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84 Cards in this Set

  • Front
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Dilated cardiomyopathy etiology
primary is idiopathic
secondary=alcohol, viral, pregnancy, CAD.
Dilated cardiomyopathy heart shapes
Round, global or spherical in shape
Dilated cardiomyopathy Symptoms
SOB, pulmonary edema, fatigue, dry cough, chest pain, palpitations.
Dilated cardiomyopathy echo findings
4 chamber enlargement, decreased EF, regurgitant valves, thin walls, thrombus in apex and puffs of smoke(spontaneous contrast) indicating slow moving blood.
Hypertrophic cardiomyopathy etiology (HCOM)
Idiopathic, genetic origin
Cellular malformation affecting myocardium
Hypertrophic cardiomyopathy heart shapes
Assymmetric septal hypertrophy causing a possible outflow tract obstruction is classic finding, but may be concentric hypertrophy
Hypertrophic cardiomyopathy complication
Mitral regurgitation is common and sudden cardiac death
Hypertrophic cardiomyopathy symptoms
dyspnea, ANGINA, syncope and arrhythmias
Hypertrophic cardiomyopathy echo findings
When obstruction is present due to ASH and SAM, it is HOCM and the CW Doppler waveform will be dagger shaped and the PW of the LVOT will alias
Hypertrophic cardiomyopathy teatments
a myotomy or myectomy to remove excess septal tissue.
Restrictive/Infiltrative cardiomyopathy etiology
infiltrated by foreign substance
Restrictive/Infiltrative cardiomyopathy classification
Amyloidosis - protein(most common), Sarcoidosis – inflammatory, forms masses, Hemochromatosis, excess iron and Glycogen Storage Disease, glucose
Restrictive/Infiltrative cardiomyopathy heart appearance
Gives the ventricular walls a ground glass appearance. Also called speckled or granular
Restrictive/Infiltrative cardiomyopathy symptoms
dyspnea, CHF, fatigue, weakness and chest pain
Restrictive/Infiltrative cardiomyopathy echo findings
diastolic filling patterns due to very stiff walls. May have small pericardial effusion and regurgitant valves.
brightness in the walls. Usually symmetrical, but no guarantee because HCM can easily be concentric LVH as well.
Congestive Heart Failure definition
The heart's Inability to pump adequate amount of blood to meet metabolic demands of the body for Oxygen. Usually a dilated heart, but not always
Congestive Heart Failure common causes
HTN and may have LVH from the body’s attempts to work harder to provide the blood needed or from valvular disease preventing blood flow from moving out of heart
Congestive Heart Failure LVH complications
LVH eventually leads to dilated CMO with thin walls as disease process progresses. Typically will find moderate to severe jets of MR and/or TR
Congestive Heart Failure left heart effects
– Blood backs up into lungs and causes pulmonary edema, congestion, cough.
Congestive Heart Failure right heart findings
Blood backs into venous system. Causes peripheral/pedal edema. May have enlarged liver with ascites and bulging neck veins. Also dilated IVC
Definition of Cor Pulmonale
right side heart failure
Cor Pulmonale signs
enlarged liver with ascites and bulging neck veins. Also dilated IVC
CHF echo findings
RVVO with a dilated RV and a flattened or paradoxical septum
CHF drugs
diuretics, ACE inhibitors, digitalis.
Pericarditis symptoms
inflammation of the pericardium, usually after some sort of injury, e.g. MI, virus, bacterial infection, autoimmune response
Pericarditis auscultation sound
friction rub
pericaritis symptoms
Positional and respiratory pain
Pericardial Effusion definition
fluid in the pericardial sac
Pericardial Effusion can be confused with?
layer of epicardial fat if anterior only
critical factor in Pericardial Effusion
Rate of filling is the most critical factor to determine whether it will cause hemodynamic effect on the heart’s ability to fill with and eject blood
Pericardial Effusion cause
Fluid in sac usually drains into lymphatic system but when it is obstructed, the sac expands to hold it.
long standing Pericardial Effusion findings
fibrin strands in fluid
syndrome associated with Pericardial Effusion
Dressler’s syndrome is one cause of PE. Happens after MI
Pericardial Effusion to differentiate it from a Pleural effusion
use the DAO as a landmark in the PLAX. Fluid anterior to the DAO is pericardial, posterior is pleural
Pericardial Effusion how to quantify severity
Measuring fluid helps to quantify severity
Cardiac Tamponade heart views
Usually large effusions with swinging heart. Fills rapidly
Cardiac Tamponade symptoms
Pulsus paradoxus and electrical alternans are present. Beck’s triad – decreased systemic blood pressure, increased venous pressure, quiet heart sounds.
Cardiac Tamponade echo findings
RV collapse during Diastole. RA will collapse more easily, so if the RV is collapsing, the pressure is increased.
