NURS 5461 CARDIOMYOPATHY EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS GRADED A++
CARDIOMYOPATHIES
A large group of diseases of the myocardium that result in mechanical and/or electrical
pump dysfunction
WHO Classification
Dilated • Enlarged • Systolic dysfunction 2. Hypertrophic • Thickened • Diastolic
dysfunction 3. Restrictive • Diastolic dysfunction 4. Arrhythmogenic RV dysplasia •
Fibrofatty replacement 5. Unclassified • Fibroelastosis • LV noncompaction
DILATED CARDIOMYOPATHY (DCM)
Dilation and impaired contraction of ventricles • Reduced systolic function with or
without heart failure • Characterized by myocyte damage • *Starts in left ventricle then
often spreads to right ventricle, then to atria • Can lead to valvular problems and
arrhythmias
DCM - known by many other names
Alcoholic cardiomyopathy Congestive cardiomyopathy Diabetic cardiomyopathy Familial
dilated cardiomyopathy Idiopathic cardiomyopathy Ischemic cardiomyopathy.
Peripartum cardiomyopathy Primary cardiomyopathy
DCM
characterized by ventricular enlargement and contractile dysfunction (Cant
squeeze=blood back up) with normal left ventricular (LV) wall thickness. • The right
, ventricle may also be dilated and dysfunctional. • Dilated cardiomyopathy is the third
most common cause of heart failure and the most frequent reason for heart
transplantation. Accounts for 10,000 death annually. • 1 in 9 deaths in US, heart failure
is mentioned on death certificate
DCM SIGNS & SXS
Indicator of the severity • Fatigue • Dyspnea on exertion, shortness of breath •
Orthopnea, paroxysmal nocturnal dyspnea • Increasing edema, weight, or abdominal
girth
DCM PE FINDINGS
• signs of heart failure and volume overload • Tachypnea • Tachycardia • Hypertension •
Signs of hypoxia (eg, cyanosis, clubbing) • Jugular venous distension (JVD) •
Pulmonary edema (crackles and/or wheezes) • S 3 gallop • Enlarged liver • Peripheral
edema
DCM WORKUP
• Complete blood count • Metabolic panel • Thyroid function tests • Cardiac biomarkers •
B-type natriuretic peptide assay • Chest radiography • Echocardiography • Cardiac
magnetic resonance imaging (MRI) • Electrocardiography (ECG) • Endomyocardial
Biopsy if cannot find cause
DCM MANAGEMENT
• Essentially the same as treatment of chronic heart failure • Angiotensin-converting
enzyme (ACE) inhibitors ('pril)• Angiotensin II receptor blockers ('tan) (ARBs) • Beta-
blockers • Aldosterone antagonists Eplerenone)• Cardiac glycosides • Diuretics •
ANSWERS WITH COMPLETE SOLUTIONS GRADED A++
CARDIOMYOPATHIES
A large group of diseases of the myocardium that result in mechanical and/or electrical
pump dysfunction
WHO Classification
Dilated • Enlarged • Systolic dysfunction 2. Hypertrophic • Thickened • Diastolic
dysfunction 3. Restrictive • Diastolic dysfunction 4. Arrhythmogenic RV dysplasia •
Fibrofatty replacement 5. Unclassified • Fibroelastosis • LV noncompaction
DILATED CARDIOMYOPATHY (DCM)
Dilation and impaired contraction of ventricles • Reduced systolic function with or
without heart failure • Characterized by myocyte damage • *Starts in left ventricle then
often spreads to right ventricle, then to atria • Can lead to valvular problems and
arrhythmias
DCM - known by many other names
Alcoholic cardiomyopathy Congestive cardiomyopathy Diabetic cardiomyopathy Familial
dilated cardiomyopathy Idiopathic cardiomyopathy Ischemic cardiomyopathy.
Peripartum cardiomyopathy Primary cardiomyopathy
DCM
characterized by ventricular enlargement and contractile dysfunction (Cant
squeeze=blood back up) with normal left ventricular (LV) wall thickness. • The right
, ventricle may also be dilated and dysfunctional. • Dilated cardiomyopathy is the third
most common cause of heart failure and the most frequent reason for heart
transplantation. Accounts for 10,000 death annually. • 1 in 9 deaths in US, heart failure
is mentioned on death certificate
DCM SIGNS & SXS
Indicator of the severity • Fatigue • Dyspnea on exertion, shortness of breath •
Orthopnea, paroxysmal nocturnal dyspnea • Increasing edema, weight, or abdominal
girth
DCM PE FINDINGS
• signs of heart failure and volume overload • Tachypnea • Tachycardia • Hypertension •
Signs of hypoxia (eg, cyanosis, clubbing) • Jugular venous distension (JVD) •
Pulmonary edema (crackles and/or wheezes) • S 3 gallop • Enlarged liver • Peripheral
edema
DCM WORKUP
• Complete blood count • Metabolic panel • Thyroid function tests • Cardiac biomarkers •
B-type natriuretic peptide assay • Chest radiography • Echocardiography • Cardiac
magnetic resonance imaging (MRI) • Electrocardiography (ECG) • Endomyocardial
Biopsy if cannot find cause
DCM MANAGEMENT
• Essentially the same as treatment of chronic heart failure • Angiotensin-converting
enzyme (ACE) inhibitors ('pril)• Angiotensin II receptor blockers ('tan) (ARBs) • Beta-
blockers • Aldosterone antagonists Eplerenone)• Cardiac glycosides • Diuretics •
