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Flashcards

Echo II - Cardiomyopathies

Adriana Long Sonography English 93 cards

Cards in this deck (93)

  1. 1Types of Cardiomyopathy: • ____ and ____• Primary ; secondary
  2. 2Primary Cardiomyopathy: • Disease of the cardiac myocardium of an ____ origin (____)• Unknown ; idiopathic
  3. 3Secondary Cardiomyopathy: • Caused by ____ that affect the myocardium• Diseases
  4. 4Secondary Cardiomyopathy: • ____ • ____ • ____ abnormalities • ____ • ____ • ____ • ____• Viruses
    • Ischemia
    • Metabolic
    • Endocrinopathies
    • HTN
    • Toxins
    • Scleroderma
  5. 5Etiology of CM: • ____ • ____ • ____• Congenital
    • Idiopathic
    • Acquired
  6. 6Congenital: • ___ - a disorganization of myocardial ___• Genetic ; fibers
  7. 7Idiopathic: • ____ origin• Unknown
  8. 8Acquired: • ____ patients (possibly due to HTN or AS)• Elderly
  9. 9Categories and Classifications of CM: • ____ • ____/____ • ____/____• Hypertrophic
    • Dilated/congestive
    • Restrictive/infiltrative
  10. 10Hypertrophic: • ____ walls• Thickened
  11. 11Dilated/Congestive: • ___ wall chambers with ___ internal dimensions• Thin ; large
  12. 12Restrictive/Infiltrative: • Deposits ___ the myocardium• Within
  13. 13Echo and Cardiomyopathy: • Confirms ___ • Confirms ___ • Evaluates ____ consequences• Diagnosis
    • Type
    • Physiologic
  14. 14PSAX: • Use to determine ___ of hypertrophy ---> ___ or ___ (or both) • ____ myocardium due to fiber DISARRAY• Extent
    ---> LV ; RV
    • Brightened
  15. 15Hypertrophic Cardiomyopathy Characteristics: • Hypertrophic (____) myocardium (___)• Thick ; LVH
  16. 16Hypertrophic Cardiomyopathy Characteristics: • ____ function • ___-____ ventricle/s • With or without ___-___ ____ • Hypertrophic = ____• Hyperdynamic
    • Non-dilated
    • Sub-aortic obstruction
    • Thick
  17. 17LV Hypertrophic Presentations Concentric Hypertrophy: • ____ hypertrophy of all the LV walls• Equal
  18. 18LV Hypertrophy Presentations Mid-Ventricular Hypertrophy: • Involves hypertrophy and ___ obstruction at the level of the ____ ____• LVOT ; papillary muscles
  19. 19LV Hypertrophy Presentations Abnormal/Asymmetric LV Hypertrophy (LVH): • ____ septal hypertrophy (ASH) ---> Septum is ___-___ times THICKER than ____ wall• Asymmetric
    ---> 2-3 ; posterior
  20. 20Clinical Features of Hypertrophic CM: • High risk of ___ ___ • ____ • Exercise ____ • ____ • ___ • ____• Sudden death
    • Angina
    • Intolerance
    • Syncope
    • CP
    • Dyspnea
  21. 21Clinical Features of Hypertrophic CM: • ____ • ____ (PVC's and A-fib) • ____ ____ murmur • ____ in later stage • ___ • ____ ---> Most likely with ___ thrombus• Fatigue
    • Arrhythmia
    • Systolic ejection
    • CHF
    • Endocarditis
    • Embolus
    ---> LA
  22. 22Types of Hypertrophic CM Non-Obstructive (HCM): • ____ hypertrophy • Hypertrophy is region that DOES NOT obstruct the ___ ---> Associated with inverted ___ wave on EKG• Apical
    • LVOT
    ---> T
  23. 23Types of Hypertrophic CM Provocable Hypertrophic: • An LVOT obstruction ONLY present when ____ ---> ____, ___ (amyl nitrate) or ____ maneuver• Provoked
    ---> Exercise ; drugs ; Valsalva
  24. 24Types of Hypertrophic CM Hypertrophic Obstructive Cardiomyopathy (HOCM): • ___ regions obstructs the LVOT • Also known as ____ ---> ____ ____ ____ ____• Thickened
    • IHSS
    ---> Idiopathic Hypertrophic Subaortic Stenosis
  25. 25Hypertrophic Cardiomyopathies LV Function: • Normal ___ function • Abnormal ___ function• Systolic
    • Diastolic
