Im Cv Cardiomyopathy Usmle 2

Front 1

Etiology of Dilated Cardiomyopathy
(6)*

Back 1

TIMED:
- Toxic (EtOH, heavy metals)
- Infectious / Ischemic
- Metabolic / Mechanical (arrthymia, valve dz)
- Endocrine
- Drugs

Hint 1

TIMED

Front 2

what are the Reversible and Irreversible(2) toxic causes of Dilated Cardiomyopathy?

Back 2

Reversible:
prolonged EtOH use

Irreversible:
Cocaine;
heavy metal toxicity

Front 3

what are the Reversible and Irreversible(2) endocrine causes of Dilated Cardiomyopathy?

Back 3

Reversible:
Thyroid disease
(hypo or hyper)

Irreversible:
Acromegaly;
Pheochromocytoma

Front 4

Reversible metabolic deficiencies that cause Dilated Cardiomyopathy? (4)

Back 4

HypoC;

HypoP;

Thiamine deficiency (wet beri-beri);

Selenium deficiency

Front 5

Infections that cause Dilated Cardiomyopathy
(3)

Back 5

HIV;

Coxsackie virus;

Chagas disease

Front 6

Drugs that cause Dilated Cardiomyopathy (2)

Back 6

Doxorubicin (Adriamycin);

AZT

Front 7

Dx:
Cardiomyopathy w/ R + L Heart failure; A-fib; Mitral regurg; S-3 Gallop

Back 7

Dilated Cardiomyopathy

Front 8

Diastolic or Systolic Dz Cardiomyopathy:
1. Dilated
2. Restrictive
3. Hypertrophic

Back 8

Systolic:
Dilated

Diastolic:
Restrictive & Hypertrophic

Front 9

Diagnostic results of Dilated cardiomyopathy
- auscultation
- EKG (3)
- CXR (2)
- Echo (2)

Back 9

Auscultation: S-3;

EKG: Vent Hypertrophy, BBB and/or A-fib;

CXR: Inc heart size; pulm congestion

Echo: low EF, large ventricles

Front 10

Tx Dilated Cardiomyopathy
(3)

Back 10

stop any toxic agents;

Anticoagulation w/ coumadin (even w/o evidence of thrombus);

Heart transplant

Front 11

Dx:
Right or left ventricular enlargement w/ loss of contractile function causing CHF, arrythymia, or thrombus formation.

Back 11

Dilated Cardiomyopathy

Front 12

Definition:
Scarring and infiltration of the myocardium causing decreased right or left ventricular filling

Back 12

Restrictive Cardiomyopathy

Front 13

Etiology of Restrictive Cardiomyopathy
(7)*

Back 13

ACHES:
Amyloidosis;
Carcinoid heart dz / Congenital;
Hemochromatosis;
Endomyocardial fibrosis
Sarcoidosis / Scleroderma

Hint 13

ACHES

Front 14

Dx:
Pulmonary HTN (right CHF); S-4 gallop; Low QRS voltage on EKG; Exercise intolerance; Diastolic dz

Back 14

Restrictive Cardiomyopathy

Front 15

*Aside from the normal cardiac work-up, what is the gold standard Dx test for Restrictive CM?

Back 15

Endomyocardial Bx

Front 16

Definition:
Increase in the size of the interventricular septum causing narrowing of the LV outflow tract leading to anterior mitral valve outflow obstruction

Back 16

Hypertrophic Cardiomyopathy

Front 17

another name for Hypertrophic Cardiomyopathy

Back 17

IHSS
(Idiopathic Hypertrophic Subaortic Stenosis)

Front 18

(3) causes of paradoxical splitting of S-2

Back 18

Hypertrophic cardiomyopathy (IHSS);

Aortic stenosis;

LBBB

Front 19

murmur that decrease with squatting (and increases when returning to standing position)

Back 19

Hypertrophic CM (IHSS)

Front 20

Etiology of Hypertrophic Cardiomyopathy
(2)

Back 20

50% idiopathic
50% familial (autosomal dominant, w/ variable penetrance)

Front 21

Dx:
Angina (at rest or exercise); Syncope; Arrhythmias; CHF

Back 21

Hypertrophic Cardiomyopathy

Front 22

sudden death from Hypertrophic CM is usually due to what?

Back 22

Arrhythmias

Front 23

Dx:
25-yo man becomes severly dyspneic and collapses while running laps, His father died suddenly at an early age.

Back 23

Hypertrophic CM (IHSS)

Front 24

Diagnostic results to Dx Hypertrophic CM
- Auscultation (2)
- EKG (4)
- Echo (2)

Back 24

Auscultation - Systolic ejection murmur, Paradoxical splitting of S2;

EKG - LVH, PVCs, A-fib, ST + Q abnormalities;

Echo - septal hypertrophy, LVH w/ small LV

Front 25

Tx for Hypertrophic CM
(2 together)

if becomes more severe?

Back 25

1. No exercise
2. Beta-blocker

More severe:
implantable Cardiac Defibrillator