Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations-Myocarditis/Cardiomyopathy > Foundations-Myocarditis/Cardiomyopathy > Flashcards

Foundations-Myocarditis/Cardiomyopathy Flashcards

1
Q

Cardiomyopathy

A

Structural/functional abnormality of heart muscle in the absence of:

  • CAD
  • HTN
  • Valvular disease
  • Congenital heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three main structural/functional categories

A
  1. Dilated
  2. Hypertrophic
  3. Restrictive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common cardiomyopathy

A

Dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define Dilated cardiomyopathy

A

Thin, enlarged ventricular wall, systolic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define hypertrophic cardiomyopathy

A

Myocardial hypertrophy (thick muscle) in the absence of HTN or aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define restrictive cardiomyopathy

A

Nondilated ventricles, impaired filling, reduced diastolic function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define Heart Failure

A
  • Results from any structural or functional cardiovascular abnormality causing a supply/demand mismatch
  • With Systemic perfusion being inadequate to meet the body’s metabolic demand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the main cause of dilated cardiomyopathy?

A

Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the other non-idiopathic causes for dilated cardiomyopathy?

A 
"ABCD PIG": 
Alcohol
Beriberi (thiamine deficiency)
Coxsackie B, Chagas disease
Drugs: adriamycin (anthracycline), cocaine
Pregnancy
Idiopathic, infection
Genetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common cause of heart failure due to systolic dysfunction?

A

Ischemic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a common cause of dilated cardiomyopathy?

A

Ischemic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is Ischemic cardiomyopathy characterized?

A

LVEF≤35-40% FROM coronary artery disease

-often occurs after MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment for ischemic cardiomyopathy

A 
ASA
High-intensity statin
Beta-blocker
ACE-inhibitor
Loop diuretic if fluid overload
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is hypertensive cardiomyopathy characterized?

A

Concentric LVH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can lead to hypertensive cardiomyopathy?

A

Uncontrolled and sustained HTN over a long time period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define alcoholic cardiomyopathy

A

Excessive alcohol use leads to myocardial dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Who is at risk for alcoholic cardiomyopathy?

A

> 90g (7-8 drinks) per day for at least 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When would you see a prolonged QTc (precursor to ventricular arrhythmias)

A

Alcoholic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define Peripartum Cardiomyopathy

A
  • Development of heart failure late in pregnancy or within 5 months of giving birth
  • LVEF<45% with or without dilation
  • Most common w/in 1 month postpartum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the risk factors for Peripartum Cardiomyopathy?

A
  • age>30
  • African descent
  • Cocaine abuse
  • Multiple fetuses
  • Preeclampsia/eclampsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for Peripartum Cardiomyopathy?

A

Heart transplant performed in 1/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Define Takotsubo Cardiomyopathy

A
  • “Stress Cardiomyopathy”
  • ->Catecholamine induced
  • Characterized by transient LV dysfunction that appears as systolic apical ballooning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sx’s of Takotsubo Cardiomyopathy

A
  • Substernal chest pain
  • Troponin levels often 7x the upper limit of normal
  • ECG with ST-elevation is common
  • Echocardiography shows apical ballooning pattern, decreased LVEF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What age group does dilated cardiomyopathies occur in?

A

Age 20-60

25
Q

Physical exam findings in dilated cardiomyopathy- Vitals

A
  • Hypotensive
  • Tachycardic (cardiogenic shock)
  • Tachypnea
26
Q

Signs of left sided HF in dilated cardiomyopathy

A

Pulmonary congestion:

  • Productive cough
  • Dyspnea (at rest, exertional, lying flat)
  • Crackles or wheezing
27
Q

Signs of right sided HF in dilated cardiomyopathy

A
  • JVD
  • Hepatojugular reflux
  • Peripheral edema (pitting)
28
Q

Diagnostic findings on a CXR in dilated cardiomyopathy

A
  • Enlargement of cardiac silhouette
  • Pulmonary vascular congestion
  • Pleural effusion (R sided)
  • Kerley B lines
29
Q

Diagnostic findings on an EKG in dilated cardiomyopathy

A
  • LVH
  • Conduction delay
  • Arrhythmias
30
Q

What are the effects of ACE inhibitors in treating dilated cardiomyopathy

A

-Reduce preload and afterload by vasodilation–> BP reduction

31
Q

What are the effects of Beta Blockers in treating dilated cardiomyopathy

A

Reduce detrimental effects on the heart from catecholamine stimulation

  • Slow HR to increase diastolic perfusion
  • Decrease after load
32
Q

When do we use Beta blockers in treating dilated cardiomyopathy

A

HFrEF and LVEF ≤40%

33
Q

Contraindications for beta blockers in dilated cardiomyopathy

A

HR<50
2nd or 3rd degree AV block
Asthma is a contraindication; COPD is NOT

34
Q

What are the surgical options for dilated cardiomyopathy

A
  • LVAD
  • Cardiac resynchoronization therapy (CRT)
  • Automatic implantable cardioverter-defibrillator (AICD)
  • Heart transplantation
35
Q

What is hypertrophic cardiomyopathy caused by?