  26. 26Abnormal Diastolic Function: • Impaired ___ • Decreased ____ • ____ Reversal (small E, big A) (impaired relaxation) • Prolonged ____ (Isovolumic Relaxation Time)• Relaxation
    • Compliance
    • E/A
    • IVRT
  27. 27Hypertrophic Cardiomyopathies: • Wall are in the way and too ___ to relax • LV couldn't accommodate ___ ___ from LA• Thick
    • Rapid filling
  28. 28HOCM/IHSS Characteristics: • ___ ____ ____ (SAM) of the MV apparatus• Systolic Anterior Motion
  29. 29SAM: • During systole when the MV is closed, the MV leaflets and/or chordae move ___ into the ____ • Often causes/WORSENS the obstruction of the ___ ___• Anterior ; LVOT
    • Outflow tract
  30. 30HOCM and SAM: • Because the anterior MVL is being "___" into the LVOT due to ___ velocities going through the LVOT stenosis, the MV function is ____ • Leading to --- ____• "Pulled" ; stenosis ; disrupted
    • MR
  31. 31HOCM and SAM: • Results in a mild to moderate ____ directed MR jet • MR may lead to ___• Posterior
    • LAE
  32. 32SAM: • The "amount" of SAM correlates with the severity of the ____ ___ • Amount = ___ and ___• LVOT obstruction
    • Degree ; duration
  33. 33Classic IHSS or HOCM: • ___ + ___ = LVOT obstruction• ASH ; SAM
  34. 34HOCM: • Abnormal THICKNESS of the ____ walls • ASH ration must be ___:___ ---> ____ thicker than posterior wall (at least ___%) ---> ASH often causes ___• Ventricular
    • 1.3:1
    ---> Septum ; 30%
    ---> LVOTO
  35. 35Concentric Hypertrophy: • May cause ____ Mid-Ventricular Hypertrophy: • May cause ____• LVOTO
    • LVOTO
  36. 36Apical Hypertrophy Involves LV Apex: • Often ___ ___ cause LVOTO• Does not
  37. 37HOCM: • Beware of ___-___ ---> Has the same appearance of SAM but is not caused by an ___ ___ ----> SAM without ___• Pseudo-SAM
    ---> LVOT obstruction
    ---> ASH
  38. 38HOCM: • May be caused by other ____ ---> ___, ____ chordae, ____, etc.• Disorders
    ---> HTN ; long ; hypovolemia
  39. 39HCM: M-Mode Diagnostic Criteria: • ____ LV with ___ wall motion • ___ • SAM of the MV ___• Small ; hyperkinetic
    • LVH
    • Apparatus
  40. 40HCM: M-Mode Diagnostic Criteria • "___" point to septal contact of the MV (touches ___) • "___" notch/bump • ___• "E" ; IVS
    • "B"
    • LAE
  41. 41HCM: M-Mode: • SAM (____ touches IVS) • MV pulled "___" during SYSTOLE• AMVL
    • "Open"
  42. 42HCM: M-Mode Diagnostic Criteria: • ___ ___ (partial mid-systolic closure) ---> Due to sudden ____ in CO pressure when LVOT becomes obstructed• AoV notching
    ---> Decrease
  43. 43AoV Notching: • Pressure drops due to the ____/____, allowing AoV to start to ___ • ___-___• Stenosis/obstruction ; close
    • Bow-tie
  44. 44HCM: M-Mode Diagnostic Criteria Diastolic Dysfunction: • E/A ___ • Diastolic ___ of the E-F slope (flatter)• Reversal
    • Reduction
  45. 45Doppler Evaluation of HCM: • Use ____ views to assess change in ___ flow velocities• Apical ; diastolic
  46. 46Doppler Evaluation of HCM: • Determine if ____ obstructive exists ---> Use ___ due to high velocities ---> The jet has late ___ peaking thus producing a "___ ____" jet• LVOT
    ---> CW
    ---> Systolic ; "dagger shaped"
  47. 47Doppler Evaluation of HCM: • Trace waveform to obtain ___ velocity and ____ • If SAM is present, MR will ___ be present• Peak ; gradient
    • Always
  48. 48HCM Color Doppler: • With LVOTO present, a ___ (turbulent) pattern will be seen in the area of the ____ LVOT• Mosaic ; narrowed
  49. 49HCM Provocative Maneuvers To determine if you have a LATENT obstruction you can use the following maneuvers: • ___ ___ • ___ maneuver • ___ ___ • ___ ___ ___ • Sudden ___ from the standing position• Amyl nitrate
    • Valsalva
    • Hand grips
    • Passive leg elevation
