Term
| What is seen on echo of dilated cardiomyopathy (DCM)? |
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Definition
| ventricular enlargement and systolic dysfunction |
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Term
| What is seen on echo of hypertrophic cardiomyopathy (HCM)? |
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Definition
| imappropriate myocardial hypertrophy in the ahscence of HTN or aortic stenosis |
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Term
| What is seen on echo of restrictive cardiomyopathy (RCM)? |
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Definition
| abnormal filling and diastolic dysfunction |
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Term
| What is the most common form of CM? |
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Definition
|
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Term
| What is the rarest form of CM? |
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Definition
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Term
| Which chmabers of the heart are enlarged in DCM? |
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Definition
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Term
| What is the most common etiology of DCM? |
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Definition
|
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Term
| Name 4 factors suspected in the initiation of DCM. |
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Definition
| 1) Etoh or other toxicity (doxyrubicin, cobalt) 2) Pregnancy 3) Genetics 4) Post-viral (coxsackiev) myocarditis |
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Term
| What are the most common ages for the occurence of DCM? |
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Definition
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|
Term
| What gender is DCM more common? |
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Definition
|
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Term
| What is usually the ultimate cause of death in pts w/ DCM? |
|
Definition
| cardiac failure or arrythmia |
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Term
| Name 3 things that are associated with higher mortality in DCM. |
|
Definition
| Age, male sex, and severe CHF |
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Term
| What are the most common sx of DCM? |
|
Definition
| decreased exercise tolerance, dyspnea, fatigue, edema |
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Term
|
Definition
| hypotension, tachypnea, tachycardia, JVD |
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|
Term
| What is heard on auscultation of DCM? |
|
Definition
| displaced PMI, S3 gallop, mitral regurg murmur, crackles or signs of pleural effusion |
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Term
| What should be on the top of the list of DDx if DCM is suspected? |
|
Definition
|
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Term
| What is considered the most definitive diagnostic tool for DCM? what does it show? |
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Definition
| Echo - LV dysfunction, impaired ventricular dysfxn, EF <40% |
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Term
| What is seen on EKG in a pt w/ DCM? |
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Definition
| low QRS voltage, nonspecific ST-T changes, conduction delay, ventricular ectopy |
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Term
| What is seen on CXR in DCM? |
|
Definition
| cardiomegaly, pulmonary congestion |
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|
Term
| what is seen on cardiac cath in DCM? |
|
Definition
| LV dilation and dysfunction, high diastolic pressure, low CO |
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Term
| What would you advise a pt w/ DCM to do? |
|
Definition
| Activity as tolerated, no etoh, restrict salt and fluid |
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Term
| What are the 1st line drugs to tx DCM? |
|
Definition
| ACE inhibitors (lisinopril, enalapril) |
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|
Term
| What meds are given to tx congestion state of DCM? |
|
Definition
| Diuretics (HCTZ, furosemide) |
|
|
Term
| What meds can reduce mortality in DCM? |
|
Definition
|
|
Term
| What is given to pts with an EF <30% in DCM? |
|
Definition
| warfarin (anticoagulation) |
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|
Term
| What meds are thought to help improve QOL in pts w/ DCM? |
|
Definition
| Cardiac glycosides (digoxin) |
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|
Term
|
Definition
| ventricular hypertrophy (LV most often) with impaired ventricular filling d/t diastolic dysfxn |
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|
Term