A

Genetic disease of heart muscle (myocardium)

  • Autosomal dominant
  • Mutation in sarcomere protein genes
36
Q

Define hypertrophic cardiomyopathy

A

Unexplained LV hypertrophy without dilation of the ventricles or a cardiovascular disease that could cause the degree of hypertrophy seen

37
Q

What is diagnostic of hypertrophic cardiomyopathy

A

> 15 mm LV wall thickness

38
Q

What are the two classifications of hypertrophic cardiomyopathy

A
  1. Obstructive

2. Non-obstructive

39
Q

Define obstructive hypertrophic cardiomyopathy

A

midsystolic obstruction of flow through the LV outflow tract as a result of systolic anterior motion of the mitral valve (SAM) toward the septum

40
Q

What is the number one risk for sudden cardiac death?

A

History of syncope and/or a family history of sudden death

41
Q

Hypertrophic cardiomyopathy sx’s

A 
Fatigue
Dyspnea
Angina 
Palpitations
Presyncope or syncope
Orthopnea and paroxysmal nocturnal dyspnea (PND)
Dizziness
42
Q

What is a systolic ejection crescendo-decrescendo murmur indicate?

A

Hypertrophic cardiomyopathy

43
Q

What is diagnostic of Hypertrophic cardiomyopathy

A

Transthoracic echocardiogram

44
Q

What is the treatment for pt’s with symptomatic arrhythmias in hypertrophic cardiomyopathy

A

beta-blocker or anti-arrhythmic

45
Q

What is the treatment for pt’s with arrhythmias sustaining frequent shocks from ICD with hypertrophic cardiomyopathy

A

Antiarrhythmic therapy:

  • Sotalol
  • Amiodarone
46
Q

What is the treatment for pt’s with HCM and Atrial Fibrillation, despite CHADS2VASc score

A

Anticoagulation

47
Q

Non-pharmacologic treatment for hypertrophic cardiomyopathy

A

Surgical septal myectomy

Alcohol septal ablation

48
Q

How is restrictive cardiomyopathy characterized

A

Non-dilated, non-hypertrophied ventricles with impaired LV filling
=Diastolic dysfunction

49
Q

What is the most common cause of secondary restrictive cardiomyopathy in the US?

A

Amyloidosis

50
Q

What diseases cause secondary restrictive cardiomyopathy

A

Sarcoidosis
Scleroderma (Progressive Systemic Sclerosis)
Metastatic malignancy
Radiation induced
Drug induced (chloroquine, hydroxychloroquine)
Hemochromatosis

51
Q

Clinical presentation of restrictive cardiomyopathy

A 
Progressive exercise intolerance and SOB
Fatigue
Orthopnea
Palpitations (frequently causes atrial fibrillation)
Thromboembolic complications
Orthostatic hypotension and syncope
52
Q

Amyloidosis systemic signs

A

easy bruising

periorbital purpura macroglossia

53
Q

+ Kussmaul Sign

A

JVP fails to fall during inspiration, and actually rises

54
Q

Define cardiac amyloidsosis

A
  • Multisystem deposition of amyloid fibrils

- Amyloidosis is a systemic disease, with cardiac infiltration being common

55
Q

Myocarditis

A

-An inflammatory infiltrate of the myocardium with necrosis and/or degeneration of adjacent myocytes not typical of the ischemic damage associated with coronary artery disease

56
Q

What is the most common cause of myocarditis in developed countries?

A

Viral infections

57
Q

In developing countries, what are causes of myocarditis

A
  • Rheumatic carditis
  • Chagas disease
  • Complications of HIV are more common
58
Q

What is the gold standard diagnostic test for myocarditis

A

Endomyocardial Biopsy

59
Q

When is Endomyocardial Biopsy indicated?

A
  1. New onset fulminant HF within 2 weeks with hemodynamic compromise
  2. New onset HF with failure to respond to treatment

Foundations-Myocarditis/Cardiomyopathy (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions