Echocardiography Final

Front 1

Dilated cardiomyopathy etiology

Back 1

primary is idiopathic
secondary=alcohol, viral, pregnancy, CAD.

Front 2

Dilated cardiomyopathy heart shapes

Back 2

Round, global or spherical in shape

Front 3

Dilated cardiomyopathy Symptoms

Back 3

SOB, pulmonary edema, fatigue, dry cough, chest pain, palpitations.

Front 4

Dilated cardiomyopathy echo findings

Back 4

4 chamber enlargement, decreased EF, regurgitant valves, thin walls, thrombus in apex and puffs of smoke(spontaneous contrast) indicating slow moving blood.

Front 5

Hypertrophic cardiomyopathy etiology (HCOM)

Back 5

Idiopathic, genetic origin
Cellular malformation affecting myocardium

Front 6

Hypertrophic cardiomyopathy heart shapes

Back 6

Assymmetric septal hypertrophy causing a possible outflow tract obstruction is classic finding, but may be concentric hypertrophy

Front 7

Hypertrophic cardiomyopathy complication

Back 7

Mitral regurgitation is common and sudden cardiac death

Front 8

Hypertrophic cardiomyopathy symptoms

Back 8

dyspnea, ANGINA, syncope and arrhythmias

Front 9

Hypertrophic cardiomyopathy echo findings

Back 9

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

Front 10

Hypertrophic cardiomyopathy teatments

Back 10

a myotomy or myectomy to remove excess septal tissue.

Front 11

Restrictive/Infiltrative cardiomyopathy etiology

Back 11

infiltrated by foreign substance

Front 12

Restrictive/Infiltrative cardiomyopathy classification

Back 12

Amyloidosis - protein(most common), Sarcoidosis – inflammatory, forms masses, Hemochromatosis, excess iron and Glycogen Storage Disease, glucose

Front 13

Restrictive/Infiltrative cardiomyopathy heart appearance

Back 13

Gives the ventricular walls a ground glass appearance. Also called speckled or granular

Front 14

Restrictive/Infiltrative cardiomyopathy symptoms

Back 14

dyspnea, CHF, fatigue, weakness and chest pain

Front 15

Restrictive/Infiltrative cardiomyopathy echo findings

Back 15

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.

Front 16

Congestive Heart Failure definition

Back 16

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

Front 17

Congestive Heart Failure common causes

Back 17

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

Front 18

Congestive Heart Failure LVH complications

Back 18

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

Front 19

Congestive Heart Failure left heart effects

Back 19

– Blood backs up into lungs and causes pulmonary edema, congestion, cough.

Front 20

Congestive Heart Failure right heart findings

Back 20

Blood backs into venous system. Causes peripheral/pedal edema. May have enlarged liver with ascites and bulging neck veins. Also dilated IVC

Front 21

Definition of Cor Pulmonale

Back 21

right side heart failure

Front 22

Cor Pulmonale signs

Back 22

enlarged liver with ascites and bulging neck veins. Also dilated IVC

Front 23

CHF echo findings

Back 23

RVVO with a dilated RV and a flattened or paradoxical septum

Front 24

CHF drugs

Back 24

diuretics, ACE inhibitors, digitalis.

Front 25

Pericarditis symptoms

Back 25

inflammation of the pericardium, usually after some sort of injury, e.g. MI, virus, bacterial infection, autoimmune response

Front 26

Pericarditis auscultation sound

Back 26

friction rub

Front 27

pericaritis symptoms

Back 27

Positional and respiratory pain

Front 28

Pericardial Effusion definition

Back 28

fluid in the pericardial sac

Front 29

Pericardial Effusion can be confused with?

Back 29

layer of epicardial fat if anterior only

Front 30

critical factor in Pericardial Effusion

Back 30

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

Front 31

Pericardial Effusion cause

Back 31

Fluid in sac usually drains into lymphatic system but when it is obstructed, the sac expands to hold it.

Front 32

long standing Pericardial Effusion findings

Back 32

fibrin strands in fluid

Front 33

syndrome associated with Pericardial Effusion

Back 33

Dressler’s syndrome is one cause of PE. Happens after MI

Front 34

Pericardial Effusion to differentiate it from a Pleural effusion

Back 34

use the DAO as a landmark in the PLAX. Fluid anterior to the DAO is pericardial, posterior is pleural

Front 35

Pericardial Effusion how to quantify severity

Back 35

Measuring fluid helps to quantify severity

Front 36

Cardiac Tamponade heart views

Back 36

Usually large effusions with swinging heart. Fills rapidly

Front 37

Cardiac Tamponade symptoms

Back 37

Pulsus paradoxus and electrical alternans are present. Beck’s triad – decreased systemic blood pressure, increased venous pressure, quiet heart sounds.

Front 38

Cardiac Tamponade echo findings

Back 38

RV collapse during Diastole. RA will collapse more easily, so if the RV is collapsing, the pressure is increased.

Front 39

Cardiac Tamponade treatment

Back 39

pericardiocentesis or a pericardial window

Front 40

Cardiac Tamponade effects on valves

Back 40

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.

Front 41

Constrictive Pericarditis definition

Back 41

Calcification of Pericardium over time - Heart in Cement

Front 42

Constrictive Pericarditis diastolic pathology

Back 42

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.

