Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

DMST 367 Echo 3 > Restrictive And Other Cardiomyopathies > Flashcards

Restrictive And Other Cardiomyopathies Flashcards

1
Q

What does this image represent?

A

Dip and plateau/ square root sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why is there a different in waveform for the two?

A

Top is elevated filling pressures and the bottom is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does this image represent? And what features are present? 4

A
  1. Amyloidosis
  2. LVH present
  3. Speckled myocardium
  4. Small pericardial effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does this image represent? What is evident symptoms?

A
  1. Amyloidosis
  2. LVH and myocardial speckling evident
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the difference between the waveforms?

A
  1. Left: Normal heart 10cm/s
  2. Amyloid - S’ = 4cm/s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

RWMA don’t correspond to what in sarcoidosis?

A

Coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does this image represent?

A

RCM- HES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does this image represent?

A

Fabry disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does this image represent?

A

ARVC/D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does this image represent?

A

LV non-compaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does this image represent?

A

LV non-compaction

Look at the trabecular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does this image represent?

A

Non-compaction of the LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does this image represent?

A

Non-compaction of LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is restrictive cardiomyopathy RCM?

A

A type of cardiomyopathy characterized by increased resistance to ventricular filling due to increased myocardial stiffness, decreased compliance, or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is RCM associated with? 2

A

Increased filling pressures such as:
1. Increased LVED
2. Increased LAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the etiology of RCM?

A

Abnormal infiltration, storage or fibrosis within the myocardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are non-infiltrative restrictive CMO causes? 5

A
  1. Idiopathic CMO
  2. Familial CMO
  3. Hypertrophic CMO
  4. Scleroderma (scars in the heart)
  5. Diabetic CMO Fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is causes of infiltrative RCM? 4

A
  1. Amyloidosis
  2. Sarcoidosis
  3. Hurler’s disease
  4. Loeffler’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is causes of storage disease RCM?5

A
  1. Endomyocardial fibroelastosis
  2. Carcinoid heart disease
  3. Radiation
  4. Chemo effects
  5. HES
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hypertrophic CMO is a separate class from RCM but can cause what? Therefoer it can also be considered what?

A
  1. Restrictive physiology
  2. Non-infiltrative form of RCM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do we get a “dip and plateau”/ “square root” sign? 4

A
  1. Marked increase in LA Pressure
  2. Rapid rise in LV pressure with early diastolic filling
  3. Rapid equalization of LV and LA pressure
  4. Abrupt termination of early diastolic filling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Along with dip and plateau and square root, what is also seen with RCM filling pressures? 2

A
  1. Constrictive pericarditis
  2. Lots of early diastolic filling, but almost no late diastolic filling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are some RCM clinical findings? 4

A
  1. DDfxn =HFpEF
  2. ECG
  3. CXR
  4. Ausculations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the clinical finding of HFpEF for RCM?

