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3 types of cardiomyopathy
Resstrictive, dilated, and hypertrophic
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Dilated cardiomyopathy
often presents when and with what symptoms?
30-50 yo, MC in men, cc dyspnea, S3 gallop, rales, JVD
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nuclear stress test Measures
Ejection fraction, fixed or reversible ischemia
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treat dilated cardiomyopathy
Treat underlying cause
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common causes of dilated cardiomyopathy
CAD, HTN. Can be genetic; notify family.
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How to diagnose Takotsubo cardiomyopathy
Catheterization
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s/s Takotsubo cardiomyopathy
Crushing retrosternal chest pain, abnormal cardiac enzymes
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causes of restrictive CMY
collagen defect diseases
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s/s restrictive CMY
fatigue, dyspnea, decreased exercise tolerance, leg edema, ascites, orthostatic hypotension, atrial fibrillation
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how to diagnose restrictive CMY
echocardiography
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treat RCM
Intermittent diuretic, low salt diet, failing weighing. Treat symptoms
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mode of transmission of hypertrophic cardiomyopathy
Autosomal dominant
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structural abnormalitiesin HCM
Ventricular hypertrophy, Muscle changes at septum, mitral leaflets enlarged
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presentation of HCM
Dyspnea, angina with exertion, arrhythmia or palpitations, exertional syncope, murmur if severe
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Frank Starling’s Law
the greater the volume of blood in the heart during diastole, the more forceful the cardiac contraction, the more blood the ventricle will pump
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Effect of Valsalva maneuver on heart murmurs
all murmurs will get softer except for mitral valve prolapse and hypertrophic obstructive cardiomyopathy
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What murmurs increase on inspiration
Right sided
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which murmurs increase on expiration
left sided
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Diagnose HCM
Echocardiography
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Factors that can contribute to sinus tachycardia and PAC
Heart failure, thyrotoxicosis,anemia
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If PAC symptomatic, treat with:
BB or CCB
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Atrial fibrillation originates where
Pulmonary veins
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treat A-fib with either _____ or ______
Rate or rhythm
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Treat unstable A fib
Cardio version 200 joules
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How to rule out apical thrombus
transesophogeal echo
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Drugs for rate control of A fib
metoprolo l00-200 mg, diltiazem, flecanide, amiodarone, digoxin
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