Systemic Diseases

Question 1

Hypertensive heart disease is an end-organ consequence of ____ hypertension.

Answer 1

Systemic

Question 2

Hypertension is categorized by a systemic blood pressure above ____ mmHg and a diastolic above ____ mmHg

Answer 2

140 mmHg; 90 mmHg

Question 3

What are the m-mode findings of hypertension?

Answer 3

LVH
LA enlargement
Aortic root dilation

Question 4

What are the 2D findings of hypertension?

Answer 4

Concentric LVH and normal systolic function
Aortic valve may be sclerotic
LA enlargement
Dilation of aortic root
Mitral Annular Calcification (MAC)

Question 5

What are the Doppler findings of hypertension?

Answer 5

• Diastolic compliance may be impaired (MV pattern = prolonged relaxation)
• Aortic regurgitation and/or MR

Question 6

____ is a disease that affects the body’s ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy.

Answer 6

Diabetes

Question 7

What does diabetes do to heart disease?

Answer 7

Speeds it up

Question 8

More than ____% of deaths in diabetes patients are attributed to heart and vascular disease.

Answer 8

65%

Question 9

What are the m-mode findings of diabetes?

Answer 9

• Mostly normal
• LA enlargement if diastolic dysfunction is present

Question 10

What are the 2D findings of diabetes?

Answer 10

Normal systolic function
LA enlargement, possibly

Question 11

What are the Doppler findings of diabetes?

Answer 11

• Diastolic compliance may be impaired (MV pattern = prolonged relaxation)
• Look for MV inflow and pulmonary veins

Question 12

What is it called when too little thyroid hormone is produced in the body?

Answer 12

Hypothyroidism

Question 13

Those with hypothyroidism have symptoms associated with slow metabolism, such as:

Answer 13

Fatigue
Weakness

Question 14

Those with hypothyroidism will often have a ____ LV performance and cardiac output.

Answer 14

Decreased

Question 15

What is it called when there is too much thyroid hormone in tissues of the body?

Answer 15

Hyperthyroidism

Question 16

Hyperthyroidism will cause a(n) ____ in total blood volume and LV contractility.

Answer 16

Increase

Question 17

On 2D, hyperthyroidism will show a ____ ventricle.

Answer 17

Hyperdynamic

Question 18

___ is when too many parathyroid hormones (maintains calcium levels in the blood) are made by the glands.

Answer 18

Hyperparathyroidism

Question 19

Hyperparathyroidism causes an abnormally high level of ____ in the blood.

Answer 19

Calcium

Question 20

Chronic renal insufficiency is when a disease slowly and gradually destroys the filtering capacity of the ____.

Answer 20

Kidneys

Question 21

What are the echo findings of chronic renal insufficiency?

Answer 21

• LVH (due to long standing HTN)
• Systolic dysfunction (especially when on dialysis)
• Pericardial effusion

Question 22

____ is a connective tissue disease and chronic autoimmune disease.

Answer 22

Lupus

Question 23

Lupus is known as the “____ ____”

Answer 23

“great imitator”

Question 24

Symptoms of Lupus include fever, joint pain, fatigue, general malaise, and “____” rash

Answer 24

“butterfly”

Question 25

A cardiac complication of ____ is that it causes inflammation of any part of the heart: myocarditis, endocarditis, or pericarditis.

Answer 25

Lupus

Question 26

Noninfectious endocarditis, called ____, forms on the valves in Lupus patients.

Answer 26

Libman-Sachs

Question 27

With Lupus, you often find thickened leaflets, regurgitation, and leaflets that can’t ____ fully.

