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Luis Foundations 2 > Myocarditis > Flashcards

Myocarditis Flashcards

1
Q

what heart disease is charaterized by abnormal heart muscle not from CAD, HTN, Valve disease, or CHD?

A

cardiomyopathies

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2
Q

what is the most common cardiomyopathy, and its cause

A

dilated, idiopathic

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3
Q

inability to contract and expel blood is a ____ side heart problem, while cor pulmonale is a ____ side heart problem

A

Left, Right

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4
Q

heart disease associated with enlarged atria

A

Cardiomyopathy

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5
Q

what disease has LV cavity increases with not HTN or Hypertrophy and has endocardial fibrosis

A

Cardiomyopathy

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6
Q

what are the ABCDPIG causes of Dilated CM

A

Alcohol, beri beri, Cox, Drugs, Pregs, Idiopathic, genetic

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7
Q

Most common cause of dilated cardiomyopathy, and thus most common cause of HF due to systolic dysfunction. LVEF<35% from CAD

A

Ischemic CM

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8
Q

Treat this disease with ASA, statins, beta blockers, ACE, Loops, and K-sparring diuretics

A

Ischemic CM

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9
Q

associated with Acetaldehyde damage, leads to prolonged QT.

A

alcoholic CM, abstain

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10
Q

what disease has HF late in pregnancy (within 1 month of birth)

A

Peripartum Cardiomyopathy

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11
Q

when can you wean a patient with perpartum CM off therapy

A

LVEF>50%

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12
Q

Broken heart syndrome with systolic apical ballooning

A

Takotsubo

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13
Q

what CM leads to a troponin level 7x elevated, ST elevation, and with apical ballooning pattern

A

Takotsubo

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14
Q

Which CM has SXS of both LHF and RHF, with heaves and a shifted PMI

A

Dilated cardiomyopathy

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15
Q

What can you see in a CBC & CMP in Dilated CM?

A 
CBC = anemia (high output state)
CMP = hyponatriemia, LFTs, electrolyte inbalance
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16
Q

What can you see in a CXR, EKG, Cardiac Cath in DCM?

A

CXR = cardiomegaly, pulm congestion, Kerley B lines,
EKG = LVH, conduction delay, arrythmias.
Cardiac Cath = exclude ischemia

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17
Q

What disease do you treat like HF (Ace/Arbs, Beta blockers, aldostrone ant, Diuretics, Nitro, Sacubitril-valsartan)?

A

Dilated Cardiomyopathy.

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18
Q

If your patients has ischemic dilated CM what do you do?

A

Revascularization

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19
Q

How do ACE-I help DCM

A

reduce preload, afterload by vasodilation. Prevent cardiac remodeling.

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20
Q

What are the side effects of an ACE?

A

CHAA, Cough, hyperK, angio edema, acute nephritis

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21
Q

How do Beta blockers help DCM

A

In EF<40%, can reduce catecholamine effects and slow HR = increased filling time, while decreasing afterload. This allows better coronary perfussion.

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22
Q

When should you not give beta blockers to a patient with DCM

A

HR< 50, 2/3 degree heart block, asthma, COPD

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23
Q

What are surgical options for DCM

A

LVAD, cardiac resynchronization therapy if EF<35% or Bundle branch block on EKG.

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24
Q

most common cause of DCM

A

idiopathic

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25
Q

most common cause of HCM

A

Genetics, athlete that had SCD

26
Q

What disease has abnormal thickening of the intramural coronarys

27
Q

A hypercontractile LVH with a small cavity is

28
Q

what disease is associated with coronary compression during systole, and impaired filling in diastole, and with SAM (mital valve sytolic anterior motion)

29
Q

How does LVOTO affect preload, afterload, and inotropy in HCM

A

decrease preload & afterload but increased inotrophy

30
Q

what disease leads to SCD from venticular arryhthmias?

31
Q

How thick can the septal wall get in HCM

A

> 30 m, which leads to hypoperfusion, and syncope

32
Q

what disease do you see a double apical impulse (S4), and S2, and a crescendo-decrescendo murmur.

