PANCE Blueprint Cardiology - All Smarty PANCE cardiology flashcard lesson sets combined + EKG (Smarty PANCE) Exam Questions and Answers 100% Correct

PANCE Blueprint Cardiology - All Smarty PANCE cardiology flashcard lesson sets combined + EKG (Smarty PANCE) Exam Questions and Answers 100% Correct What is the definition of cardiomyopathy? Heart disease resulting from a primary abnormality in the myocardium List two types of surgical procedures to correct hypertrophic obstructive cardiomyopathy 1. Open heart and excision 2. Alcohol ablation done through cardiac catheterization What heart sound will likely be present with hypertrophic obstructive cardiomyopathy? S4 List three medications that may be used both to prevent arrhythmia and ease symptoms with hypertrophic obstructive cardiomyopathy 1. Diuretics 2 Beta-blockers 3. Non-dihydropyridine CCB (verapamil or diltiazem) Once a patient is diagnosed with hypertrophic obstructive cardiomyopathy what family counseling must be done? Entire family must be screened for HOCM Angina, syncope, and heart failure in a child likely represents ____________. HOCM (Hypertrophic Cardiomyopathy) What causes the sudden cardiac death in a patient with hypertrophic obstructive cardiomyopathy? Ventricular tachycardia that degenerates into ventricular fibrillation What maneuver makes the hypertrophic obstructive cardiomyopathy murmur louder? Valsalva or standing What are the signs of hypertrophic obstructive cardiomyopathy on the exam? - Apical lift - S4 gallop - Ejection murmur medial to apex Constrictive cardiomyopathy occurs by what mechanism? Pericardial sac constricts Restrictive cardiomyopathy occurs by what mechanism? Deposition into or between the myocardial cells What is the treatment for dilated cardiomyopathy? Same as systolic heart failure - (Beta blocker - Loop Diuretic - ACE inhibitor) What are the three categories of cardiomyopathy and which is the most common? Dilated (90%) Hypertrophic Restrictive What is the ejection fraction in a cardiomyopathy? less than 40% (in the presence of increased left ventricular dimension) What do low ejection fraction and hypertrophic (HOCM) heart have in common? Sudden death due to VT Which chamber is most affected in cardiomyopathies? Left ventricle What chambers are affected (and how) in dilated cardiomyopathy? Enlargement and dilation of all four chambers What is the most common cause of non-ischemic dilated cardiomyopathy in the US? Chronic alcoholism What is the second most common cause of non-ischemic cardiomyopathies? (#1 in other parts of the world) Viral myocarditis What is damaged in dilated cardiomyopathy and what does it result in? Myocytes are injured and necrosis occurs with myocardial fibrosis - when muscle cells fail they dilate Does dilated cardiomyopathy have a systolic or diastolic dysfunction? Systolic dysfunction What is the number one cause of dilated cardiomyopathy overall? Ischemic cardiomyopathy (more than 60% of patients with heart failure have this) What is seen histologically in dilated cardiomyopathy? Nonspecific abnormalities, variations in myocyte size, myocyte vacuolization, fibrosis, and fat replace myocardium How does alcoholism lead to dilated cardiomyopathy? Alcohol destroys microvilli brush border and leads to nutritional deficits (thiamine in particular) (glutamine helps regenerate) alcohol is toxic to cardiac tissue which leads to myocyte death What does the heart of someone with dilated cardiomyopathy resemble? Basketball In which chamber are changes seen in hypertrophic cardiomyopathy? L ventricle hypertrophy without ventricular chamber dilation What is hypertrophic cardiomyopathy characterized by? Myocardial hypertrophy, abnormal diastolic filling in 1/3 of cases, and intermittent ventricular outflow obstruction Which wall of the ventricle is more hypertrophic in hypertrophic cardiomyopathy? The septum of the L ventricle is larger than the free wall What is seen histologically in hypertrophic cardiomyopathy? Hypertrophy of myocardial fibers and interstitial fibrosis Where is the mutation that leads to hypertrophic cardiomyopathy located? Any one of several genes that encode proteins within the sarcomere What is seen on an echocardiogram for hypertrophic cardiomyopathy? Hypertrophic septum and LV wall along with decreased ejection fraction What happens to the myocardium in restrictive cardiomyopathy? The myocardium is infiltrated with abnormal tissue- leading to impaired ventricular wall motion and abnormal contraction and relaxation What population is most susceptible to restrictive cardiomyopathy? Men of northern European descent