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27 Cards in this Set

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Examples of conditions that cause LV pressure overload
HTN, aortic stenosis, coarctation of the aorta
Examples of conditions that cause LV volume overload
Aortic regurgitation, mitral regurgitation, patent ductus arteriosus, systemic arteriovenous fistula
Examples of conditions that cause primary myocardial failure
Coronary artery disease (LV systolic and/or diastolic dysfunction), hypertrophic cardiomyopathy (LV diastolic dysfunction), dilated cardiomyopathy (biventricular systolic dysfunction)
Examples of conditions that cause RV volume overload
Atrial septal defect, tricuspid regurgitation
Examples of conditions that cause RV pressure overload
Pulmonic stenosis, cor pulmonale
Dilated cardiomyopathy
Systolic dysfunction
Hypertrophic cardiomyopathy
Diastolic dysfunction
Ischemic cardiomyopathy
Combination of systolic and diastolic cardiomyopathy
Acute pericarditis
Precursor to: restrictive pericarditis and cardiac tamponade (ventricular underloading)
Examples of conditions that cause high output failure
Arteriovenous fistula, hyperthyroidism, severe anemia
Examples of conditions that cause ventricular underloading
Mitral stenosis, hypovolemia, pericardial restriction, RV infarction
Etiologies of dilated cardiomyopathy
Includes toxic (eg, EtOH), infectious (Coxsackie B, Chagas'), non-infectious (eg, autoimmune diseases such as SLA, Rheumatic fever, RA, etc.), metabolic (eg, Kawshiorkor, hyperthyroidism) and infiltrative (eg, amyloidosis)
Pathophysiology of dilated cardiomyopathy
1. Systolic pump failure due to reduced contraction
2. Eccentric hypertrophy due to compensation for decreased shortening ability of fibers
Clinical features of LHF in dilated cardiomyopathy
Dyspnea, orthopnea, LV enlargement, S3 gallop
Complications of RHF in dilated cardiomyopathy
Peripheral edema, elevated CVP, hepatomegaly, RV enlargement
Diagnostic features of systolic heart failure
Large heart, low ejection fraction
CHF in dilated cardiomyopathy can lead to these complications
Thromboembolism, arrhythmias (esp. a-fib)
Therapy for dilated cardiomyopathy
Diuretics, beta-blockers, vasodilators, anticoagulants, inotropes*
This cardiomyopathy is typically characterized by bi-ventricular failure
Dilated cardiomyopathy
Clinical presentation of hypertrophic cardiomyopathy
Angina, dyspnea, syncope (following exercise, may be fatal)
Clinical features of diastolic heart failure
Small heart, normal or elevated ejection fraction;
pulmonary congestion, dyspnea, systemic edema
Therapy for hypertrophic cardiomyopathy
Beta-blockers (relax myocardium and prolong diastolic filling time; relieve ischemia/angina; decrease outflow obstruction), surgery (remove septal muscle)
Features of restrictive cardiomyopathy
Stiff ventricular walls caused by infiltration, hypertrophy or fibrosis (diastolic dysfunction)
This cardiomyopathy can mimic chronic constrictive pericarditis
Restrictive cardiomyopathy
Clinical features of pericardial tamponade
Rapid onset, shock, sympathetic response (tachycardia, diaphoresis), Beck's triad
Beck's triad
1. Decreased MAP ("paradoxical pulse")
2. "Kussmaul's sign": increased systemic venous pressure, neck veins distend on inspiration (due to impaired RV filling, so the pressure stays high)
3. "Quiet heart" - heart is insulated by pericardial effusion
This pericardial disease presents as right-sided failure with small heart
Chronic constrictive pericarditis