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Cardiovascular II > Myocardium diseases > Flashcards

Myocardium diseases Flashcards

1
Q

LVEF in dilated cardiomyopathy

A

<40%

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2
Q

LVEF in hypertrophic cardiomyopathy

A

50-80%

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3
Q

LVEF in restrictive cardiomyopathy

A

45-90%

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4
Q

Mechanism of HF in dilated cardiomyopathy

A

Impairment of contractility –> systolic dysfunction

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5
Q

Mechanism of HF in hypertrophic cardiomyopathy

A

Impairment of compliance –> diastolic dysfunction

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6
Q

Mechanism of HF in restrictive cardiomyopathy

A

Impairment of compliance –> diastolic dysfunction

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7
Q

Causes of dilated cardiomyopathy

A

Genetic
Alcohol
Peripartum
Myocarditis
Hemochromatosis
Chronic anemia
Doxorubicin (Adriamycin) toxicity
Sarcoidosis
Idiopathic

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8
Q

Causes of hypertrophic cardiomyopathy

A

Genetic
Friedreich ataxia
Storage disease
Infants of diabetic mother

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9
Q

Causes of restrictive cardiomyopathy

A

Amyloidosis
Radiation-induced fibrosis
Idiopathic

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10
Q

Indirect myocardial dysfunctions in dilated cardiomyopathy

A

IHD
Valvular heart disease
HTN heart disease
Congenital heart disease

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11
Q

Indirect myocardial dysfunctions in hypertrophic cardiomyopathy

A

HTN heart disease
Aortic stenosis

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12
Q

Indirect myocardial dysfunction in restrictive cardiomyopathy

A

Pericardial constriction

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13
Q

Characterized by ventricular chamber enlargement with impaired systolic contractile function.

A

Dilated cardiomyopathy

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14
Q

Genetic mutations that cause dilated cardiomyopathy

A

Mutations in proteins for sarcolemma, cytoskeleton, and nuclear envelope (laminin)

Mutation in TTN –> encodes titin

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15
Q

Inheritance of genetic dilated cardiomyopathy

A

Autosomal dominant

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16
Q

Takotsubo cardiomyopathy falls under what cardiomyopathy type?

A

Dilated

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17
Q

Causes of excess catecholamine production that can result in dilated cardiomyopathy

A

Pheochromocytoma
Cocaine or dopamine use
Intense autonomic stimulation
Emotional duress –> Takotsubo

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18
Q

Complications of dilated cardiomyopathy

A

Secondary mitral regurgitation
Abnormal cardiac rhythms
Embolism from intracardiac thrombi

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19
Q

Microscopy of heart in dilated cardiomyopathy

A

Hypertrophied with enlarged nuclei
Interstitial and endocardial fibrosis of a variable degree

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20
Q

Abnormally thickened ventricular wall with abnormal diastolic relaxation. Due to sarcomeric alterations, defective energy transfer, and/or exaggerated response of myocardial fibroblasts.

A

Hypertrophic cardiomyopathy

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21
Q

Inheritance of genetic causes of hypertrophic cardiomyopathy

A

Autosomal dominant with variable penetrance

22
Q

Genetic mutations associated with hypertrophic cardiomyopathy

A

Sarcomeric proteins –> missense
Beta-myosin heavy chain
Cardiac TnT
Alpha-tropomyosin
Myosin binding protein C (MYBP-C)

23
Q

Affect of sarcomeric alterations in hypertrophic cardiomyopathy

A

Abnormal cardiac contraction causing a secondary compensatory hypertrophy

24
Q

Affect of myofiber disarray in HOCM without outflow obstruction

A

Ventricular arrhythmias
Myocyte hypertrophy

25
Q

Complications of ventricular arrhythmias in HOCM without outflow obstruction

A

Syncope
Sudden cardiac death

26
Q

Complications of myocyte hypertrophy in HOCM without outflow obstruction

A

Ventricular hypertrophy
Increased stiffness and impaired relaxation –> diastolic dysfunction
Elevated LVEDP
Dyspnea, exertional

27
Q

Cause of outflow obstruction of blood flow to aorta in HOCM with obstruction

A

Abnormal motional of anterior mitral valve leaflet to cover the LV outflow tract

Also results in mitral regurgitation

28
Q

Harsh systolic ejection murmur heard best at the L lower sternal border. Intensity increases with decreased preload and decreases with increased preload and increased afterload.

