Final Pathology Review Part 1

1. Normal LV size

2. Biventricular hypertrophy

3. Significant biatrial enlargement

Restrictive cardiomyopathy

Average EF% with HCM

70-80%

Increased LVEDP seen with DCM will demonstrate?

B bump

Most common echo finding in HIV patients

Pericardial effusion

Expansion of the LV apex with basal hyperkinesis

Takotsubo cardiomyopathy

Which cardiac abnormality is consistent with the Doppler tracing?

Constrictive pericarditis

1. Widespread ST elevation

2. Trace MR

3. Trace TR

4. Mild pericardial effusion

Pericarditis

Layer most affected by Staphylococcus Aureus

Endocardium

1. LVH

2. Prominent papillary muscles

3. Hyperechoic endocardial layer

4. Conduction defects

Fabry disease

Refers to an arterial pulse waveform with alternating strong and weak beats

Pulsus alternans

Preferred method of diagnosis of constrictive pericarditis

Cardiac catheterization

Cardiomyopathy strongly associated with diabetes

DCM

Most common type of infiltrative cardiomyopathy to develop restrictive cardiomyopathy

Amyloidosis

1. Restrictive filling pattern

2. Tall E wave

3. Small A wave

4. Decreased deceleration time

Restrictive cardiomyopathy

Heterogeneous speckled appearance of the myocardium of the RV and LV consistent with?

Infiltrative cardiomyopathy

1. HF with preserved EF%

2. Significant diastolic dysfunction

Restrictive cardiomyopathy

What causes the AV to close mid systole?

LVOT obstruction

Equal diastolic pressures in the RV and LV

Constrictive pericarditis

Cardiac tamponade causes?

Restrictive diastolic filling

1. Biventricular wall thickening

2. Mild pericardial effusion

3. Thickening of all four valve leaflets

Amyloidosis

Most important cardiac structure that should be evaluated with suspected tamponade

RV free wall

1. Irregular contour

2. Abnormal motion

3. Large trabeculations

Non-compaction cardiomyopathy

How does restrictive cardiomyopathy affect pulmonary venous flow?

Increased diastolic (D) and blunted systolic (S)

Dagger shaped waveform with high systolic velocity and late systolic peak reflects a dynamic obstruction 

HOCM

Most common pattern of LVH with HCM

Isolated IVS hypertrophy

Acute transient stress-induced cardiomyopathy

Takotsubo cardiomyopathy

What would cause you to suspect cardiac tamponade?

Becks triad

Typical treatment for advanced pericarditis

Pericardectomy

A valve ring abscess is usually a sign of what cardiac disorder?

Infective endocarditis

What are the calipers measuring?

Abnormal respiratory variation in the E velocity of the MV due to cardiac tamponade

Early stages of infiltrative cardiomyopathy are commonly associate with which type of diastolic dysfunction?

Grade 1

What effect does DCM have on HR?

Increases

HCM has associated?

MR

Electrical alternans is a common finding with?

Cardiac tamponade

1. Autosomal recessive disease

2. Abnormal storage of glycogen

3. Increased ventricular thickening

Pompe disease

1. Chemotherapy

2. Decreased EF%

3. Global hypokinesis

4. New onset of SOB

Pericardial effusion

Infection only affects the cardiac valves with no involvement of myocardium or other cardiac structures

Marantic endocarditis

Pulsus paradoxus is commonly seen with?

Constrictive pericarditis and cardiac tamponade

Name a complication of DCM

Stroke

What would cause an increase in the murmur associated with hypertrophic subaortic stenosis?

Amyl nitrite administration

Who would benefit from the placement of an intra-aortic balloon pump?

DCM

What m-mode measurement will increase in patients with DCM?

EPSS

Average EF% with DCM

10-20%

1. Non-dilated LV

2. Thick walled LV

3. EF 63%

4. E/A 2.1

5. E/E 19

6. Moderate biatrial enlargement

7. Moderate pulmonary HTN

8. RVH

9. Dilated IVC

Restrictive cardiomyopathy

Dilated IVC and HPVs are commonly associated with?

Constrictive pericarditis and cardiac tamponade

In cardiac tamponade, the RV free wall will collapse during diastole except in patients with?

