DCMO

LV volumes EF
Simpsons
LV size

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What regurg is in 100% of patients with DCMO

With DCMO will the LVOT velocity be increased of decreased

Decreased

What measurement is used to grade the degree of diastolic dysfunction

Dp/Dt

Why is Dp/Dt more accurate then simpsons when it comes to DCMO

MR decreases afterload and makes it easier for the heart to contract. This will make the Simpsons measurement look like its higher then it actually is

Low EF means a low....

Cardiac output

Abnormal Dp/Dt

<1200

What Pulmonary vein reversal velocity would indicate elevated LVEDP

>35 cm/s

What E/e ratio would indicate elevated LVEDP

>15

What IVRT time would indicated elevated LVEDP

<60

Elevated LVEDP

>15

All patients with DCM will have some degrees of what

Diastolic dysfunction

As the LV dilates the MV inflow enters the LV further from what

Apex

How does a patient get HCMO

Inherited

What part of the heart is most commonly effected by HCMO

IVS

In HCMO a mutated gene affects what part of the heart

Contractile elements of the sarcoma remains

What are the 2 types of HCMO

Non obstructive | Hypertrophic obstructive CMO

What is most common hypertrophy of the IVS

Basal anterior septum

With non obstructive HCMO what will the LVOT PG be and what will it be in obstructive

<30 | >30

How does obstruction occur in HCM

MV leaflet comes in contact with the IVS

What is SAM

Systolic anterior motion of the MV

There is a high risk of death if the IVS measures what

>30mm

What is persistent obstruction

Obstruction at rest with provocation | Seen at rest with valsalva maneuver

What type of CMO gets worse during valsalva

Provocable obstruction

What type of CMO does obstruction only occur with valsalva

Latent obstruction

Obstruction increased by what 4 things in CMO

Lower preload Lower LV volume Increased contractility Decreased contractiliy

What are the maneuvers to uncover latent obstruction

Amyl nitrate Valsalva Stress test

What will you see in a spectral trace of dynamic flow obstruction

Mid to late systole peaking (looks like a steak knife)

decribe LVOT Vs MR

LVOT starts late peaks mid to late systole | MR starts early and ends late peaks mid

The higher degree of obstruction in the LVOT in HCMO the more or less MR

Why do we not want to use diuretics with HCMO

Reduce Preload