    • Squatting
  50. 50Treatment of HCM: • ___ ___ involves the removal of a portion of the ___ • ___ repair or replacement• Surgical myectomy ; septum
    • MV
  51. 51Treatment of HCM: • ___ ___ ---> Via angiography, ____ are identified by angio dye and alcohol is injected to induce a ____• Septal Ablation
    ---> Perforators ; MI
  52. 52Dilated Cardiomyopathy: • ___ ___ form of cardiomyopathies • AKA ___ ____ • Known for the ___-___ enlargement• Most common
    • Congestive cardiomyopathy
    • Multi-chamber
  53. 53Dilated Cardiomyopathy: • Known for ___ systolic and diastolic function (___ ejection fraction) • Poor diagnosis due to ___ systolic function • Dilated = ___• Decreased ; low
    • Low
    • Big
  54. 54Causes of Dilated CM: • ___ (unknown origin) ---> Most common • ___ ---> Viral/___/___/fungal or ___• Idiopathic
    • Infectious
    ---> Bacterial/parasite/AIDS
  55. 55Causes of Dilated CM: • ___ Heart Disease (____ HD) and Long standing ___ • ___ (ex. thiamine/Vitamin B1 deficiency) • ___-___ (during pregnancy) or Post-partum (___ pregnancy)• Ischemic ; coronary ; HTN
    • Metabolic
    • Peri-partum ; after
  56. 56Causes of Dilated CM: • ___ : alcohol, ___, ___ drugs ---> ____ agents : ex. Adriamycin • ___ disease ---> Hyperthyroidism ; hypothyroidism• Toxins ; lead ; medications
    ---> Chemotherapy
    • Endocrine
  57. 57Signs/Symptoms of Dilated CM: • ___ (with associated findings) ---> ____, orthopnea, and ___ ___• CHF
    ---> Dyspnea ; pulmonary edema
  58. 58Signs/Symptoms of Dilated CM: • Decreased ___ ---> ___, fatigue, weakness, ____• CO
    ---> Tachycardia ; hypotension
  59. 59Signs/Symptoms of Dilated CM: • ____ ---> ____, A-fib, V-tach, ___, sudden death• Dysrhythmias
    ---> Palpitations ; syncope
  60. 60Signs/Symptoms of Dilated CM: • ____ valves ---> Associated findings: ___, ___ and decreased ___• Regurgitant
    ---> Murmurs ; hemoptysis ; output
  61. 61Signs/Symptoms of Dilated CM: • ____ ---> CP • ____ ---> Rare complication• Ischemia
    • Endocarditis
  62. 62Dilated CM 2D Findings: • Gross ___ of the heart ---> ___ of all 4 chambers ---> Increased ___ and ___• Dilatation
    ---> Enlargement
    ---> Volume ; mass
  63. 63Dilated CM 2D Findings: • Globally ____ systolic and diastolic function ---> Global decrease in ___ ___ • Spontaneous ___/"smoke"• Decreased
    ---> Wall motion
    • Contrast
  64. 64Dilated CM: M-Mode: • ___ walls and ___ function • ____ chamber sizes• Thin ; decreased
    • Increased
  65. 65Dilated CM: M-Mode: • ___ "E" point to septal separation (EPSS) ---> > ___ cm • "B"/___ ___ on MV• Increased
    ---> > 0.7 cm
  66. 66Dilated CM: M-Mode: • ____ "D-E" excursion of the MV • Decreased ___ excursion ---> Takes on a ____ ____ appearance• Decreased
    • MV
    ---> Double diamond
  67. 67Dilated CM: M-Mode: • Decreased ___ ___ excursion ---> Represents decrease ____• Aortic root
    ---> CO
  68. 68Dilated CM: M-Mode: • Possible ____ HTN ---> PV M-Mode displays flying "___" and absent "A" ___/___• Pulmonary
    ---> "W" ; dip/wave
  69. 69B Notch/B-Bump DCM: • Anytime you see a "B" bump during M-Mode of the MV, it indicates significant ___ of the LV end ___ pressure (ELVEDP)• Elevation ; diastolic
  70. 70Dilated CM: Doppler Evaluation: • ____ is probable • Reduced ___ ___ velocity/ ___ (velocity time interval) • ____ Dysfunction• Regurgitation
    • Aortic ejection ; VTI
    • Diastolic
  71. 71Complications of Dilated CM: • ___ ___ with neurological events (usually from ___/___ thrombus) • Sudden death (due to ventricular ___)• Systemic embolization ; LV/LA
    • Arrhythmias
