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Cardio > HCM > Flashcards

HCM Flashcards

1
Q

LV thickness of —- indicates HCM

A

15 mm

With family history 13 is enough

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2
Q

IVS/PW ratio in HCM

A

1.3

If hypertensive 1.5

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3
Q

MR Jet in HCM

A

Inferolateral mid to late systolic

Central or Antr jet indicates primary MV d/s

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4
Q

When to do Exercise stress Echo in HCM

A

If LVOTO less than 50 mm Hg

Pharmacological stress not recommended

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5
Q

Risk of sudden death in HCM high if wall thickness is

A

MORE than 3 CM

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6
Q

SAM in HCM indicates a gradient of

A

30mmHg at least

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7
Q

How to calculate HCM gradient from the M mode of AML

A

x/y *25 +25; X is duration of SAM ; y is time to SAM

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8
Q

How to differentiate HCM from athletes heart

A

LV>55 mm; HCM -Small LV

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9
Q

When to consider septal ablation in HCM

A

If gradient at rest or exercise more than 50

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10
Q

HCM incidence

A

1in500

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11
Q

Septal Q in HCM is seen in

A

V5,6 aVL,I,2,3,aVF

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12
Q

Shape of LV in Apical HCM

A

Spade

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13
Q

Midsystolic notching of Aortic Valve is seen in

A

HOCM

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14
Q

Spike and Dome pattern is seen in HCM in

A

ARTERIAL WAVEFORM

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15
Q

Effect of Valsalva in HOCM murmur

A

INCREASES intensity and duration

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16
Q

Best position for HCM murmur

A

Standing; better than lying or sitting

17
Q

In squatting LV becomes

A

BIG

18
Q

Brockenborough Braunwauld sign is

A

Post extrasystolic drop in PULSE PRESSURE
So weak pulse after a VPC

Systolic BP falls . Diastolic doesn’t change much

19
Q

If ECG is s/o HCM and Echo is normal what to do

A

MRI

20
Q

Association of WPW and HCM

A

33% had WPW in one study

21
Q

Q in HCM is —-shaped

A

Dagger; just means narrow unlike W of MI

22
Q

Indications for invasive septal reduction therapy in HOCM

A

Gradient (rest or provocable) 50 or more

AND Refractory Symptoms

23
Q

CW profile in HCM

A

Dagger shaped. Due to the late systolic peak

In contrast fixed obstruction has a smoother contour and earlier peak

24
Q

Predictors of higher risk of SCD in HCM in Holter

A

NSVT-prolonged or repetitive episodes

But primary prevention of SCD in HCM is not well defined

Others include Thickness >30mm, Hypotensive BP response in TMT, Syncope, Family h/o SCD

25
Q

3 types of Amyloidosis that affects heart

A
  1. AL Amyloidosis - Plasma cell dyscrasias- cardiac involvement seen in 50% of AL Amyloidosis
  2. AA Amyloidosis- In chronic inflammation- card involved only in 5%
  3. TTR Amyloidosis ( Transthyretin)- Wild Type causes Senile systemic Amyloidosis- causes infiltrative CMP looks like HCM

Cardio (36 decks)

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