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Cardiovascular > EXAM #1: CARDIOMYOPATHY > Flashcards

EXAM #1: CARDIOMYOPATHY Flashcards

1
Q

What is the definition of cardiomyopathy?

A

Myocardial disease that results in cardiac dysfunction

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2
Q

What is the definition of dilated cardiomyopathy?

A

Dilation of all four chambers of the heart

*Note that this is the most common

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3
Q

What is the definition of hypertrophic cardiomyopathy?

A

Massive hypertrophy of the LV that results in dysfunction and arrhythmia

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4
Q

What is the definition of restrictive cardiomyopathy?

A

Decreased compliance of ventricular endomyocardium that restricts filling during diastole

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5
Q

What is the most common etiology of dilated cardiomyopathy?

A

Idiopathic

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6
Q

What are the less common etiologies of dilated cardiomyopathy?

A

1) IHD
2) HTN
3) Alcoholic
4) Infectious (Chagas and coxsackie)
5) Metabolic

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7
Q

Describe the pathogenesis of dilated cardiomyopathy?

A

Dilated ventricles with thin walls lead to systolic dysfunction

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8
Q

What are the complications of dilated cardiomyopathy?

A

1) Biventricular CHF
2) Arrhythmia
3) Mitral/ tricuspid valve regurgitation

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9
Q

What are the symptoms of dilated cardiomyopathy?

A

LV failure:

  • Fatigue
  • Weakness
  • Dyspnea (exertional, orthopenia, PND)
  • Pallor/tachycardia
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10
Q

Describe the pathogenesis of orthopena in dialted cardiomyopathy.

A

1) Lay down= increase preload
2) Heart can’t hand preload
3) Back-up into lungs

= Orthopnea

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11
Q

What are the signs of LV failure?

A
  • Tachycardia
  • Cardiac apex is displaced left and down
  • Apical lift/thrill
  • S3*
  • Mumurs

*S3 is UNIVERSAL in HF

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12
Q

What are the indications of dilated cardiomyopathy leading to biventricular failure?

A

Added sx. of RV failure:

  • IMPROVED dyspnea (less filling to LV)
  • Edema
  • JVD
  • S3 is UNIVERSAL
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13
Q

What is pulsus alternans?

A

Every other pulse is stronger in intensity

  • Weak myofibrils cannot recover for each beat
  • Full contraction occurs every other beat
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14
Q

What is cardiac cachexia?

A

B/c of RV failure and edema of liver, bowel, spleen etc…

  • Limited intake
  • Edematous bowel and liver don’t absorb and metabolism nutrients
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15
Q

How will dilated cardiomyopathy appear on Echo?

A
  • Large dilated “baggy” heart

- V. limited ventricular wall motion in systole

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16
Q

What is alcoholic cardiomyopathy?

A

Dilated cardiomyopathy from direct alcohol myotoxicity

Note that alcohol causes cardiodepression in the absence of toxicity

17
Q

What is a specific association with alcoholic cardiomyopathy?

A

A-fib/ arrhythmia

18
Q

What do you need to be concerned about in terms of the lab evaluation of alcoholic cardiomyopathy?

A
  • Blood alcohol levels
  • Liver chemistry
  • Hypovitaminoses
19
Q

What is the treatment for alcoholic cardiomyopathy?

A

Patient MUST stop drinking

40-50% die within 3 years of diagnosis

20
Q

What are the old names for hypertrophic cardiomyopathy?

A

IHSS
HOCM
HCM

21
Q

What is the etiology of hypertrophic cardiomyopathy?

A

Genetic mutation in sarcomere proteins (autosomal dominant)

22
Q

Macroscopically, how does the heart appear in Hypertropic Cardiomyopathy?

A
  • Increased mass
  • Asymmetric septal hypertrophy
  • Concentric hypertrophy
  • Apical hypertrophy
23
Q

How does Hypertrophic Cardiomyopathy appear microscopically?

A

Myofiber hypertrophy with “disarray”

24
Q

What is the average age of onset of Hypertrophic Cardiomyopathy?

A

26

This is a common cause of SUDDEN DEATH in young athletes.

25
Q

What causes sudden death in hypertrophic cardiomyopathy?

A

Ventricular arrhythmias

26
Q

What is a hallmark symptom of hypertrophic cardiomyopathy?

A

Syncope with exercise

27
Q

What are the signs of hypertrophic cardiomyopathy?

A
  • Displaced/ bifid LV
  • Bisferiens carotid pulse
  • S4
  • Systolic murmur
28
Q

What are the ECG characteristics associated with hypertrophic cardiomyopathy?

A
  • Increased voltage in anterior leads
  • ST and T-wave changes
  • Q-waves inferior and lateral
  • Ventricular arrhythmia
29
Q

What study is diagnostic for hypertrophic cardiomyopathy?

A

Echo

30
Q

What is the treatment for hypertrophic cardiomyopathy?

A

1) Reduce physical activity
- Catecholamines= arrhythmogenic
2) Beta-blockers
- Reduce contractility to limit obstruction
3) Myotomy/myectomy

31
Q

What causes restrictive cardiomyopathy?

A
  • Amyloidosis
  • Sarcoidosis
  • Endocardial fibroelastosis
  • Loeffler Syndrome
  • Hemochromatosis
32
Q

How does restrictive cardiomyopathy present?

A

CHF with low-voltage ECG and diminished QRS amplitude

Cardiovascular (38 decks)

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