A

HF due to elevated LVEDP + LAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the Clinical findings of ECG with RCM?
Arrhythmias such as: 1. A-fib (Common) 2. PVCs
26
What is clinical findings of CXR for RCM? 2
1. Cardiomegaly 2. Pulmonary congestion
27
What are clinical auscultations findings seen with RCM? 2
S3 and S4
28
What are some signs of left sided heart failure? 9
1. Paroxysmal nocturnal dyspnea 2. Elevated pulmonary wedge pressure 3. Pulmonary congestion 4. Restlessness 5. Confusion 6. Tachycardia 7. Exertional dyspnea 8. Fatigue 9. Cyanosis
29
What are some right sided heart failure symptoms? 8
1. Fatigue 2. Increase in peripheral venous pressure 3. Ascites 4. Enlarged liver and spleen 5. May be secondary to chronic pulmonary problems 6. Distended jugular veins 7. Anorexia and complications of GI distress 8. Dependent edema
30
Most infiltrative disease affect what? Except what?
1. LV 2. ARVD
31
ARVD is typically associated with what side of the heart?
Right side
32
What are RCM echo findings? 4 (Anatomy)
1. Bi-atrial enlargement 2. +/- LVH 3. Normal LV chamber size 4. DDfxn grade 1-3
33
Why is there Bi-atrial enlargement for RCM?
RCM mimics constrictive pericarditis, but bi-atrial enlargement indicates RCM
34
DDFxn of RCM is dependent on what?
1. Severity 2. May be normal funciton in early stages
35
What is the role of echo in terms of assessment for RCM? 3
Assess: 1. Chamber size and function 2. Degree of diastolic function 3. Degree or MR or TR
36
What do we need to determine with echo for RCM? 4
1. RVSP 2. RCM vs constrictive pericarditis 3. Degree of bi-atrial enlargement 4. Presence of pericardial effusion
37
What are the medical treatments for RCM? 2
1. CHF drugs such as diuretics and ACE inhibitors 2. Anticoagulants (A-fib)
38
What are surgical treatments for RCM? 3
1. Pacemaker 2. Implantable cardioverter defibrillator (ICD) 3. Cardiac transplant (poor long term results)
39
What are five restrictive CMO types?
1. Amyloidosis 2. Sarcoidosis 3. Hemochromatosis 4. HES 5. Fabry disease
40
What is amyloidoses?
Infiltrative disease characterized by the deposition of amyloid fibrils in the extracellular space of various tissues
41
What is the most common type of RCM?
Amyloidosis
42
With amyloidosis, there is a deposit of what between myocytes?
Amyloid proteins
43
Why is diagnosis of amyloidosis challenging? What is it misdiagnosed as commonly?
1. Requires biopsy 2. Misdiagnosed in early stages as LVH due to HTN
44
What organs may amyloidosis affect? 3
1. Kidneys 2. Liver 3. Heart
45
What are different amyloid disease types? 3
1. Primary/ idiopathic 2. Secondary 3. Familial (hereditary)
46
Primary/ idiopathic amyloid disease affects which demographic more?
Males 3:1
47
What is secondary amyloid disease associated with?
Other inflammatory disorders like R.A., Tuberculosis, chrohn's disease
48
What is another name for familila amyloid disease?
Transthyretin (TTR) type CMO
49
Who is most likely affected by Familial amyloid disease?
Senile males
50
What does the ECG look like for amyloid disease?
Low voltage ECG from
51
Why is there low voltage ECG with amyloid disease?
myocardial damage
52
In terms of amyloid disease, in addition to low voltage ECG, what is a very sensitive sign of amyloid?
LVH
53
What does the CXR look like for amyloid?3
1. Cardiomegaly 2. Pulmonary venous congestion 3. Pleural effusion
54
What can Cardiac MRI do for Amyloid disease? 2
1. Assess the extent of amyloid deposition 2. Better tissue characterization than echo
55
What are some 2D echo features of amyloidosis? 5
1. Granular appearance of the myocardium 2. **Concentric LVH + RVH** 3. **Mild-moderate bi-atrial enlargement** 4. **Pericardial effusion** 5. Evidence of PHTN
56
In terms of amyloid disease, what leads to more more severe diastolic dysfunction?
The greater the wall thickness
57
In terms of amyloid disease, what results in the most restrictive filling pattern in most patients? (Where is it?)
>15mm in the IVS/PW
58
What are some quantitative values of amyloid disease?4
1. Mitral E/A >2.0 2. Decel time <160ms 3. TDI e' septal <5cm/s 4. E/e' ratio >14
59
What is early changes for amyloid look like? (LV systolic function)
LV systolic function and size may be normal
60
What does late changes of Amyloid disease look like? (LV systolic function) 4
1. LV may dilate 2. LVEF may reduce 3. Mimics DCM as the thick LV muscle starts to thin and the LV dilates 4. LA will dilate
61
What is sarcoidosis?