33
Q

TTE is used to diagnose what disease

34
Q

What are the first line meds for sxs arrythmias with HCM

A

beta blockers or anti-arrythmics (sotalol, amiodarone)

35
Q

what do you give a patient with A-fib and HCM

A

anticoagulants

36
Q

how does a beta blocker help in HCM

A

reduces inotrophy, 02 demands, and increases LV fill time

37
Q

if a Beta blocker doesnt work for HCM, whats next?

A

discontinue BB and give CCM like verapamil

38
Q

If a beta blocker or a CCM didnt help a patient with HCM, whats next

A

give Disopyramide (antiarrhythmic), strong anticholinergic effect & prolonged QT

39
Q

what are the surgical treatments for HCM

A

Surgical septal myectomy (needs cardiopulm bypass)

Alcohol ablation: ablate SAM (mitral valve systolic anterior motion)

40
Q

What type of murmur do you see in HCM

A

crescendo-descendo in LLD position

41
Q

What CM is associated with non-dilation, non-hypertrophic disease but has amyloidosis

A

RCM - with bi-atrial enlargement (from impaired LV filling)

42
Q

What are some main causes of RCM

A

1st = idopathic (associated with Loefflers Eosinophilia)

Amyloidosis, Sarcoidosis, cancer, radiation induced, hemochromatosis.

43
Q

What is the most common worldwide cause of RCM

A

Leofflers eosinophiliac endocarditis

44
Q

What disease shows RHF sxs (LE pitting, edema, hepatomegaly, ascites, JCD), Cardiac cachexia, and periorbital purpura

45
Q

What disease gives a positive Kussmaul’s sign

A

Kussmauls = JVD during inspiration.

RCM

46
Q

What is the front line daignosis test for RCM

A

Echo: with infiltrate disease, you can see concentric LVH, and specific strain patterns. without amyloids, see dilated atria

47
Q

What type of pattern can be seen in a Cardiac MR with RCM

A

Late Gadolinium Enhancement (LGE)

48
Q

What lab tests can show that a patient has RCM?

A 
CBC = eosinophilia smearing
CMP = LFTs and Fe conc.
BNP = elevated in RCM not in restrictive pericarditis
EKG = ST changes in 90% of patients and low voltage
49
Q

What tests will differentiate between RCM and restrictive pericarditis

A

Cardiac cath
Ventricular biopsy: see infiltrates,
BNP: elevated in RCM
CBC = Leofflers eosiniophilia

50
Q

What are the medical goals and tx for RCM

A

Goal: reduce LV filling pressure w/o losing CO
Meds = beta blockers and CCB (increase LV filling time)
Diuretics (reduce preload)
ACE/ARB (poorly tolerated>
Anticoag - if A-fib

51
Q

How do you treat amyloids, sarcoidosis, or hemochromatosis in RCM

A 
Amyloids = chemo
Sarcoidosis = corticosteroids
Hemochrom = phlebotomy
52
Q

What disease is associated with Periorbital purpura

53
Q

What disease is associated with cardiac cachexia

A

Amyloidosis of RCM

54
Q

Inflammatory infiltrate of myocardium with necrosis not from ischemia or CAD

A

Dallas Criteria

55
Q

Causes of Myocarditis

A

Idiopathic or viral

Chagas, HIV, autoimmune

56
Q

what percentage of Myocarditis leads to DCM

57
Q

What disease presents with Flu like or URI sxs?

A

Myocarditis

58
Q

what are the acute signs of decompensated HF in myocarditis

A

S3, edema, tachy

Pericardial friction rub with pericarditis

59
Q

What is the Gold stnd for diagnosing Myocarditis

A

Endomyocardial Biopsy

60
Q

Why do you do an Echo and Cardiac MR when suspecting Myocarditis

A

Echo = rule out HF

Cardiac MR = rule out ischemic CM

61
Q

What disease can be diagnosed with serum viral titers

A

Myocarditis

62
Q

What is the common tx for Myocarditis

A

Supportive, most recover.

Luis Foundations 2 (5 decks)

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