(hans) cardio 105 - 110 Flashcards
name 7 causes of dilated cardiomyopathy
- previous MI
- previous ischemia
- alcohol
- postviral myocarditis
- radiation
- toxins such as doxorubicin
- chagas disease
name 4 types of drugs that lower mortality in dilated cardiomyopathy
ACEi, ARBs, beta blockers (metoprolol or carvedilol), spironolactone
what 2 drugs are used to control symptoms of dilated cardiomyopathy?
diuretics and digoxin
if QRS is wide (more than 120 msec), what is the treatment option for dilated cardiomyopathy
biventricular pacemaker which improves both symptoms and survivial
what is the diff btw hypertrophic cardiomyopathy vs. hypertrophic obstructive cardiomyopathy
HCM is a reaction to stressors on the heart such as inc blood pressure, whereas HOCM is a genetic disorder with an abnormal shape to the septum of the heart.
what are the 2 things that worsen hypertrophic cardiomyopathy?
- anything that leads to inc heart rate (exercise, dehydration, diuretics)
- dec Lt. ventricular chamber size
what are the 4 drugs that reduce Lt. ventricular chamber and worsens HOCM symptoms?
ACEi, ARBs, digoxin, hydralazine
what are the 2 maneuvers that reduce Lt. ventricular chamber and worsens HOCM symptoms?
valsalva, standing suddenly
what is the best initial test for HOCM?
echo
best initial therapy for both HOCM and ordinary HCM?
beta blockers
what particular drug is useful for HCM but contraindicated in HOCM?
diuretics
what are the 2 specific treatments for HOCM?
- implantable defibrillators
2. ablation of the septum
HOCM pt comes in with symptoms of syncope, what is the best next step?
implantable defibrillators
HOCM pt comes to see you with persisting symptoms after ablation of the septum, what is the best next step?
surgical myomectomy to remove part of the septum
name 3 types of drugs that are helpful for dilated cardiomyopathy but no for hypertrophic cardiomyopathy
ACEi/ARBs, spironolactone, digoxin
what are the 5 main causes for restrictive cardiomyopathy
- sarcoidosis
- amyloid
- hemochromatosis
- endomyocardial fibrosis
- scleroderma
more blood flow increases all murmurs except for 2?
MVP, HOCM
standing or doing valsalva is equivalent to giving what kind of medication?
diuretic use
what types of murmur will decrease by standing or valsalva?
mitral/aortic stenosis
mitral/aortic regurgitation
what types of murmur will decrease by squatting or leg raising?
MVP, HOCM
how does “hand grip” affect the intensity of the murmur of aortic stenosis? and explain why
decreases, b/c hand grip decreases the Lt. ventricular emptying by inc pressure
how does “amyl nitrate” affect the intensity of the murmur of aortic stenosis? and explain why
increases, b/c amyl nitrate increases the Lt. ventricular emptying
hand grip improves symptoms of MVP and HOCM why?
hand grip decreases ventricular emptying by increasing afterload. A bigger, fuller heart improves the obstruction of HOCM.
what valvular motion is classic for HOCM?
systolic anterior motion (SAM) of the mitral valve
what is the common pattern of HOCM in EKG?
septal Q waves in the inf. and lateral leads
