Cardiology: Ventricular Dysfunction and Diastolic Dysfunction
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Questions and Answers

What is a key characteristic of systolic dysfunction in heart failure?

  • Reduced ejection fraction (correct)
  • Dilated right atrium
  • Increased ejection fraction
  • Normal left ventricular dimensions

What should be the first-line treatment for patients with certain types of heart conditions?

  • Medication for fluid retention
  • ICD (Implantable Cardioverter Defibrillator) (correct)
  • Septal myectomy for all cases
  • Ventricular dilation therapy

Which of the following is NOT a characteristic of restrictive cardiomyopathy (RCM)?

  • Dilated heart chambers (correct)
  • Presence of an S4 heart sound
  • Hypertension not being the cause
  • Jugular venous distension (JVD)

What is the highest yield cause of amyloidosis relevant to restrictive cardiomyopathy?

<p>Multiple myeloma (D)</p> Signup and view all the answers

Which symptom is more commonly associated with diastolic dysfunction rather than systolic dysfunction?

<p>S4 heart sound (C)</p> Signup and view all the answers

What is the defining characteristic of dilated cardiomyopathy?

<p>Isolated ventricular dilation or widespread four-chamber dilation (D)</p> Signup and view all the answers

Which sign is commonly associated with restrictive cardiomyopathy?

<p>Jugular venous distension (JVD) (B)</p> Signup and view all the answers

In patients with restrictive cardiomyopathy, which condition can lead to abnormalities in protein deposition?

<p>Multiple myeloma (C)</p> Signup and view all the answers

What heart sound may be present in restrictive cardiomyopathy due to increased ventricular stiffness?

<p>S4 heart sound (C)</p> Signup and view all the answers

What is the effect of diastolic dysfunction on left ventricular end-diastolic volume (LVEDV)?

<p>LVEDV increases due to impaired filling (D)</p> Signup and view all the answers

Flashcards

Systolic Dysfunction in Dilated Cardiomyopathy (DCM)

Reduced ejection fraction, typically below 30%, indicating that the heart is not pumping blood effectively.

Septal Myomectomy

A procedure used to remove a portion of the left ventricular septum, reducing the pressure gradient in the outflow tract.

Diastolic Dysfunction in Restrictive Cardiomyopathy (RCM)

Heart muscle stiffens, making it difficult for the heart to relax and fill with blood during diastole.

S4 Heart Sound in RCM

A heart sound heard at the end of diastole, caused by the stiff heart muscle resisting filling.

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Jugular Venous Distention (JVD) in RCM

Increased pressure in the right atrium, causing the jugular veins to bulge in the neck.

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Dilated Cardiomyopathy (DCM)

A type of heart failure characterized by a weakened heart muscle and a dilated heart chamber. The heart struggles to pump blood effectively due to a reduced ejection fraction, often below 30%.

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Restrictive Cardiomyopathy (RCM)

A type of heart failure where the heart muscle stiffens and struggles to fill with blood during relaxation. This leads to an inability to pump enough blood despite a normal or near-normal ejection fraction.

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Study Notes

Ventricular Dysfunction

  • Ventricular dilation can be isolated or diffuse, affecting all four chambers.
  • A key characteristic is systolic dysfunction, where ejection fraction is reduced (e.g., 30%).
  • Septal myectomy may be considered if the left ventricular outflow tract pressure gradient exceeds 50 mmHg.
  • Implantable cardioverter-defibrillator (ICD) is usually the initial treatment.
  • Dilated cardiomyopathy (DCM) can have a multifactorial etiology.

Diastolic Dysfunction (Heart Failure)

  • Heart failure can arise from diastolic dysfunction, even without hypertension as a cause.
  • Jugular venous distension (JVD) is a hallmark sign of restrictive cardiomyopathy (RCM).
  • An S4 heart sound may also be present in RCM.
  • Cardiac dilation is not a feature in RCM.
  • High-yield causes of RCM include:
    • A history of radiation therapy (leading to fibrosis).
    • Amyloidosis (protein deposition in abnormal locations).
    • Hemochromatosis (iron overload).
  • The presenting condition (e.g., dilated or non-dilated heart) guides diagnosis; don't rely on a single cause being linked to only one type of cardiomyopathy.
  • Amyloidosis, frequently linked to multiple myeloma, is a key factor in RCM.
  • RCM, like hypertrophic cardiomyopathy (HCM), demonstrates decreased values in:
    • Ejection Fraction (EF)
    • Left Ventricular End-Diastolic Volume (LVEDV)
    • Left Ventricular End-Diastolic Pressure (LVEDP)
  • To differentiate DCM from RCM, consider clinical findings:
    • DCM is associated with a large cardiac silhouette, an S3 heart sound, and a lateralized apex beat.
    • RCM is characterized by JVD, an S4 heart sound, and no lateralized apex beat.

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Description

This quiz covers key aspects of ventricular dysfunction and diastolic dysfunction related to heart failure. Topics include ejection fraction, treatment options, and specific signs associated with restrictive cardiomyopathy. Test your understanding of these crucial cardiac conditions.

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