Answer 27

Coapt

Question 28

____ causes thickening and hardening of the skin, joints and internal organs (heart).

Answer 28

Scleroderma

Question 29

Echo features of scleroderma include:

Answer 29

- Global LV dysfunction - Nodules in myocardium or on valves - Pericardial constriction and/or effusion - Pulmonary hypertension - CHF - Conduction Abnormalities - Pericardial effusion (concurrent) - Can act just like an infiltrative cardiomyopathy

Question 30

____ ____ is a disorder that affects blood vessels in the fingers, toes, ears and nose.

Answer 30

Reynaud’s Phenomenon

Question 31

____% of scleroderma patients have Reynaud’s Phenomenon.

Answer 31

90%

Question 32

With Reynaud's Phenomenon ____ or ____ can cause small blood vessels in the fingers and toes to constrict and change color.

Answer 32

Stress or cold

Question 33

____ is an inflammatory arthritis that can cause the vertebrae to fuse.

Answer 33

Ankylosing spondylitis

Question 34

____ is a rare, usually benign, adrenal tumor that produces excessive catechomalines (high BP, palpitations, headache, sweating).

Answer 34

Pheochromocytoma

Question 35

What are the echo features of Ankylosing spondylitis?

Answer 35

- Dilation of aorta - AI

Question 36

What are the echo features of Pheochromocytoma?

Answer 36

- Increased HR and contractility - LV systolic dysfunction - LVH

Question 37

____ occurs when excess growth hormone is secreted from the pituitary gland (usually due to benign tumor).

Answer 37

Acromegaly

Question 38

What are the echo features of Acromegaly?

Answer 38

- Systolic and Diastolic Dysfunction - LVH - CHF

Question 39

Osler-Weber-Rendu is a disorder that affects ____.

Answer 39

Blood vessels

Question 40

A patient can get ____ disease as a result of poor cardiac output with malperfusion, or if there is long-standing RV dysfunction.

Answer 40

Liver

Question 41

____ results from prolonged heart disease, which affects the blood flow from the liver to the heart and consequently leads to build up of pressure.

Answer 41

Cardiac cirrhosis

Question 42

When the heart doesn't pump as well as it should, blood "backs up" into the ____.

Answer 42

Liver

Question 42

Pulmonary Hypertension is diagnosed when the blood pressure in the heart to lung circulation exceeds ____ mmHg at rest or___ mmHg with exercise.

Answer 42

25 mmHg; 30 mmHg

Question 43

What are the m-mode findings of pulmonary hypertension?

Answer 43

- RV dilation - Paradoxical septal motion - Septal hypertrophy - Right ventricular hypertrophy (RVH)

Question 44

What are the 2D findings of pulmonary hypertension?

Answer 44

- Dilated PA, RV, and RA; LV may be small - Paradoxical septal motion - Flattened IVS in PSAX - “D” shaped LV - Dilated IVC and hepatic veins

Question 44

What are the numbers for pulmonary hypertension - right heart systolic pressure?

Answer 44

Normal: 18-25 mmHg Mild: 30-40 mmHg Moderate: 40-70 mmHg Severe: >70 mmHg

Question 45

What are the numbers for pulmonary hypertension - acceleration time?

Answer 45

Normal: > 100 msec Mild: 80-100 msec Moderate: 60-80 msec Severe: < 60 msec

Question 46

Eisenmenger syndrome is a form of ____.

Answer 46

Pulmonary HTN

Question 47

When right heart systolic pressure increases past 70 mmHg is can turn into this. Right heart pressures become higher than the left heart pressures.

Answer 47

Eisenmenger syndrome

Question 48

Cor Pulmonale is ____ heart failure.

Answer 48

Right sided

Question 49

____ means the heart can't pump enough blood to meet the body's needs.

Answer 49

Congestive heart failure

Question 50

____ can occur when something suddenly affects the heart's ability to function.

Answer 50

Acute heart failure

Question 51

Signs and symptoms of acute heart failure are similar to those of chronic heart failure, but are more ____ and start or worsen suddenly.

Answer 51

Severe

Question 52

For acute heart failure, do a complete exam looking very hard for evaluation of both:

Answer 52

- Systolic function: EF, WMA, dp/dT (if MR is present) etc. - Diastolic function: MV inflow, pulmonary veins, TDI

Question 53

Hypereosinophilic syndrome occurs when there is too many ____.

Answer 53

white blood cells