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23 Cards in this Set
- Front
- Back
Dilated cardiomyopathy pathology
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LV is weak so it stretches under the pressure of the blood
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Dilated cardiomyopathy presentation
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atypical chest pain
middle aged black males dilated and imparied contraction of one or both ventricles EF <40% atrial and/or ventricular arrhythmias |
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Causes of dilated cardiomyopathy
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Ischemia
Viral Chemo drugs Antiretroviral drugs Ethanol Hemochromatosis Amyloidosis Thyroid hormone excess or deficiency Peripartum cardiomyopathy |
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Chaga's disease
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megaesophagus
megacolon cardiac disease left ventricular apical aneurysms all kinds of problems on ECG |
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Peripartum cardiomyopathy
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last trimester-6 months post-partum
prognosis depends on if heart returns to normal avoid future pregnancy |
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Increased risk for peripartum cardiomyopathy
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multiparous
African American >30 yrs |
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If EF <20% in DCM
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high incidence of mural and peripheral thrombus
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Tx of DCM
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transplant
treat underlying cause if in HF use diurectics |
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Use Diurectics when
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have HF and can't breath
but if ventricle is obstructed like aortic stenosis or HCM be careful it will be like blood trying to force through a closed door and they die |
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Traits of hypertrophic cardiomyopathy (HCM)
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disproportionate hypertrohpy of LV
predominance of septal wall sudden cardiac death (esp. when there is familial history) |
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4 symptoms that correlate with mortality in HCM
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age--increased risk in kids
sypmtoms at presentation or thereafter Obstruction of outflow--LVH >25mm on ECG Genetic defect |
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HCM symptoms
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most are asymptomatic
dyspnea with exertion orthopnea chest pain syncope or near syncope palpitations postrual lightheadedness fatigue edema LVH LAH there is no correlation between degree of obstruction and symptoms |
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Increased risk of sudden death with HCM
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>30yrs old
small ventricle evidence of non sustained VT |
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* HCM physical findings *
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S4 (younger pts)
LV lift at apex Murmur is DECREASED with sustained hand grip Murmur is INCREASED when preload is decreased EKG--LVH, LAH, LAD (normal EKG is uncommon) |
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HCM vs AS
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Murmur is inversly proprotional with preload in both
HCM--pulse is brisk AS--pulse is delayed (pulsus tardus) HCM--murmur radiates to base or axilla AS--murmur radiates to the neck and increases with handgrip |
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Tx of HCM
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transplant
no drug improves survival be VERY careful with anything that decreases LV volume like diurectics |
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Restrictive cardiomyopathy trats
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non-dilated, non-hypertrophied ventricles
severy diastolic dysfunction causes dilated atria normal LV function rare and a diagnosis of exclusion |
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Restrictive CM causes
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secondary to amyloidosis, sarcoidosis, endomycardial fibrosis or induced from chemo or radiation
less frequent in US |
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RCM
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can be any age but more common in elderly
pulmonary and systemic congestion dyspnea peripheral edema palpitations fatigue weakness exercise intolerance |
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RCM physical findings
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usually normal cardiac exam
S3 or S4 usually S4 EKG is non-specific Prominent X and Y decents |
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RCM vs constrictive pericarditis
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RCM has:
EKG with normal voltages non-displaced apical impulses no evidence of peripheral calcifications on CXR |
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Takasuf's CM
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Looks like an MI
Post menopausal women sever life stressor increases catecholamines which causes micro spasms in coronary arteries |
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Takasuf's CM Tx
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supportive care
will reverse in 1-3 weeks |