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15 Cards in this Set
- Front
- Back
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• Name 6 main secondary causes for cardiomyopathy
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1. Dilated: most common, heart cant pump, heart is distended
1a: EtOH, good prgnosis if you quit drinking 1b- peripartum 1c- drug indiced 2. Hypertrophic: often the septum is large, cant fill during diastole 3. Restrictive: wont allow vent to pump well, atria dilate |
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wht are some risks for peripartum dilated cardiomyopathy
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old
multiple births african maternal cocaine preeclampsia **PE is common |
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whats a cardiomyopathy
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1 or 2 damage to heart mm (NOT HTN, valvular disease, CAD, congential)
• CHF in the last month of pregnancy or the first 5 mo. postpartum with NO OTHER CAUSE **EF <45% |
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52 YOWM presents to the ED with 6
months of gradually worsening SOB, DOE and edema. His DOE had increased to the point he was unable to climb 1 flight of stairs. He also noted some mild, dull aching precordial discomfort when he attempted exertion. He denies PMH of hypertension, DM, alcohol intake or drug abuse • PMH: Illnesses: had been diagnosed c schizophrenia but refused to take meds or see his physician Surg: none Bld Tx: none Allergies: NKDA • SH: divorced; homeless; smokes 1ppd; ETOH occasionally (?) • FH: Mother c Type 2 DM • Exam: T 98.4; BP: 138/90; R 26; P 120 • HEENT: no oral lesions • Neck: JVD to angle of mandible • Cor: PMI displaced L and downward; RR; S1, S2 nl. Loud S3 and S4. Gr II/VI SEM at apex radiation to axilla • Chest: bibasilar crackles • Ab: nl BS; Liver palp 3 FB below RCM: span ~ 14 cm. Mildly tender. + HJR • Ext: 3-4+ edema to mid thighs; no cyanosis • Neuro exam intact * heart is hige on CXR, no vascular changes |
DILATED cardiomyopathy
**Echo will show dilation, NO CAD, normal valves. |
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tell me a little about dilated cardiomyopathy
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3 most common of hte cardiomyopathies
**needs transplant (irreversible damage) **20-40 yo **usually idiopathic, but EtOH and drugs, peripartum!!!- told a story about thsi |
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sx of restricted cardiomyopathy
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1, tired
2. SOB, DOE, orthopena, PND 3. weight gain, edema 4. sudden death 5. systemic embolis will get: 1. Tachycardia +/- arrhythmias 2. Tachypnea 3. JVD, HJR 4. Bibasilar crackles 5. S3, S4 6. Edema 7. Holosystolic regurg M |
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whats the cardiomyopathy that preggers can get
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dilated
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what are the CXR, EKG and ECHO of dilated cardiomyopathy?
prognosis tx |
1. cardiomegaly, vasc redistribution
2. a fib, ST.T wave changes 3. ECHOL LV dilation, decreased EF **die in like 4 years, need transplant. damage is irreversible ACEi B blockers |
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48 YOWF presented to the emergency
room with alcohol withdrawal. She had seen a cardiologist 2 weeks ago for congestive heart failure. At that time she had a 2 month Hx of gradually increasing SOB, fatigue and edema. Her PCP had done a CXR, noted cardiomegaly and referred her to cardiology • The history was unremarkable except for 2 prior episodes of acute pancreatitis which required hospitalization. She was drinking 2 bottles of cheap wine/day (MadDog) • Exam at that time revealed mild JVD, an irreg irreg rhythm; loud S3; no M; an enlarged liver and 2-3+ edema • The CXR showed mod cardiomegaly; the EKG showed atrial fib; an ECHO revealed diffuse chamber enlargement c an EF of 30% • Cardiologist advised her to stop alcohol consumption and started an ACE inhibitor and diuretic • 12 days later she took his advise. |
hard to evaluate, common. Type of DILATED
women more sensitivestop drinking happens with TONS of Etoh Prognosis is better than other dilated, but you need to STOP drinking *perhaps is reversible if you |
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• 26 YOWF senior medical student who
recently delivered a healthy baby boy. She presents to Urgent Care with sudden onset of fatigue and SOB. Her PMH was completely neg. Pregnancy, L&D were all normal. • She denied drug or alcohol use • SH: married; excellent student • Exam: anxious appearing F • BP: 159/90 P 98 R 22 T afebrile • Neck: no JVD • Cor: RR; S1S2 nl. No M. Soft S3 and S4. • 1+ edema bilat. • No calf tenderness • CXR mild-mod cardiomegaly • EKG unremarkable • VQ scan was normal • Cardiac cath: nl coronaries; EF 30% whats the DX and RX |
1 DX: peripartum cardiomyopathy
2. diuretics, digoxin **also another type of dilated cardiomyopathy **happnes in the last trimester **PE is common |
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what are 3 examples of dilated cardiomyopathies
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1. EtOH
2. preg: PE, recover well 3. Drug: cocaine, heavy metal, meth, cancer "zumab" anthracyclines |
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anterior movement of hte ant leaf of mitral valve is associated with what
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hypertrophic cardiomyopathy
huge bananna heart congenital, males more common 30-40 *bisferiens pulse |
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when is hypertrophic cardiomyopathy heard louder, softer
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Loud: valsalva
2. Soft: squatting **this is opposite of most |
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• 55 YOWM presents to the rheumatology
clinic with patches of thickened skin over the upper chest, upper arms, neck and hands. The referring Dx is morphea. • He has noted mild SOB and fatigue for several months but has continued to work • PMH is completely neg • SH: married; works as mechanic; minimal ETOH; no tobacco • FH: neg • Exam: negative except for very strange feeling deposits in the skin • Biopsy of the skin lesions showed massive deposition of homogenous, sl eosinophilic material which stained + c Congo Red and was birefringent on polarized microscopy • CXR revealed mild cardiomegaly. • In spite of aggressive therapy, patient died |
restricted cardiomyopathy
*least common *low voltage EKG |
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what vessel is involved with claudication if there is pain here...
1. Butt/Hip 2. Thigh 3. Upper Calf 4. lower calf 5. foot |
1. Illioarotic (when combined with ED its leisch)
2. common femoral 3. femoral 4. popliteal 5. Tibial or peroneal |