| What is the form of HCM in which the location of the septal hypertrophy causes obstructive interference to the LV outflow? |
|
Definition
|
|
Term
| What do cardiac muscle cells look like in HCM? |
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Definition
|
|
Term
| What is the most common cause of sudden cardiac death? |
|
Definition
|
|
Term
|
Definition
| Genetic - autosomal dominant in 50% |
|
|
Term
| what is the pathology in HCM? |
|
Definition
| defects of the cardiac sarcomere proteins (myosin, tropomyosin, troponin T) |
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|
Term
| What are 2 other etiologies of HCM? |
|
Definition
| abnormal sympathetic stimulation (excess catecholamines - NE) and thickened coronary art. from ischemic HD |
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|
Term
| What is the peak incidence for age of onset of HCM? |
|
Definition
|
|
Term
| What is the peak age for pts w/ h/o HTN? |
|
Definition
|
|
Term
| Which gender is HCM more common? |
|
Definition
| men slightly more than women |
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|
Term
| What is associated with a higher risk of sudden death from HCM? (6) |
|
Definition
| <30 yo, famhx sudden cardiac death, aborted cardiac death, sustained VT or SVT, recurrent syncope in young, brady arrythmias |
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|
Term
| What are the most common sx of HCM? |
|
Definition
| dyspnea (90%), syncope, CP, palpatations, dizziness |
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|
Term
| what might you hear on auscultation of HCM? |
|
Definition
| harsh systolic ejection murmur, displaced PMI, splitting of S2, S3 in CHF, loud S4, holosystolic murmur, bisferians pulse |
|
|
Term
| What is a major arrythmia that occurs in HCM? What is a consequence of this? |
|
Definition
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|
Term
| What body position makes the heart murmur softer in HCM? Louder? |
|
Definition
| Squatting makes it softer and standing makes it louder |
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|
Term
| What is the main diagnostic test used to dx HCM? What is seen on the test? |
|
Definition
| Echo - assymetric septal hypertrophy, LVH, diastolic dsfxn |
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|
Term
| Is CXR helpful in the dx of HCM? |
|
Definition
| Nonspecific - may or may not show cardiomegaly |
|
|
Term
| What lifestyle rec. would you give a pt w/ HCM? |
|
Definition
| Avoid strenuous exercise and excessive wt gain |
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|
Term
| What are 1st line drugs for the tx of HCM? |
|
Definition
|
|
Term
| Name 2 other drugs used in the tx of HCM? |
|
Definition
| calcium channel blockersand antiarrythmia (amniodarone) |
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|
Term
| What surgery is done to tx HCM? |
|
Definition
| catheter septal ablation using etoh infusion (myomectomy) |
|
|
Term
| What surgery helps prevent sudden cardiac death in HCM? |
|
Definition
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|
Term
| What surgery is done on a pt w/ HCM who has severe MR + CHF or pulm HTN? |
|
Definition
|
|
Term
| In which form of CM are the ventricular wallsexcessively rigid, impeding ventricular filling? |
|
Definition
|
|
Term
| What is infiltrative CM? Name 2 diseases that cause this condition. |
|
Definition
| RCM char by abnormal substances in the heart tissue. Amyloidosis and hemochromatosis |
|
|
Term
| Is there a genetic predisposition to RCM? |
|
Definition
|
|
Term
| What is the most common etiology of RCM in the US? |
|
Definition
|
|
Term
| What is the most common etiology of RCM related to other diseases? |
|
Definition
|
|
Term
| What is the most common etiology of RCM internationally? |
|
Definition
|
|
Term
| Describe the ventricle in RCM. Does it affect systolic or diastolic function? |
|
Definition
| Stiff, fibrotic ventricle with decreased compliance resulting in restricted diastolic filling |
|
|
Term
| What does restricted diastolic filling cause? |
|
Definition
| Low stroke volume and CHF |
|
|
Term
| What are the 3 most common sx of RCM? |
|
Definition
| Exercise intolerance, dyspnea, fatigue |
|
|
Term
|
Definition
| M/T regurg, JVD, pedal edema, ascites, hepatomegaly, dec. breath sounds |
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|
Term
| Name 3 ways to differentiate RCM from constrictive pericarditis? |
|
Definition
| pericardial knonck, no murmurs, pericardial calcification on CXR |
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|
Term
| What med is given to maintain NSR? |
|
Definition
|
|
Term
| What is used to tx hemochromatosis? |
|
Definition
|
|
Term
| What med is commonly given to pts w/ RCM to help control sx? |
|
Definition
|
|
Term
| Is heart transplant indicated in RCM? |
|
Definition
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