Infiltrative, granulomatous disease affecting multiple organs, which involves the heart in 25% of patients
62
Which demographic is primary affected by sarcoidosis?
1. Females 2:1 2. Young Africans 3. Japanese
63
How common is sarcoidosis?
Rare
64
What does the granulomas infiltrate with sarcoidosis? 5
1. **Lungs** 2. **Lymph nodes** 3. Liver 4. Spleen 5. Skin
65
What are some clinical features of sarcoidosis?
1. Progressive HF S/S 2. sudden death 3. ECG features
66
What are some ECG features of sarcoidosis?
1. Ventricular arrhythmias 2. **Heart block**
67
The Dx for sarcoidosis is confirmed with what?
Myocardial biopsy
68
What are some early findings for sarcoidosis?
LVH
69
What are some late findings for sarcoidosis? 3
1. RWMA 2. Segmental wall thinning (fibrosis) 3. LV dilation and decreased EF
70
What wall is affected by sarcoidosis in terms of thinning?
Basal anteroseptal wall
71
What is hemochromatosis?
Iron storage disease characterized by the accumulation of excessive iron within the cells of various organs
72
What are the two types of hemochromatosis?
1. Primary 2. Secondary
73
Which gender is affected more with hemochromatosis? When does it become more apparent?
1. Females 2. Middle ages
74
What is primary hemochromatosis?
Metabolic syndrome with excessive absorption of iron from diet and reduced elimination
75
What is secondary hemochromatosis?
Iron overload due to repeated blood transfusions in patients with chronic anemia, prolonged hemodialysis alcoholic liver disease
76
What is the hemochromatosis clinical pentad? 5
1. CHG 2. **Liver cirrhosis** 3. Impotence 4. Diabetes 5. Arthritis
77
What is seen physically with hemochromatosis?2
1. High blood iron levels 2. "Bronze" skin
78
What does HES stand for?
Hypereosinonphilic syndrome
79
What is HES?
Blood disorder characterized by persistently elevated blood eosinophil counts without an identifiable underlying etiology
80
HES affects which side of the heart?
Both
81
What is needed to confirm diagnosis of HES?
Biopsy
82
What is the pathophysiology of HES? 4
1. Eosinophils infiltrate the endocardium 2. Mural thrombus and scarring 3. Thrombus is replaced by thrombosis 4. This stage may mimic DCM or RCM
83
What is Fabry disease?
Characterized by symmetric or asymmetric ventricular hypertrophy, conduction defects and aortic root dilation due to the accumulation of excessive lysome storage
84
What are five echo features of Fabry disease?
1. Hyperechoic endocardium 2. LVH 3. Diastolic dysfunction 4. Bi-atrial enlargement 5. Ao root dilatation
85
Fabry disease may present as what?
Depending on the manifestation 1. HCM 2. DCM 3. RCM
86
What are four less common infiltrative cardiomyopathies?
1. ARVD 2. LV non-compaction 3. Carcinoid heart disease 4. Collagen disorders
87
What are two examples of collagen disorders?
1. Lupus 2. Rheumatoid artritis
88
What does ARVD stand for?
Arrhythmogenic RV dysplasia/ cardiomyopathy
89
What is ARVD?
A progressive replacement of the RV myocardium by fibrous and fatty tissue, resulting in wall thinning and aneurysm formation
90
How common is ARVD?
Rare
91
What is the etiology of ARVD?
Genetic
92
What are clinical signs of ARVD? 3
1. Potentially asymptomatic 2. Arrhythmias > sudden death 3. CHF s/s
93
What is the most diagnostic way to determine ARVD?
Cardiac MR
94
What are Echo features of ARVD? 5
1. RV systolic and diastolic dysfunction 2. RV dilation, RV small aneurysms 3. RV trabeculations get bigger 4. Hyper-reflective moderator band 5. **Normal LV**
95
What is LV non-compaction?
A genetic cadiomyopathy characterized by prominent trabeculations and deep recesses, most commonly in the LV, which communicate with the ventricular cavity
96
What sign is seen clinically with LV non-compaction?
Arrhythmias
97
What is the best way to diagnostically see LV non-compaction? 2
1. Contrast may be useful 2. MRI better to assess extent of the disease
98
LV non-compaction occurs when?
During embryology
99
In terms of LV non-compaction, what supplies blood to the left heart?
Deep intertrabecular spaces from within the Left chamber, this is before coronary arteries have developed in the embryp
100
In terms of LV non-compaction, Trabeculae normally do what with LV wall?
Compact into the LV wall starting at base and ending at apex
101
Where is non-compaction seen with LV non-compaction? Why?
Apex, because this is the last area to compact

DMST 367 Echo 3 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions