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cardiology #2 > myocardial and pericardial dz > Flashcards

myocardial and pericardial dz Flashcards

1
Q

inflammation of heart muscle resulting in myocardial necrosis and degeneration

A

myocarditis

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2
Q

variable clinical presentation including

  • viral prodrome
  • acute chest pain 1-4wks after viral or GI infection
  • subacute HF sx onset
  • cardiogenic shock
  • abnormal vital signs
A

myocarditis

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3
Q

has positive inflammatory markers, cardiac biomarkers and biopsy

A

myocarditis

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4
Q
  • Echo: normal to mildly reduced LV fxn to severe ventricular dysfxn
  • MRI– ventricular dysfunction and signs of inflammation
A

myocarditis findings

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5
Q

biopsy shows evidence of myocardial tissue necrosis and increased inflammatory cellular infiltrates

A

myocarditis biopsy findings

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6
Q

when do you do biopsy with myocarditis?

A

severe or refractory cases after other causes hae been excluded

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7
Q

3 tx of myocarditis

A
  • rest & tx signs of HF
  • avoid NSAIDs, alcohol, exercise, digoxin
  • routine f/u
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8
Q

name the condition

normal systolic function + diastolic dysfunction in non-dilated, rigid ventricle which impedes ventricular filling (reduced extent & rate)

A

restrictive cardiomyopathy

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9
Q

3 most common causes of restrictive cardiomyopathy

A
  1. Amyloidosis
  2. sarcoidosis
  3. hemochromatosis

all are infiltrative causes

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10
Q

3 most common causes of restrictive cardiomyopathy

A
  1. Amyloidosis
  2. sarcoidosis
  3. hemochromatosis

all are infiltrative causes

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11
Q

this describes the pathophys of what condition

stiff myocardium leads to decreased compliance, increased effort to fill ventricles cause elevated ventricular filling pressures & atria dilation

A

RCMP pathophysiology

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12
Q

can cause sx of L or RHF and nonspecific sx like palpitations, fatigue, malaise, weakness, anorexia, nausea, nocturia

A

RCMP

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13
Q

most common sx of both RCMP & HCM is

A

dyspnea

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14
Q

cardiomyopathy with kissmaul sign

A

RCMP

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15
Q

describe kussmaul sign

A

increased JVP with inspiration

normal is decreased

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16
Q

ventricular and atria finding on ECHO in RCM vs HCM

A
  • RCM– normal ventricle thickness + bilateral atrial dilation
  • HCM– asymmetric wall thickness
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17
Q

has no specific treatment but heart transplant is the only definitive treatment; can also treat the underlying d/o

A

RCMP tx

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18
Q

what can you do to identigy or r/o specific causes of RCMP

A

endomyocardial biopsy

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19
Q

differentiate RCM from constrictive pericarditis

A
  • RCM: S3, high BNP, biatrial enlargement
  • CP: pericardial knock, calcifications/thickining, low BNP
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20
Q

autosomal dominant; inappropriate LVH or RVH resulting in left ventricular outflow obstruction, diastolic dysfunction d/t hypercontractile ventricles and myocardial ischemia

A

HCM

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21
Q

what is this called

left ventricular outflow tract (LVOT) obstructed d/t asymmetrical septal hypertrophy and systolic anterior motion (SAM) of the mitral valve

A

subaortic outflow obstruction

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22
Q

what worsens subaortic outflow obstruction (2)

A
  • increased contractility (exercise, digoxin)
  • decreased LV volume (dehydration, maneuvers)
23
Q

most are asymptomatic but the ones w/ sx are dyspnea on exertion, palpiations, chest pain, exertional syncope

A

HCM sx

24
Q

2 tx of HCM

A
  • reduce outflow gradient w/ BB, non-DHP CCBs, disopyramide
  • ICD placement for secondary prevention of sudden death in hx of Vfib or sustained VT, syncope or holter monitor events
25
Q

