Restrictive Cardiomyopathy Flashcards
In restrictive cardiomyopathy, what are the main LV findings?
- Non-dilated LV (or small cavity).
- Normal systolic function (in early disease; impairs later on).
- Impaired diastolic dysfunction (with or without LVH).
RCM can be classified as primary/idiopathic or secondary; which has normal wall thickness and which has LVH?
Primary/idiopathic = normal wall thickness; Secondary = LVH.
Which classification of RCM (primary/idiopathic or secondary) are due to infiltrative disorders?
Secondary.
Impaired diastolic dysfunction results in an increase in what three pressures?
LVEDp and LAp (and as a result elevated right sided pressures).
True or false; a common finding in RCM is biatrial dilatation.
True.
True or false; a common finding in RCM is biventricular dilatation.
False; usually the ventricles are normal size and systolic function.
True or false; a common finding in RCM is a dilated IVC.
True.
In restrictive physiology (grade III diastolic dysfunction) what are the “normal” findings?
E/A >2, DT <130ms, reduced e’ velocities, dilated LA, S/D<1 and E/e’ >13.
What is the most common cause of secondary RCM?
Cardiac Amyloidosis.
LV wall thickness of >12mm (with concentric thickening) may suggest an infiltrative disease in the absence of what?
Other pathology, such as HTN, HCM or significant AS.
True or false; a common finding in RCM is a small pericardial/pleural effusion.
True.
With regards to the pulmonary vein flow, a PV and a dur-A dur of what is indicative of restrictive filling?
PVa ≥ 0.35m/s ; a dur - A dur ≥ 20ms.
IVRT is the time interval between the end of LVOT ejection and the onset of mitral inflow; a short or long IVRT is in keeping with severe restrictive filling?
Short.
What is considered short for IVRT?
<50ms.
“A” dur refers to what?
Duration of atrial filling wave on PW Doppler (mitral inflow).