  72. 72Complications of Dilated CM: • ___ ___ (rare) • ___ ____ ---> Not always present, usually SMALL• Infective endocarditis
    • Pericardial effusion
  73. 73Complications of Dilated CM: • Thrombus ---> Located usually in ___ ---> To help determine if clot, remember: Use ___ frequency transducer for better resolution, exam ___ windows, add ___ flow---> Apex
    ---> Higher ; various ; color
  74. 74Treatment of Dilated CM: • ___ ---> Treatment ___ to etiology (if known)• Medication
    ---> Specific
  75. 75Treatment of Dilated CM: • ____ treatment ---> ___ replacements ---> ___ procedure - ventricular reduction ---> ____ ---> ____• Valvular
    ---> Batista
    ---> Defibrillator
    ---> Transplant
  76. 76Restrictive/Infiltrative Cardiomyopathy: • ____ common type of cardiomyopathy • Deposits in the ___ causing myocardial ___ that impairs VENTRICULAR FILLING• Least
    • Myocardium ; stiffening
  77. 77Restrictive/Infiltrative Cardiomyopathy: • Normal ___ function • Restrictive = ___• Systolic
    • Stiff
  78. 78Signs and Symptoms of RCM: • ____ including dyspnea, orthopnea • ____ • ___ • ____ • ___ exercise tolerance• CHF
    • Fatigue
    • Weakness
    • Angina
    • Poor
  79. 79Signs and Symptoms of RCM: • ___ • ___ edema • ____/____ • ____• JVD
    • Peripheral
    • Hepatomegaly/ascites
    • Hypotension
  80. 80Types of Restrictive CM: • ___ • ____ • ____ • ____ storage (Pompes) • ____ ____• Amyloidosis
    • Sarcoidosis
    • Hemochromatosis
    • Glycogen
    • Endomyocardial Fibrosis
  81. 81Restrictive CM 2D Echo: • ___ hypertrophy ---> ____ ---> Typically seen in ___ ventricles• Ventricular
    ---> Thick
    ---> Both
  82. 82Restrictive CM 2D Echo: • ___ or normal LV size • "___ ___" / ___ appearance of myocardium • Normal or ___ LV function• Small
    • "Ground Glass" ; bright
    • Decrease
  83. 83Restrictive CM 2D Echo: • ___ dysfunction • ___ enlargement • ___ is possible (pleural and pericardial)• Diastolic
    • Biatrial
    • PE
  84. 84Amyloidosis: • ___ ___ type ---> ___ disorder involving extracellular deposits of AMYLOID PROTEIN within myocardium (involves multiple systems)• Most common
    ---> Metabolic
  85. 85Amyloidosis Sonographic Appearance: • "____"/___ appearance of myocardium and bi-atrial enlargement• "Sparkle" ; bright
  86. 86Hemochromatosis: • Increased ___ storage disease • Iron is deposited in the ___ where it impairs LV function• Iron
    • Myocardium
  87. 87Glycogen Storage (Pompes): • Involves excessive glycogen storage in the heart ___ • Typically occurs ___ in life (___)• Tissue
    • Early ; hereditary
  88. 88Endomyocardial Fibrosis: • Involves formation of ___ ___ of tissue in the ___ • ___ the myocardium • May be ___ or ___• Fibrotic sheets ; endocardium
    • Lines
    • Diffuse ; local
  89. 89M-Mode of RCM: • ____ • Evaluates for ___ and chamber ___• Hypertrophy
    • Function ; size
  90. 90RCM Doppler Evaluation: • Evaluate for ___ ____ ---> INCREASED ___ velocity, DECREASED ___ velocity ---> ____ E/A ratio• Diastolic dysfunction
    ---> E ; A
    ---> Increased
  91. 91RCM Doppler Evaluation: • Deceleration time ___ • Heart wall cannot ___/___ to accommodate flow from ___ ___• Shortened
    • Relax/expand ; atrial kick
  92. 92Treatment of RCM: • ____ • Cardiac ____• Medication
    • Transplantation
  93. 93Treatment of RCM: • Most definitive way to diagnose restrictive cardiomyopathy = ___ ____• Endomyocardial biopsy

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Sonography (Echo II) Flashcards on Echo II - Cardiomyopathies , created by Adriana Long on 04/01/2020.
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