Dilated And Hypertrophic CMO Flashcards
All cariomyopathies are classified according to what 2 things
Physiology (1st)
Ethology (2nd)
Primary disease of the myocardium excluding myocardial dysfunction due to ischemia or chronic valvular disease
cadiomyopathy
Cardiomyopathy where all four chambers of the heart are enlarged
Dilated cardiomyopathy
They impaired LV and RV systolic function in DCMO will cause what
Reduced CO
The diastolic dysfunction in DCMO will cause what
Elevated end diastolic LV pressure
Infectious causes of DCMO
Viral myocarditis
Parasites
AIDS
Toxic causes of DCMO
Alcohol
Chemo
Drugs
Endocrine causes of DCMO
Hypothyroidism
Hyperthyroidism
Phenochromocytoma
8 causes of DCMO
Infectious Toxic Peripartum Metabolic Genetic Endocrine Idiopathic Stress induced
What will the QRS complex look like with DCMO
Large
What will you see on the ECG with DCMO
Sinus tachycardia
Conduction defects
What dietary changes can you make when you have DCMO
Restrict salt
What two things need to be ruled out when looking for causes of LV and RV dysfunction with DCMO
Valvular disease
Ischemic disease
The B bump is caused by what in a M-mode tracing
High LVEDP
What is a abnormal EPSS
> 7mm
A >20mm EPSS with = what EF
<30%
What is a abnormal sphericity index
> 0.76
EF, FS, and CO will be increased of decreased with DCMO
Decreased
What MV abnormality will be seen with DCMO
MV tenting
Quantitative assessment of DCMO
LV volumes EF
Simpsons
LV size
What regurg is in 100% of patients with DCMO
MR
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
More
Why do we not want to use diuretics with HCMO
Reduce Preload
