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43 Cards in this Set
- Front
- Back
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What are two causes of cm's?
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idiopathic (unknown)
autosomal dominant gene |
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What are four alternate acronyms for HCM ?
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ASH
SAM IHSS HOCM |
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What is the most common cm?
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ASH
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What does ASH stand for?
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asymmetric septal hypertrophy
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What does SAM stand for?
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systolic anterior motion of the MV
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What does IHSS stand for
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iodpathic hypertrophic subaortic stenosis
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What other two conditions go along with IHSS?
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SAM and ASH
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What does HCM stand for?
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hypertrophic cardiomyopathy
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What does HOCM stand for?
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hypertrophic obstructive cardiomyopathy
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What other two conditions accompany HOCM?
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SAM and HCM
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What will you see in the myocardium with HOCM?
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myocardial fiber disarray
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What chamber will be affected by HOCM?
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LA
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What happens to the LA with HOCM?
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it's dilated
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Why is the LA dilated with HOCM?
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diastolic dysfunction and/or MR
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What happens to the LV with HOCM?
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becomes noncompliant and you get diastolic dysfunction
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What may two things may be seen regarding the septum with HOCM?
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subaortic septal hypertrophy causing obstruction
septal scarring from MV leaflets striking it |
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What else may cause obstruction with HOCM?
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anterior MV leaflet motion
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What three things may be seen regarding the MV with HOCM?
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thickening
MAC/fibrosis systolic anterior motion |
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What are five physical signs of HOCM?
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DOE
angina arrhythmias syncope sudden death |
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What murmur is associated with hypertrophic cardiomyopathy?
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crescendo-descescendo systolic murmur that increases with valsalva or amyl nitrite
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What effect does aml nitrite have with HOCM?
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tachycardia
LVOT gradient increase SAM increase murmur increase |
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What is another type of hypertrophc cardiomyopathy?
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AHCM - apical hypertrophic cardiomyopathy
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What EKG finding is associated with it AHCM?
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increased QRS voltages and negative T waves
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What country is AHCM more prevalent in and what is the incident percentage?
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Japan
20% of all HCM vs 2% in US |
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What is a term used to describe one view of AHCM on echo?
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ace of spades
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What is ACHM's usual cause?
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genetic
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What might you see on doppler in LVOT with AHCM?
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flow acceleration in mid lv
late peaking systolic jet |
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What is the ratio for assessing asymmetric hypertrophy?
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1.3:1
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What appearance might the myocardium have with HCM and why?
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bright from fiber disarray
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What will you see in regard to the ventricular walls with HCM?
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asymmetric or symmetric thickening
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What might you see in regard to ventricular contraction and EF with HCM?
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could be normal or could be hyperdynamic
EF can be elevated, 60-70% |
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What might you see in regard to the AV with HCM?
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mid systolic closure
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How is asymmetric hypertrophy defined?
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septal to posterior wall > 1.3:1
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What will alter septal contact and how?
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valsalva and amyl nitrite will increase it if patient not on beta blockers
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The Venturi effect can be associated with which cardiomyopathy?
a) dilated b) restrictive c) hypertropic d) ischemic |
c) hypertrophic
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LVOT obstruction causes the AV to:
a) flutter in diastole b) close in mid-systole c) flutter in systole d) close in late systole |
b) close in mid systole
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what does this show
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mid systolic closure or aortic valve
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Doppler shows mitral inflow and shows A wave greater than E wave. What does this mean?
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diastolic dysfunction, impaired relaxation
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What are four other doppler findings which might be apparent with HCM?
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gradient
turbulence mr late peaking systolic jet |
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Does Inderal (beta block) increase SAM?
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no, decreases heart rate and reduces SAM
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What kind of doppler jet goes along with HOCM and IHSS
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late peaking
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61 YO male with IHSS and a resting gradient of 144 mm Hg. Admitted ot hospital with CP. Next day gradient is 15. what happened.
a) LV infarct b) RV nfarct c) a-fib d) post MI VSD |
a) LV infarct
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what does this show
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SAM
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