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Cardiomyopathies > Hypertrophic > Flashcards

Hypertrophic Flashcards

1
Q

What is the etiology of HCM?

A

Idiopathic - but may due to dominant autosomal gene with variable penetrance

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2
Q

What is ASH?

A

Asymmetric septal hypertrophy ( most common)

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3
Q

What’s the ratio for ASH?

A

> 1.3 :1

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4
Q

What is IHSS ? It’s A.K.A?

A

Idiopathic hypertrophic sub aortic stenosis
also known as HOCM

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5
Q

IHSS combines what 2 things?

A

SAM & ASH

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6
Q

HOCM combines what 2 things?

A

SAM & HCM

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7
Q

Which cardiomyopathy is autosomal dominant?

A

HCM

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8
Q

HCM is what kind of disarray?

A

Myocardial fiber

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9
Q

HCM leads to?

A

Diastolic dysfunction (filling issues)

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10
Q

True or false- LAE occurs with HCM

A

True

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11
Q

True or false - MR does not occur with H?

A

False. MR does occur

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12
Q

With HOCM what leaflet does the obstruction hit?

A

AMVL

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13
Q

Mitral valve _____ and septal ___ may result from leaflets striking the IVS

A

Thickening ; scarring

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14
Q

True or false- MAC may be present with HCM

A

True

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15
Q

Diastolic dysfunction occurs with HCM because of the?

A

Noncompliant LV

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16
Q

What are the 5 symptoms of HCM?

A

DOE
Angina
syncope
Sudden death
Arrhythmias

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17
Q

What murmur is associated with HCM?

A

Systolic murmur- crescendo decresendo. Increased with amyl nitrate or valsalva

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18
Q

What is amyl nitrate?

A

Vasodilator for chest pain

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19
Q

They’re are 4 HCM variation. Name them. Describe them.

A

Sigmoid - septum is thicker than the rest of septum
Reverse curve - entire septum curves into LV
Apical - ace of spades HCM- apex is thicker than rest of LV
Netural- concentric HCM

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20
Q

What is the most common HCM variation?

A

Sigmoid 40-50%

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21
Q

What is the second most common HCM variation?

A

Reverse curve 30-40%

22
Q

AHCM shows what signs on EKG?

A

Increased QRS and giant negative T waves

23
Q

AHCM is most common in what country?

A

Japan

24
Q

AHCM has what specific sign we use to describe it?

A

Ace of spades

25
Q

What is the etiology of AHCM?

A

Genetic

26
Q

What does the Doppler of AHCM look like?

A

Sharp downward peak then flow acceleration in mid LV

27
Q

Flow acceleration in mid LV describes what type of HCM?

A

Apical Hypertrophic cardiomyopathy

28
Q

What will the myocardium of a HCM look like?

A

Bright appearance from fiber disarray

29
Q

True or false - with HCM the LV cavity is large

A

False. LV is small with HCM

30
Q

Ventricular contraction with HCM may be ___ or _____

A

Normal Or hyper dynamic

31
Q

With HOCM what might occur with the aortic valve?

A

Mid systolic closure is there’s an obstruction

32
Q

HCM may be symmetric or asymmetric. What is the ratio for asymmetric Hypertrophy?

A

> 1.3 :1

33
Q

With HOCM septal contact with the AMVL increases with what 2 things?

A

Valsalva or amyl nitrate

34
Q

LVOT obstruction causes the aortic valve to?

A

Close during mid systole

35
Q

With HCM what does the mitral inflow look like?

A

Decreased E wave due to abnormal relaxation and large A wave

36
Q

On your E/A wave. What is the duration just before the E wave called?

A

IVRT

37
Q

On your E/A wave. What is the duration just after the A wave called?

A

IVCT

38
Q

True or false - mid ventricular subaortic gradient may be present with HCM?

A

True

39
Q

What does the Doppler of HOCM & IHSS look like?

A

Late peaking systolic jet ; dagger shape

40
Q

A late peaking Doppler jet goes with?

A

IHSS & HOCM

41
Q

What is the drug inderal ?

A

Beta blocker

42
Q

The drug indetral ____ SAM with excercise

A

Reduces

43
Q

True or false- With HCM the subaortic gradient will increase with provocation

A

True

44
Q

A 64 year old female with IHSS and a resting gradient of 150mmhg was admitted to the hospital with chest pain. The next day the resting gradient was 15mmhg. What happened?

  1. LV infarction
  2. RV infarction
  3. A-fib developed
  4. Post MI VSD
A
  1. LV infarction
45
Q

What are 2 treatments for HCM?

A
  • surgical septal myectomy ( open heart surgery to remove thick myocardium)
  • ETOH septal ablation (non-surgical. Catheter put into groin and into aorta and into the vessels that enter the IVS. Alcohol is injected into thick myocardium. The toxicity of the alcohol shrinks and kills the thick areas.
46
Q

Strain measures the ____ within the ____

A

Deformation ; myocardium

47
Q

The acoustic signature in tissue that the GLS software tracks is called?

A

Speckle

48
Q

What’s a normal GLS?

A

-16 to -20 %or more

49
Q

HOCM patients usually have a GLS of?

A

-8% to -10%

50
Q

What changes first within the myocardium?
Strain or EF?

A

Strain is though to change first

51
Q

____ is the acoustic signature in myocardial tissue which is what strain tracks

A

Speckle

Cardiomyopathies (5 decks)

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