Diseases of the myocardium

Question 1

A group of diseases of the myocardium associated with mechanical or electrical dysfunction that usually show dilation or hypertrophy are are due to many things

Answer 1

Cardiomyopathy

Question 2

Cardiomyopathy is traditionally classified into

Answer 2

3 morphological patterns

Question 3

What are the 3 morphological patterns of cardiomyopathy

Answer 3

dilated (congestive) (most common)
Hypertrophic
Restrictive (obliterative or infiltrative)

Question 4

Characterized by dilation and impaired ineffective contraction of one or both ventricles (usually left)

Answer 4

Dilated cardiomyopathy

Question 5

In dilated cardiomyopathy, the __ of the heart is impaired and patients may develop overt heart failure, atrial and or ventricular arrhythmias, or sudden cardiac death

Answer 5

systolic function

Question 6

Most common of the 3 patterns of cardiomyopathy (60% of cases)

Answer 6

Dilated cardiomyopathy

Question 7

Causes of dilated cardiomyopathy

Answer 7

Genetic (20-50%)
Chronic alcoholism (15-40%)
sleep apnea
(LOTS others)

Question 8

In most patients with dilated cardiomyopathy symptoms of __ develop

Answer 8

congestive heart failure

Question 9

Mitral regurgitation may be present with

Answer 9

Dilated cardiomyopathy

Question 10

In dilated cardiomyopathy the hear is usually __ due to __

Answer 10

enlarged and heavy
dilation of all four chambers (histologically insignificant)

Question 11

Marked thickening of the left ventricular wall of 15 mm or more without dilation

Answer 11

Hypertrophic cardiomyopathy

Question 12

Not explained by another cardiac or systemic disorder

Answer 12

Hypertrophic cardiomyopathy

Question 13

What is also profoundly enlarged and hypertrophied in hypertrophic cardiomyopathy

Answer 13

interventricular septum

Question 14

Hypertrophic cardiomyopathy may result in hemodynamically significant obstruction with in the __

Answer 14

left ventricular outflow tract

Question 15

HCM associated with LVOT obstruction is called

Answer 15

idiopathic hypertrophic subaortic stenosis (IHSS)

Question 16

There is usually reduced __ in HCM

Answer 16

stroke volume

Question 17

Most cases of HCM are __ in multiple genes encoding proteins of the __

Answer 17

genetic
cardiac sarcomere and calcium regulation

Question 18

Characterized by massive left ventricular hypertrophy without ventricular dilation. Disproportionate thickening of the ventricular septum relative to the left ventricular free wall

Answer 18

HCM

Question 19

What shape does the left ventricle take in HCM

Answer 19

banana-shaped

Question 20

about 1/3 of patients with HCM have a function obstruction of the __

Answer 20

left ventricular outflow tract

Question 21

3 main microscopic abnormalities in HCM

Answer 21

Massive myocyte
Disorganized myocyte architecture
interstitial and replacement fibrosis

Question 22

restrictive ventricular filling

Answer 22

Restrictive cardiomyopathy

Question 23

A decrease in ventricular compliance and distensibility (Stiff) resulting in impaired ventricular filling during diastole

Answer 23

Restrictive cardiomyopathy

Question 24

The atria frequently become enlarged (ventricles = normal)

Answer 24

Restrictive cardiomyopathy

Question 25

Least common of the 3 patterns of cardiomyopathy

Answer 25

Restrictive cardiomyopathy

Question 26

2 Common causes of Restrictive CM

Answer 26

amyloidosis
Progressive systemic sclerosis

Question 27

Biventricular congestive heart failure is common

Answer 27

Restrictive CM

Question 28

Are one or both atria typically dilated in restrictive CM

Answer 28

Both

Question 29

Microscopically this is found with restrictive CM

Answer 29

interstitial fibrosis