4 things ppl w/ HCM should avoid

A
  • dehydration
  • exertion & strenous exercise
  • digoxin
  • vasodilators, diuretics, ACE/ARB, nitrates
26
Q

inflammation of the pericardium

A

pericarditis

27
Q

dresslers syndrome

A

post MI pericarditis + fever

28
Q

5 (technically 4) Ps of pericarditis

A
  • Pleuritic pain (sharp pain worse w/ inspiration)
  • Postural (worse supine)
  • Persistent chest Pain
  • Pericardial friction rub
29
Q
  • diffuse ST elevations (concave up) + PR depressions in precordial leads
  • ST depression & PR elevation in avR
A

pericarditis ECG findings

30
Q

normal echo but still done to r/o effusion and look for associated myocarditis

A

ECHO findings in pericarditis

31
Q

1st, 2nd, 3rd line tx of pericarditis

A
  1. NSAIDs or aspirin
  2. colchicine
  3. steroids if refractory (sx >48hrs)
32
Q

loss of ventricular elasticity (fibrosis, calcification) leading to restriction of diastolic filling; caused by acute pericarditis and chronic inflammation

A

constrictive pericarditis

33
Q

these are symptoms of?

  • dyspnea is main sx
  • R sided heart failure sx
  • Pericardial knock
A

constrictive pericarditis

34
Q

what is high pitched 3rd heart sound from sudden cessation of ventricular filling & what condition is it associated with

A

pericardial knock
associated with constrictive pericarditis

35
Q

which two pericardial diseases have both pulsus paradoxus and kussmauls sign

A
  • pericardial tamponade
  • constrictive pericarditis
36
Q

which pericardial dz would show diastolic collapse of cardiac chambers, hemodynamic compromise on an echo?

A

pericardial tamponade

37
Q

which pericardial dz would show pericardial thickening and calcification on an echo?

A

constrictive pericarditis

38
Q

which surgical procedure is done to definitively treat constrictive pericarditis?

A

pericardiectomy

39
Q

which procedure is done to treat pericardial tamponade?

A

pericardiocentesis

40
Q

name the condition

increased fluid in the pericardial space

A

pericardial effusion

41
Q

t/f, pericardial effusion shares the same etiologies as acute pericarditis

A

true

42
Q

sx of pericarditis + distant/muffled heart sounds is associated with which two pericardial dz?

A

pericardial effusion
pericardial tamponade

43
Q

these diagnostic test results is associated with which condition

  • ECG: low QRS complex, electrical alternans
  • Echo: increased pericardial fluid with NO hemodynamic compromise
A

pericardial effusion

44
Q

name the condition

pericardial effusion causing pressure on heart which limits ventricular diastolic filling

A

pericardial tamponade

45
Q

sx include: becks triad, pulsus paradoxus, kussmauls sign

A

pericardial tamponade

46
Q

name the phenomenon

pulses disappear or SBP drops more than 10 w/ inspiration

A

pulsus paradoxus

47
Q

what is becks traid (list the 3 things)

A
  • distant heart sounds
  • increased JVP
  • systemic HYPOtension
48
Q

definitive management for recurrent pericardial tamponade is ___

A

pericardial window

49
Q

name the condition

systolic dysfunction causing ventricular dilation; decreased LVEF < 40%

A

dilated cardiomyopathy
* mostly in 20-60 yo males

50
Q

can be caused by infectious, infiltrative dz, pregnancy, alcohol abuse, etc but the most common cause is idiopathic; makes up majority of all cardiomyopathies

A

dilated cardiomyopathy

51
Q

which cardiomyopathy has these clinical findings

  • S3 gallop
  • lateral PMI displacement
  • other heart failure signs
A

dilated cardiomyopathy

52
Q

which cardiomyopathy fits this finding

  • Echo: LV dilation, reduced EF, LV hypokineses
  • CXR shows cardiomegaly, pulmonary edema
A

dilated cardiomyopathy

53
Q

T or F: you treat dilated cardiomyopathy the same way you treat HFrEF

A

true

cardiology #2 (12 decks)

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