Cardiac Tamponade treatment
pericardiocentesis or a pericardial window
Cardiac Tamponade effects on valves
Mitral valve E wave will decrease with first inspiration and increase with first expiration. Tricuspid valve E wave will increase with inspiration and decrease with expiration and be more exaggerated than the left sided valve.
Constrictive Pericarditis definition
Calcification of Pericardium over time - Heart in Cement
Constrictive Pericarditis diastolic pathology
becomes a diastolic pathology where the ventricles cannot fill against the external pressure caused by the thickened pericardium
to venous engorgement and decreased cardiac output.
Constrictive Pericarditis etiolgoy
idiopathic in the United States, but can come from TB in other countries
Constrictive Pericarditis etiology in long term cases
autoimmune disease or radiation therapy.
Constrictive Pericarditis sounds
Pericardial knock
Constrictive Pericarditis doppler findings
similar to tamponade
Primary myocardial disease in CHF
CMOs
What is common in CHF that occurs at a rate of 6 to 9 times of that of the general population
Sudden death
In CHF MR or AI disease causes
Regurgitaion
What occurs in physically inactive patients with low cardiac output, and what may develop?
Pulmonary Embolism.
Venous thrombi may develop, which may produce pulmonary emboli and elevation of PAP leading to LV failure
Ischemic heart disease means
Low cardiac output
Three complications of CHF
a)Increased ventricular pressure
b)Elevated systemic & pulmonary pressure
c)decreased CO
what cardiac arrhythmias are associated with CHF
Tachy, Brady, & AFIB
which of the 3 arrhthymias (Tachy, Brady, & AFIB)precipitates CHF
Severe Bradycardia, in the absence of increased stroke volume can seriously reduce cardiac output and thus precipitate CHF
COPD can lead to...
Right heart failure
Reduced perfusion of central nervous system causes
Hypoxic encephalopathy (irritability to coma)
Which medication is used to prevent the production of a chemical that causes vessel constriction, helps to decrease BP and increase flow?
Angiotensin-Converting Enzyme (ACE) inhibitors
Which medication is used to increase the force of the heart's contraction and slows certain heart rhythms?
Digitals
What medication descreases the body's retention of salt and water, and helps to lower BP and decreases the workload of the heart?
Diuretics
What medication widens blood vessels, increasing flow?
Hydralazine
Which Medication relaxes smooth muscles and widens blood vessels and lowers BP?
Nitrates
how is CHF classified?
ACC and New York Heart Association use Class I through IV.
AHA uses grades A through D description.
pregnancy, ischemia, and infection are possible causes of what CMOs?
Dilated/congestive cardiomyopathy.
potential echocardiography findings of a dilated/cosgestive cardiomyopathy include?
a)Multi-chamber dilation
b)Increased "E" point to septal separation (on MV M-mode)
c)Valvular regurgitation
Hypertrophic cardiomyopathy is the least common of the cardiomyopathy disease states
False
Restrictive/Infiltrative cardiomyopathy creates excessively rigid walls and abnormal diastolic filling
true
BAE and BVH are common findings of restrictive/infiltrative cardiomyopathy disease states
true
Inflammatory disease, affects tissues throughout the body
Sarcoidosis
Fibrotic tissue surrounds the myocardium
Endomyocardial
fibrosis
Iron storage disease, multisystem
Hemochromatosis
Extracellular deposition of protein
Amyloidosis
heart becomes enlarged and thickened, usually occurs early in life
Glycogen storage
the most common restrictive/infiltrative cardiomyopathy disease state
Amyloidosis
Pressure gradient through the LVOT, and SAM + ASH = LVOTO
are related to
Hypertrophic (Obstructive)
Apical hypertrophy and normal LVOT + Midventricular hypertrophy with a normal LVOT are related to ... cardiomyopathy
Hypertrophic (Non-Obstructive)
Dilated chambers and regurgitaion, Apical thrombus probable, and Increased volume and mass are in what cardiomyopathy disease state?
Dilated/Congestive
what is cardiomyopathy (CMO)?
CMO is a disease that diffusely affects the myocardium, resulting in enlargement and/or ventricular dysfunction.
Diastolic collapse of the RV anterior wall is consistent with:
Cardiac Tamponade
in order to distinguish between Pleural and Pericardial Effusion on 2D echo (PLAX), it is helpful to identify
Descending aorta
Doppler evidence of Constrictive Pericarditis include:
Increased peak velocity across the TV with inspiration
An echo free space detected in systole and diastole surroundings the entire heart and is > 2 CM in width represents
Large pericardial effusion
The pulse associated with cardiac tamponade is
Pulses paradoxus
A primary common cause of CHF is
coronary artery disease (CAD)
The leakage of fluid from capillaries into interstitium is the cause of
Edema