Pulmonary HTN

Most common complication seen with septal myectomy performed to correct ASH

VSD

1. Tachycardia

2. Dyspnea

3. Orthopnea

4. Lower extremity edema

DCM

Common finding with infiltrative cardiomyopathy, endocarditis and a recent MI

Pericardial effusion

What are you looking for after a recent diagnosis of Chagas disease?

DCM and apical aneurysm

1. Dilated LV with normal wall thickness

2. Reduced function

Hemochromatosis

Positional and respiratory variation in chest pain

Pericarditis

Most common cause of DCM

Alcoholism

Fatty and fibrous tissue replacement of the myocardium of the RV

Arrhythmogenic RV cardiomyopathy

What effect will DCM have on LVOT velocity?

Decreased CO

1. Endocardial thickening

2. Fibrous tissue overgrowth LV apex

3. Diastolic dysfunction

Endomyocardial fibrosis

1. Suspected cardiac emboli causing new onset of left hemiparalysis

2. High fever

3. Heroin addiction

Vegetation on the MV

Endocarditis typically causes the formation of vegetations on the?

Ventricular side of the AV and atrial side of the MV

Double diamond sign

DCM

1. Fever of 103

2. IV drug use

3. Recent onset of extreme dyspnea

4. Emboli lodged right bronchial artery

Vegetation on the TV

VSD found in LVOT near AV

Membranous VSD

MVP and bicuspid AV are associated with?

Coarctation

What can increase the number of microbubbles crossing the IAS during saline contrast exam?

Ask patient to cough

Dilated coronary sinus associated with?

Persistent left SVC

ASD located close to atrioventricular valves and associated with cleft MV

Septum primum

1. Continuous murmur

2. Normal brachial pressures bilaterally

3. Decreased pedal pulses

Coarctation distal to the left subclavian artery

Most commonly occurring congenital defect

VSD

Most commonly detected congenital heart defect in adults

Bicuspid AV

Doppler evaluation of the abdominal aorta in severe cases of coarctation will demonstrate?

Low velocity monophasic flow

1. Discolored nail beds

2. Clubbed fingers

3. Dyspnea

TOF

1. VSD

2. Overriding aorta

3. Infundibular stenosis

4. RVH

TOF

Large ASDs can lead to?

RV volume overload and flattened IVS

Most common location for the formation of coarctation

Isthmus

Anomalous origin of the coronary artery most commonly associated with?

Bicuspid AV and TOF

In cases of pulmonary atresia, what must be present to survive after birth?

PDA

Unable to demonstrate two vessels exiting the ventricles

Truncus arteriosus

Eisenmenger syndrome most likely to occur with?

PDA or ASD

History of systolic murmur

Muscular VSD and secundum ASD

Associated with sinus venosus ASD

PAPVR

When evaluating VSD repair, what should be obtained to demonstrate success of the procedure?

SPAP

If all four pulmonary veins do not connect to the LA

TAPVR

If at least one pulmonary vein does not connect to the LA

PAPVR

ASD most commonly associated with Ebstein anomaly

Secundum ASD

Electrical abnormality commonly associated with Ebstein anomaly

Wolff-Parkinson-White Syndrome

Complex CHD that corrects itself

Corrected or L-transposition

Murmur associated with ASD

Systolic murmur with fixed split S2

Apical displacement of one or more tricuspid leaflets

Ebstein anomaly

1. Pulmonary artery forms as a branch of the LV

2. Aorta forms as a branch of the RV

Transposition

1. Inlet VSD

2. Common atrioventricular valve

3. Ostium primum ASD

4. Trisomy 21

Complete endocardial cushion defect

Flow moving through PFO from the RA to LA is related to what CHD?

Ebstein anomaly

First screening exam performed to asses for critical CHD

Pulse oximetry

Name the ASD demonstrated

Ostium secundum

1. VSD patch

2. RVOT stent

3. Moderate PI

4. RV enlargement

TOF repair

In cases of PDA, normal cardiac pressures can be assumed when?

PPG from the shunt equals 100 mmHg

Holt Oram Syndrome most commonly associated with?

ASD

Murmur associated with bicuspid AV

Systolic ejection click after S1

Cor triatriatum of the LA can lead to which flow complication?

Restricted pulmonary venous flow

Prolapse of the right aortic cusp most commonly seen with what type of VSD?

Outlet VSD

Conduit connecting the IVC to the RPA

Fontan procedure

Two openings in the MV

Double outlet MV