Cardio Quiz #2 - Myocardial Disease

Front 1

What are the 2 ways to classify heart failure?

Back 1

1) Systolic Disfunction - unable to contract well

2) Diastolic Disfunction - unable to fill well

Front 2

What is the main manifestation of Left-sided heart failure?

Back 2

Pulmonary congestion leading to pulmonary edema and pleural effusions

Front 3

Name the 4 major causes of Left-sided heart failure.

Back 3

1) Valvular disease

2) Hypertension

3) Ischemic heart disease

4) Cardiomyopathies

Front 4

What are the main manifestations of Right-sided heart failure?

Back 4

Venous Congestion - ascites, dependent pitting edema, hepatospleenomegaly w/ "nutmeg liver"

Front 5

What manifestation is common to both right and left-sided heart failure and causes fluid retention to further complicate heart failure?

Back 5

Pre-Renal Azotemia (renal failure due to poor perfusion)

Front 6

What are the 3 causes of Right-sided heart failure?

Back 6

1) Left-sided heart failure (most common)

2) Mitral Stenosis

3) Cor Pulmonale

Front 7

What condition always precedes congestive heart failure and why?

Back 7

Cardiac Hypertrophy - due to increased number of sarcomeres requiring a larger oxygen demand that cannot be met

Front 8

Which type of of hypertrophy is the result of pressure overload?

How does this change the size of the chamber?

Back 8

Concentric Hypertrophy - decrease chamber size

Front 9

Which type of of hypertrophy is the result of volume overload?

How does this change the size of the chamber?

Back 9

Eccentric/Serial Hypertrophy - increases chamber size

Front 10

What is the normal mass of the heart?

Back 10

300-350 grams

Front 11

What 2 conditions increase the mass of the heart the most (ie cause the most hypertrophy)?

Back 11

Aortic Regurgitation

Hypertrophic Cardiomyopathy

(~1,000 g)

Front 12

Back 12

Concentric Hypertrophy

Front 13

Back 13

Dilated/Eccentric/Serial Hypertrophy

Front 14

Back 14

Box-Car Nucleus - seen in hypertrophy

Front 15

What is the main criteria to diagnosis a cardiac dysfunction as a "Myocardial Disease" (ie Cardiomyopathy)

Back 15

Cardiac dysfunction not linked to CAD, valvular disease, or hypertension

Front 16

Hypertrophic (600+ g), flabby heart with all 4 chambers dilated

Back 16

Dilated Cardiomyopathy

Front 17

What type of cardiac dysfunction does dilated cardiomyopathy cause?

Back 17

Systolic dysfunction

Front 18

Give the 5 causes for dilated cardiomyopathy.

Back 18

1) Genetic mutation in mt. or myocyte cytoskeletal genes (main cause)

2) Viral myocarditis

3) Pregnancy

4) Drugs (mainly chemo and cocaine)

5) EtOH

Front 19

Back 19

Dilated Cardiomyopathy

Front 20

Back 20

Dilated Cardiomyopathy

Front 21

Back 21

Dilated Cardiomyopathy with vacular degeneration (left), interstitial fibrosis (middle), and variation in myocyte size (right)

Front 22

Massive (1000 g) hypertrophic and hypercontracted heart with asymmetric septal hypertrophy

Back 22

Hypertrophic Cardiomyopathy

Front 23

What type of cardiac dysfunction does hypertrophic cardiomyopathy cause?

Back 23

Diastolic dsyfunction (and outflow obstruction in 1/3 of cases)

Front 24

What general class of protein mutation cause hypertrophic cardiomyopathy and what 4 specific proteins are effected?

Back 24

Sarcomere proteins

1) B-myosin heavy chain (most common)

2) Troponin T

3) alpha-Tropomyosin

4) Myosin-Binding protein C

Front 25

What kind of murmur might occur with hypertrophic cardiomyopathy?

Back 25

Harsh systolic ejection murmur (due to outflow obstruction)

Front 26

What are the 3 complication of hypertrophic cardiomyopathy?

Back 26

1) focal ischemia

2) A-fib with mural thrombi

3) Sudden death from an arrthymia

Front 27

Back 27

Hypertrophic Cardiomyopathy - septal hypertrophy and functional aortic stenosis that may causes outflow obstruction

Front 28

Back 28

Myocardial Disarray from Hypertrophic Cardiomyopathy

Front 29

Normal heart size, contractility, and non-dilated ventricles but decreased filling during diastole and bilateral atrial dilation

Back 29

Restrictive Cardiomyopathy

Front 30

What are the 3 main causes of restrictive cardiomyopathy

Back 30

1) radiation

2) sarcoidosis

3) amyloidosis

Front 31

Back 31

Restrictive Cardiomyopathy

Front 32

What are the 2 indications for a right atrial cardiac biopsy?

Back 32

Suspect myocarditis or amyloidosis

Front 33

Right heart failure with thinned right ventricular walls and ventricular arrhythmias

Back 33

Arrhythmyogenic Right Ventricular Cardiomyopathy

Front 34

What syndrome is Arrhythmyogenic Right Ventricular Cardiomyopathy associated with?

Back 34

Naxos Syndrome - causes hyperkeratosis of soles/palms due a plakoglobin mutation

Front 35

Back 35

Arrhythmyogenic Right Ventricular Cardiomyopathy - thinned right ventricle walls, interstitial fibrosis (blue), fatty infiltration

Front 36

How will a secondary cardiomyopathy heart appear?

Back 36

dillated cardiomyopathy

Front 37

What is the most common cause of myocarditis?

Back 37

Coxasackie A & B virus

Front 38

What is the most common cause of heart failure in south america?

Back 38

Chaga's disease due to infection from Trypansomi cruzi

Front 39

Back 39

Hemachromatosis - cause of secondary cardiomyopathy

Front 40

Back 40

Myocarditis with lymphocyte infiltration and myocyte necrosis

Front 41

Back 41

Cysts from parasitic myocarditis

Front 42

Back 42

Carcinoid Valvular Disease - due to metastasis of a tumor to the liver that produces cytokines to damage the right heart and form plaques on the tricuspid valve

Front 43

Back 43

Leuitic (syphillis) Heart Disease - causes aneurisms of ascending aorta, dilation of aortic root, and LVH (cor bovinum)