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35 Cards in this Set
- Front
- Back
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Necessary for dx of dilated cardiomyopathy
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ejection fraction <40%
no significant CAD |
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Most common reason for heart transplantation
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dilated CM
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genes associated with hereditary cardiomyopathy
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Lamin A/C, myosin-binding protein C, Beta-myosin heavy chain, cardiac troponin T, Titin
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Gross anatomy changes for dilated CM
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biventricular dilatation
normal wall thickness |
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Main clinical manifestations of Dilated CM
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heart failure and arrhythmias
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How does mitral regurgitation occur with dilated CM?
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chamber dilates, pulling apart leaflets when they would close
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Dilated CM on CXR
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>50% chest diameter
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Diagnostic criteria of hypertrophic cardiomyopathy
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LV wall thickness >15 mm (normal <10mm)
Family hx/id genetic mutation exclude HTN (or other causes) |
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Prevalence of hypertrophic CM
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1 in 500
(more in men, more in AA) |
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What does HCM pathophys rely on?
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presence of absence of outflow of tract obstruction
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What can obstruct the HCM outflow of LV?
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anterior mitral valve leaflet
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How many HCM patients have dynamic outflow tract obstruction?
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1/3
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Most common symptoms of HCM
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dyspnea
angina palpitations sudden cardiac death (many asymptomatic) |
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Two ways angina can occur with hypertrophic CM
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dec supply due to compressed coronary microvasculature
inc demand due to inc muscle mass |
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2 causes of syncope in HCM
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arrhythmias and insufficient cardiac output
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Pts with Hypertrophic cardiomyopathy should have what for prevention?
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ICD implantation
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murmur that can indicate HCM
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harsh Creschendo-decreschendo murmur
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4 principles to think through HCM murmur sounds
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dec preload will dec LV size and dec flow
dec LV size leads to inc in obstruction in HCM AS is a fixed obstruction, HCM is dynamic inc in flow leads to inc in AS murmur |
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What do HCM appear to be on EKG?
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voltage criteria for LVH
diffuse repolarization abnormalities |
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Gold standard for dx HCM
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echocardiogram
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How can genetic testing be used for HCM?
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not required for dx
neg. does not exclude dx mutations don't change management + can prompt screening of family members |
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1st line therapy for HCM
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B-blockers
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ICD should be implanted for primary prevention with HCM and what?
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>1 of following risk factors:
family hx of SCD history of syncope non-sustained ventricular tachycardia wall thickness >30mm abnormal BP response to exercise |
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Two main tx for HCM
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surgical myectomy
alcohol septal ablation |
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Main causes of restrictive CM
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infiltration (v. mere fibrosis or primary cardiomyocyte)
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Key thought for cause with hypertrophic heart but low voltage EKG
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amyloidosis
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Dx for amyloidosis
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EKG, Echo, MRI, SPEP, ab fat pad
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Key clinical manifestation for sarcoidosis
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conduction system disease
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Dx for sarcoidosis
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presumptive if known sarcoidosis
imaging biopsy |
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Tx for sarcoidosis
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glucocorticosteroids
standard HF therapies Pacemaker/ICD heart transplant if severe (also, lacking other sarcoid) |
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fibrofatty infiltration of RV?
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arrhythmogenic RV cardiomyopathy
frequently results in ventricular arrhythmias |
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Prevalence of RVCM
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1 in 1000
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Key presentation of RVCM
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arrhythmias and heart failure
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What are found in ARVCM?
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genetic mutations, typically desmosomal proteins (most commonly, plakophilin)
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Tx for Arrhythmogenic RV CM
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no competitive athletics
ICD for high risk features |
