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Cardiovascular > Myocardia and Pericradial Diseases > Flashcards

Myocardia and Pericradial Diseases Flashcards

1
Q

types of cardiomyopaties

A

dilated

restrictive

hypertrophic

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2
Q

diseases that have to be excluded before diagnosis of cardiomyopathy

A

coronary artery disease

valvular heart disease

pericardial disease

hypertension

diseases of the greata vessels

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3
Q

common pathologic features of cardiomyopathies

A

elevated LV and ED pressures

reduced SV or CO

mitral regurgitation

supraventricular and ventricular arrhythmias

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4
Q

LV systolic function in cardiomyopathies

A

DCM - reduced

RCM - normal to reduced

HCM - normal to increased

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5
Q

etiologies for dilated cardiomyopathy

A
  1. Post-viral
  2. Post-partum
  3. Inflammatory
  4. Alcoholic
  5. Infectious
  6. Metabolic
  7. Toxins
  8. Chemotherapy
  9. End-stag restrictive cardiomyopathy

**most cases are now known to be inherited

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6
Q

dilated cardiomyopathy

A

LV dilated, systolic pump function depressed

elevated LV ED pressure, LA pressure, and pulmonary venous pressure

reduced CO leads to hypertrophy, apoptosis, and fibrosis, and finally congestive heart failure

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7
Q

physical findings of DCM

A

displaced apical impulse

apical S3

systolic murmur

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8
Q

treatment for DCM

A

removing or treating primary precipitating causes

beta blockers

ACE inhibitors

drugs that antagonize aldosterone

implantable defibrillators for arrhythmias

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9
Q

cardiac resynchronization therapy

A

three leads in right atrium, right ventricle, and coronary sinus

used to ensure heart depolarizes in snyc

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10
Q

causes of restrictive cardiomyopathy

A

amyloidosis

hemochromatosis

eosinophilia

sarcoidosis

radiation

neoplastic

infiltrative

idiopathic/inherited

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11
Q

pathophysiologic mechanisms of RCM

A

impaired LV diastolic filling

LV systolic dysfunction (late)

arrhythmias

due to thickening and stiffening of the ventricular myocardium

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12
Q

treatment for RCM

A

no specific treatments

treat underlying cause

most treatment is nonspecific and tries to deal with adverse effects

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13
Q

causes of hypertrophic cardiomyopathy

A

geneticallt transmitted diseaes with chormosomal abnormalties involving the contractile proteins

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14
Q

pathophysiology of HCM

A

hypertrophy of the LV without dilation

increases stiffness and impairs ventricular illing in diastole

lowered EDV reduces stroke volume during exercise

MI is common due to the hypertrophy

may have dynamic obstruction of LV outflow

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15
Q

management of HCM

A

directed toward reducing heart rate and LV contractility to improve LV filling

beta blockers and calcium channel blockers

diuretics if dyspnea is present

monitor arrhythmias, ICD implantation

surgery to increase outflow tract

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16
Q

pericardial diseases

A

acute pericarditis

constrictive pericarditis

pericardial effusion

17
Q

pathophysiology of acute pericarditis

A

acute inflammation of the visceral and parietal pericarium

results in chest pain, a pericardial friction rub, and ECG changes

if untreated, can progress to chronic constrictive pericarditis

18
Q

causes of acute pericarditis

A

most common is idiopathic or viral infection

other causes include:

TB

bacteria

fungus

acute MI

uremia

neoplasia

surgery

radiation

autoimmune

drugs

trauma

aortic dissection

chylopericardium

myxedema

19
Q

causes of chronic constrictive pericarditis

A

can arise from acute pericardial inflammation

viral, bacterial, TB, uremic, radiation, myxedema, and chylopericardium

surgery also may precipitate

20
Q

pathophysiology of chornic constrictive pericarditis

A

impairment of RV and LV filling

elevation of filling pressures and reduced CO

21
Q

physical findings of constrictive pericarditis

A

Kussmaul’s Sign

jugular venous distension

pericardial knock

22
Q

Kussmaul’s sign

A

increase in jugular venous pressure upon inspiration

23
Q

compliance relationship between DCM, RCM, and HCM

A
24
Q

pericardial effusion and cardiac tamponade pathophysiology

A

marked effusions cause rapid increases of pressures

severely reduces ventricular filling and forward output

25
Q

most common causes of pericardial effusions

A

neoplasia

idiopathic

uremia

infection

bacterial

iatrogenic cardiac perforation

TB

radiation

myxedema

acute aortic dissection

26
Q

physical findings of pericardial effusions

A

jugular venous distension

pulsus paradoxicus

hypotension

27
Q

treatment of pericardial effusion

A

pericardiocentesis

surgically placed pericardial window

28
Q

pulsus paradoxicus

A

a greater than 10 mmHg drop in blood pressure upon inspiration

Cardiovascular (46 decks)

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