Dr. Takubo Cardiomyopathies Cv Test 2

Front 1

Dilated cardiomyopathy pathology

Back 1

LV is weak so it stretches under the pressure of the blood

Front 2

Dilated cardiomyopathy presentation

Back 2

atypical chest pain
middle aged black males
dilated and imparied contraction of one or both ventricles
EF <40%
atrial and/or ventricular arrhythmias

Front 3

Causes of dilated cardiomyopathy

Back 3

Ischemia
Viral
Chemo drugs
Antiretroviral drugs
Ethanol
Hemochromatosis
Amyloidosis
Thyroid hormone excess or deficiency
Peripartum cardiomyopathy

Front 4

Chaga's disease

Back 4

megaesophagus
megacolon
cardiac disease
left ventricular apical aneurysms
all kinds of problems on ECG

Front 5

Peripartum cardiomyopathy

Back 5

last trimester-6 months post-partum
prognosis depends on if heart returns to normal
avoid future pregnancy

Front 6

Increased risk for peripartum cardiomyopathy

Back 6

multiparous
African American
>30 yrs

Front 7

If EF <20% in DCM

Back 7

high incidence of mural and peripheral thrombus

Front 8

Tx of DCM

Back 8

transplant
treat underlying cause
if in HF use diurectics

Front 9

Use Diurectics when

Back 9

have HF and can't breath
but if ventricle is obstructed like aortic stenosis or HCM be careful it will be like blood trying to force through a closed door and they die

Front 10

Traits of hypertrophic cardiomyopathy (HCM)

Back 10

disproportionate hypertrohpy of LV
predominance of septal wall
sudden cardiac death (esp. when there is familial history)

Front 11

4 symptoms that correlate with mortality in HCM

Back 11

age--increased risk in kids
sypmtoms at presentation or thereafter
Obstruction of outflow--LVH >25mm on ECG
Genetic defect

Front 12

HCM symptoms

Back 12

most are asymptomatic
dyspnea with exertion
orthopnea
chest pain
syncope or near syncope
palpitations
postrual lightheadedness
fatigue
edema
LVH
LAH
there is no correlation between degree of obstruction and symptoms

Front 13

Increased risk of sudden death with HCM

Back 13

>30yrs old
small ventricle
evidence of non sustained VT

Front 14

* HCM physical findings *

Back 14

S4 (younger pts)
LV lift at apex
Murmur is DECREASED with sustained hand grip
Murmur is INCREASED when preload is decreased
EKG--LVH, LAH, LAD (normal EKG is uncommon)

Front 15

HCM vs AS

Back 15

Murmur is inversly proprotional with preload in both
HCM--pulse is brisk
AS--pulse is delayed (pulsus tardus)
HCM--murmur radiates to base or axilla
AS--murmur radiates to the neck and increases with handgrip

Front 16

Tx of HCM

Back 16

transplant
no drug improves survival
be VERY careful with anything that decreases LV volume like diurectics

Front 17

Restrictive cardiomyopathy trats

Back 17

non-dilated, non-hypertrophied ventricles
severy diastolic dysfunction causes dilated atria
normal LV function

rare and a diagnosis of exclusion

Front 18

Restrictive CM causes

Back 18

secondary to amyloidosis, sarcoidosis, endomycardial fibrosis or induced from chemo or radiation

less frequent in US

Front 19

RCM

Back 19

can be any age but more common in elderly
pulmonary and systemic congestion
dyspnea
peripheral edema
palpitations
fatigue
weakness
exercise intolerance

Front 20

RCM physical findings

Back 20

usually normal cardiac exam
S3 or S4 usually S4
EKG is non-specific
Prominent X and Y decents

Front 21

RCM vs constrictive pericarditis

Back 21

RCM has:
EKG with normal voltages
non-displaced apical impulses
no evidence of peripheral calcifications on CXR

Front 22

Takasuf's CM

Back 22

Looks like an MI
Post menopausal women
sever life stressor
increases catecholamines which causes micro spasms in coronary arteries

Front 23

Takasuf's CM Tx

Back 23

supportive care
will reverse in 1-3 weeks