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39 Cards in this Set
- Front
- Back
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acute myocarditis is most commonly caused by
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viral infection
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T or F. majority of young patients with severe acut myocarditis will recover spontaneous
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true
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what are three phases of myocarditis
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acute
subacute chronic |
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the first wave of infiltrating cells triggered by viral infection is ____ cells
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NK
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what days are peak neutralizing antibodies seen
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8-14
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what are three theories of crhonic phase
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cyto T
persistant viral infection virus induced apop |
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____ are the second wave of cellular infiltrate that appears within 7 days of infection
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T lymphocyte
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___ correspond with time of most severe damage to the myocyte
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cyto Ts
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what cytokines are involved in acute phase
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IL2
TNFa interferon |
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steroids are effective treatment of myocarditis
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FALSE
aggravate the process adn increase viral titers |
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general therapy for pts with myocarditis is similar to tx for
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systolic dysfunction
neurohormonal blockade and reduce remodeling |
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what is the general prognosis for myocraditis
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1/3 recover
1/3 cardiac dysfunction 1/3 transplant |
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what are four types of cardiomyopathies
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dilated
restrictive arrhythmogenic RV hypertrophic |
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what usually cuases dilated cardiomyopathy
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uncontrolled HTN
CAD ischemic disease |
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long QT syndromes develop what type of cardiomyopathy
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hypertrophic
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high school athlete dies of SCD what happened
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hypertrophic cardiomyopathy
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most common mutation in hypertrophic cardiomyopathy
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beta myosin heavy chain
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what is variable penetrance
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sometimes express sometimes not
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why is syncope episodes important
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could be hypertrophic cardiomyopathy
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90% of patients with beta myosin heavy chain mutations have LVH detectable at age
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20
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tropininT shows up at age
myosin binding protein C at age |
40
60 |
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what is the problem iwth mitral valve in hypertrophic cardiomyopathy
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anteiror leaflet
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about 1/3 of patients with hypertrophic cariomyopathy have
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obstruct ventricular outflow
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what factors contribute to outflow tract obstruction
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hyperdynamic LV ejection
hypertrophy at septum ant leaflet problem papillary muscle architecture |
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T or F. mitral regurg may come into play of severe cases of hypertrophic cardiomyopathy
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true
because of obstructed outflow |
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what are most common symtpoms of hypertrophic cardiomyopathy
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dyxpnea on exertion
chest pain |
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what heart sound would indicate hypertrophic cardiomyopathy
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S4
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what causes bifid pulse
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obstruction outflow
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why does hypertrophic cardiomyopathy lead to S4
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dependence on atrial systole since relaxation of such a big vetnricle is slow
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outflow tract obstruction creats what murmur
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systoliic crescendo
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what two murmurs mist you find in hypertrophic cardiomyopathy
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systolic ejection crescendo due to outflwo obstruction
mitral insufficiency due to mitrla valve changes |
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is murmur of outflow obstruction accentuated by hyper or hypovolemia
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hypovolemia
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what are first line therapies for hypertrophic cardiomyopathy
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disopyramide
bb nonDHP CCBs |
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why might dual chamber pacing be necessary
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preexcitation of RV leading to dissyncrhonry
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___ is extremely effective in preventign SCD
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ICD
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what other non surgical option is avail
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alcohol ablation of setpal coronary artery
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what might happen to LAP
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huge becuase of diastolic dysfunction
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HCM can manifest very different even when found in family members with exact same mutation. this is variable ____
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penetrance
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T or F. some mutations can have SCD with minimal hypertrophy
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true
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