Front 43

Constrictive Pericarditis etiolgoy

Back 43

idiopathic in the United States, but can come from TB in other countries

Front 44

Constrictive Pericarditis etiology in long term cases

Back 44

autoimmune disease or radiation therapy.

Front 45

Constrictive Pericarditis sounds

Back 45

Pericardial knock

Front 46

Constrictive Pericarditis doppler findings

Back 46

similar to tamponade

Front 47

Primary myocardial disease in CHF

Back 47

CMOs

Front 48

What is common in CHF that occurs at a rate of 6 to 9 times of that of the general population

Back 48

Sudden death

Front 49

In CHF MR or AI disease causes

Back 49

Regurgitaion

Front 50

What occurs in physically inactive patients with low cardiac output, and what may develop?

Back 50

Pulmonary Embolism.
Venous thrombi may develop, which may produce pulmonary emboli and elevation of PAP leading to LV failure

Front 51

Ischemic heart disease means

Back 51

Low cardiac output

Front 52

Three complications of CHF

Back 52

a)Increased ventricular pressure
b)Elevated systemic & pulmonary pressure
c)decreased CO

Front 53

what cardiac arrhythmias are associated with CHF

Back 53

Tachy, Brady, & AFIB

Front 54

which of the 3 arrhthymias (Tachy, Brady, & AFIB)precipitates CHF

Back 54

Severe Bradycardia, in the absence of increased stroke volume can seriously reduce cardiac output and thus precipitate CHF

Front 55

COPD can lead to...

Back 55

Right heart failure

Front 56

Reduced perfusion of central nervous system causes

Back 56

Hypoxic encephalopathy (irritability to coma)

Front 57

Which medication is used to prevent the production of a chemical that causes vessel constriction, helps to decrease BP and increase flow?

Back 57

Angiotensin-Converting Enzyme (ACE) inhibitors

Front 58

Which medication is used to increase the force of the heart's contraction and slows certain heart rhythms?

Back 58

Digitals

Front 59

What medication descreases the body's retention of salt and water, and helps to lower BP and decreases the workload of the heart?

Back 59

Diuretics

Front 60

What medication widens blood vessels, increasing flow?

Back 60

Hydralazine

Front 61

Which Medication relaxes smooth muscles and widens blood vessels and lowers BP?

Back 61

Nitrates

Front 62

how is CHF classified?

Back 62

ACC and New York Heart Association use Class I through IV.
AHA uses grades A through D description.

Front 63

pregnancy, ischemia, and infection are possible causes of what CMOs?

Back 63

Dilated/congestive cardiomyopathy.

Front 64

potential echocardiography findings of a dilated/cosgestive cardiomyopathy include?

Back 64

a)Multi-chamber dilation
b)Increased "E" point to septal separation (on MV M-mode)
c)Valvular regurgitation

Front 65

Hypertrophic cardiomyopathy is the least common of the cardiomyopathy disease states

Back 65

False

Front 66

Restrictive/Infiltrative cardiomyopathy creates excessively rigid walls and abnormal diastolic filling

Back 66

true

Front 67

BAE and BVH are common findings of restrictive/infiltrative cardiomyopathy disease states

Back 67

true

Front 68

Inflammatory disease, affects tissues throughout the body

Back 68

Sarcoidosis

Front 69

Fibrotic tissue surrounds the myocardium

Back 69

Endomyocardial
fibrosis

Front 70

Iron storage disease, multisystem

Back 70

Hemochromatosis

Front 71

Extracellular deposition of protein

Back 71

Amyloidosis

Front 72

heart becomes enlarged and thickened, usually occurs early in life

Back 72

Glycogen storage

Front 73

the most common restrictive/infiltrative cardiomyopathy disease state

Back 73

Amyloidosis

Front 74

Pressure gradient through the LVOT, and SAM + ASH = LVOTO
are related to

Back 74

Hypertrophic (Obstructive)

Front 75

Apical hypertrophy and normal LVOT + Midventricular hypertrophy with a normal LVOT are related to ... cardiomyopathy

Back 75

Hypertrophic (Non-Obstructive)

Front 76

Dilated chambers and regurgitaion, Apical thrombus probable, and Increased volume and mass are in what cardiomyopathy disease state?

Back 76

Dilated/Congestive

Front 77

what is cardiomyopathy (CMO)?

Back 77

CMO is a disease that diffusely affects the myocardium, resulting in enlargement and/or ventricular dysfunction.

Front 78

Diastolic collapse of the RV anterior wall is consistent with:

Back 78

Cardiac Tamponade

Front 79

in order to distinguish between Pleural and Pericardial Effusion on 2D echo (PLAX), it is helpful to identify

Back 79

Descending aorta

Front 80

Doppler evidence of Constrictive Pericarditis include:

Back 80

Increased peak velocity across the TV with inspiration

Front 81

An echo free space detected in systole and diastole surroundings the entire heart and is > 2 CM in width represents

Back 81

Large pericardial effusion

Front 82

The pulse associated with cardiac tamponade is

Back 82

Pulses paradoxus

Front 83

A primary common cause of CHF is

Back 83

coronary artery disease (CAD)

Front 84

The leakage of fluid from capillaries into interstitium is the cause of

Back 84

Edema