CVRN BC UPDATED LATEST ANSWERS AND
QUESTIONS SET A+
✔✔Findings in pts with DCM (dilated cardiomyopathy) - ✔✔eccentric hypertrophy -
ventricles grow so overall volume and size are enlarged
low pulse pressure
syncope
angina
enlarged heart on palpation, poss shift to the left
fatigue and weakness
sudden weight gain
poor apetite
✔✔If EF <35% - ✔✔consider ICD placement
✔✔Management goal for DCM (dilated cardiomyopathy) - ✔✔treat underlying cause if
known
Reduce preload - diuretics, ACEI, ARBs, aldosterone antagonists
Reduce afterload - ACEI
Increase contractility - Digoxin
Decrease arrhythmias - low dose antiarrhythmics
BB - to slow HR, lower BP
Decrease clot formation - warfarin or ASA, use for 90 days
Salt and ETOH restricted diet
implantable device
heart transplant
✔✔Do not take ARBs if what is present? - ✔✔angioedema
✔✔Most common cardiac genetic disorder - ✔✔hypertrophic cardiomyopathy (HCM)
✔✔Size and volume of heart enlarged - ✔✔DCM w/ eccentric hypertrophy
✔✔heart walls thickened - ✔✔HCM, concentric hypertrophy
, ✔✔Yamaguchi Syndrome/Hypertrophy - ✔✔nonobstructive hypertrophic
cardiomyopathy (HCM)
✔✔findings of hypertrophic cardiomyopathy (HCM) - ✔✔frequently asymptomatic until
sudden cardiac death
hyperdynamic LV - compensation for decreased filling, EF increases to 70-80%
Mitral regurgitation
Left atrial enlargement
Dynamic LV outflow tract obstruction from thickened septum
Impaired relaxation and filling of left ventricle
Stiff walls resist filling
Myocardial ischemia
Sudden cardiac death
✔✔Do you treat HCM (hypertrophic cardiomyopathy) with diuretics? Why? - ✔✔No.
exacerbates symptoms by decreasing ventricular volume and increasing outflow
resistance
✔✔What is the gold standard for diagnosing HCM - ✔✔Cardiac MRI
✔✔Increased tissue and organ water with decreased tissue and organ perfusion -
✔✔HF
✔✔New York Heart Association Classification - ✔✔I: asymptomatic
II: sx with ordinary activity
III: asymptomatic only at rest
IV: sx at rest
***Variable and can change!
✔✔Is diastolic dysfunction normal with aging - ✔✔Yes
✔✔Diastolic dysfunction - ✔✔abnormal function of the heart during relaxation phase,
between beats
✔✔Left side HF s/sx - ✔✔Cough - may have pink, frothy sputum
Course rales/crackles
DOE
pale/cool skin, cyanosis
Increased HR
Peripheral edema - late sign
✔✔Right side HF s/sx - ✔✔liver congestion
Ascites
QUESTIONS SET A+
✔✔Findings in pts with DCM (dilated cardiomyopathy) - ✔✔eccentric hypertrophy -
ventricles grow so overall volume and size are enlarged
low pulse pressure
syncope
angina
enlarged heart on palpation, poss shift to the left
fatigue and weakness
sudden weight gain
poor apetite
✔✔If EF <35% - ✔✔consider ICD placement
✔✔Management goal for DCM (dilated cardiomyopathy) - ✔✔treat underlying cause if
known
Reduce preload - diuretics, ACEI, ARBs, aldosterone antagonists
Reduce afterload - ACEI
Increase contractility - Digoxin
Decrease arrhythmias - low dose antiarrhythmics
BB - to slow HR, lower BP
Decrease clot formation - warfarin or ASA, use for 90 days
Salt and ETOH restricted diet
implantable device
heart transplant
✔✔Do not take ARBs if what is present? - ✔✔angioedema
✔✔Most common cardiac genetic disorder - ✔✔hypertrophic cardiomyopathy (HCM)
✔✔Size and volume of heart enlarged - ✔✔DCM w/ eccentric hypertrophy
✔✔heart walls thickened - ✔✔HCM, concentric hypertrophy
, ✔✔Yamaguchi Syndrome/Hypertrophy - ✔✔nonobstructive hypertrophic
cardiomyopathy (HCM)
✔✔findings of hypertrophic cardiomyopathy (HCM) - ✔✔frequently asymptomatic until
sudden cardiac death
hyperdynamic LV - compensation for decreased filling, EF increases to 70-80%
Mitral regurgitation
Left atrial enlargement
Dynamic LV outflow tract obstruction from thickened septum
Impaired relaxation and filling of left ventricle
Stiff walls resist filling
Myocardial ischemia
Sudden cardiac death
✔✔Do you treat HCM (hypertrophic cardiomyopathy) with diuretics? Why? - ✔✔No.
exacerbates symptoms by decreasing ventricular volume and increasing outflow
resistance
✔✔What is the gold standard for diagnosing HCM - ✔✔Cardiac MRI
✔✔Increased tissue and organ water with decreased tissue and organ perfusion -
✔✔HF
✔✔New York Heart Association Classification - ✔✔I: asymptomatic
II: sx with ordinary activity
III: asymptomatic only at rest
IV: sx at rest
***Variable and can change!
✔✔Is diastolic dysfunction normal with aging - ✔✔Yes
✔✔Diastolic dysfunction - ✔✔abnormal function of the heart during relaxation phase,
between beats
✔✔Left side HF s/sx - ✔✔Cough - may have pink, frothy sputum
Course rales/crackles
DOE
pale/cool skin, cyanosis
Increased HR
Peripheral edema - late sign
✔✔Right side HF s/sx - ✔✔liver congestion
Ascites
