Medical Surgical Cardiomyopathy #2

Question

The nurse caring for a client with dilated cardiomyopathy is scheduling a transthoracic echocardiogram, which will reveal what type of finding associated with the diagnosis?

Answers

  1. Decreased ejection fraction
    • Rationale:

      This answer is correct because dilated cardiomyopathy is a disorder of the heart muscle that causes abnormal myocardial performance with associated decreased ejection fraction. Echocardiographic indicators that help diagnose and provide prognosis include left ventricular size and systolic function through ejection fraction. The decreased cardiac output produces the symptoms of edema, pulmonary crackles, and irregular heart rate. Treatment may include use of diuretics and sodium restricted diet

  2. Decreased heart rate
    • Rationale:

      This answer is not correct because echocardiographic indicators that help diagnose and provide prognosis of dilated cardiomyopathy include left ventricular size and systolic function through ejection fraction. Echocardiographic indicators do not rely on decreased heart rate for diagnostic consideration for dilated cardiomyopathy.

  3. Presence of bundle branch block
    • Rationale:

      This answer is not correct because echocardiographic indicators that help diagnose and provide prognosis of dilated cardiomyopathy include left ventricular size and systolic function through ejection fraction. Echocardiographic indicators do not rely on the presence of a bundle branch block for diagnostic consideration for dilated cardiomyopathy.

  4. Asymptomatic ventricular tachycardia
    • Rationale:

      This answer is not correct because echocardiographic indicators that help diagnose and provide prognosis of dilated cardiomyopathy include left ventricular size and systolic function through ejection fraction. Echocardiographic indicators do not rely on the presence of V-tach for diagnostic consideration for dilated cardiomyopathy.

Overview

The priority laboratory test in dilated cardiomyopathy is an electrolyte panel. Excess sodium in the blood will affect the cardiac excitability and conduction system of the heart in dilated cardiomyopathy, since the heart cannot pump enough blood out to the body resulting in decreased cardiac output.

Explanation

Learning Outcomes

In dilated cardiomyopathy, dilation of the cardiac chambers and congested failure may occur. This is because cardiomyopathy is a disorder of the heart muscle that causes abnormal myocardial performance and is not usually the result of disease. The cardiac sodium channel is important in the cardiac excitability and conduction system. Excess sodium will affect the heart since it cannot pump enough blood out to the body resulting in decreased ejection fraction and decreased cardiac output. Echocardiographic indicators that help diagnose and provide prognosis of dilated cardiomyopathy include left ventricular size and systolic function through ejection fraction. Edema, pulmonary crackles, and irregular heart rate may occur, and treatment may include use of diuretics and sodium restricted diet. Types of cardiomyopathy include dilated, hypertrophic, and restrictive. Dilated cardiomyopathy is the most common form.

Test Taking Tip

It is helpful to know major cardiac tests such as echocardiogram and what their purpose is in diagnosing cardiac conditions. Structures and functions are evaluated in echocardiograms. The student can think about if in a large room with just structures, the room would “echo”.

Video Rationale