A

HOCM

29
Q

Major clinical complications in hypertrophic cardiomyopathy (HOCM)

A

A fib
Mural thrombi embolization
Intractable cardiac failure
Ventricular arrhythmias
Sudden death

30
Q

One of the most common causes of sudden, otherwise unexplained, death in young athletes

A

HOCM

31
Q

Transthoracic echo findings in hypertrophic cardiomyopathy (HOCM)

A

Reduced LV cavity size
LA enlargement
Normal or increased LVEF
Overall increase in LV mass
Asymmetric LV wall thickness

32
Q

Microscopy of heart in hypertrophic cardiomyopathy

A

Massive myocyte hypertrophy
Asymmetric septal hypertrophy –> septum to free wall ratio of 3:1
Myofiber disarray –> irregular myofibers with surrounding collagen
Interstitial and replacement fibrosis

33
Q

Abnormally stiffened myocardium, because of fibrosis or infiltrative process, leading to impaired diastolic relaxation. Causing a primary decrease in ventricular compliance resulting in impaired ventricle filling.

A

Restrictive cardiomyopathy

34
Q

Peripheral eosinophilia and eosinophilic infiltrates in multiple organs, including heart, release major basic protein. Causes endomyocardial necrosis in the heart. May develop in restrictive cardiomyopathy.

A

Loeffler endomyocarditis

35
Q

Fibrosis of the ventricular endocardium and subendocardium that primary affects children and young adults in Africa and other tropical areas. May result in restrictive cardiomyopathy.

A

Endomyocardial fibrosis

36
Q

Fibroelastic thickening of the LV endocardium, most comment in first 2 years of life. A complication of mumps exposure in utero. May develop into restrictive cardiomyopathy

A

Endocardial fibroelastosis

37
Q

Most common recognized cause of restrictive cardiomyopathy in non-tropical countries

A

Cardiac amyloidosis

38
Q

Small, semi-translucent nodules (resembling drips of wax) may be seen on the atrial endocardial surfaces.

A

Cardiac amyloidosis

39
Q

Stain for amyloid fibrils that causes them to appear apple-green under polarized light

A

Congo red stain

40
Q

Effect of rigid myocardium in restrictive cardiomyopathy

A

Increased diastolic ventricular pressure –> venous congestion

Decreased ventricle filling –> decreased CO

41
Q

Major viral causes of myocarditis

A

Coxsackie virus B
Adenovirus
Parvovirus B19
HIV
HHV-6

42
Q

Major parasitic causes of myocarditis

A

Trypanosoma cruzi –> Chagas
Toxoplasma gondii

43
Q

Major bacterial causes of myocarditis

A

Borrelia burgdoferi
Mycoplasma pneumoniae

44
Q

Major toxins causing myocarditis

A

CO poisoning
Black widow venom

45
Q

Drugs that can cause myocarditis

A

Doxorubicin
Cocaine

46
Q

Autoimmune disease that can cause myocarditis

A

SLE
Kawasaki disease

47
Q

Complications of myocarditis

A

Sudden death
Arrhythmias
Heart block
DCM
Mural thrombi with embolization

48
Q

Microscopy finding in myocarditis caused by Chagas disease

A

Myofiber distended with trypanosomes

49
Q

Microscopy findings in myocarditis caused by toxoplasma

A

Toxoplasma pseudocyst in myocardial cell that contains bradyzoites

50
Q
A

Cardiovascular II (29 decks)

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