Cardiomyopathy Clinical features Etiology Diagnosis Dilated Hypertrophic Restrictive cardiomyopathy with Treatment

Cardiomyopathy DiagnosisOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » SignsInstruments & Procedures- Nasogastric tube. Read more ... » and SymptomsOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » CARDIOMYOPATHY

• CausesOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » Etiology Types Diagnosis of Cardiomyopathy  with TreatmentOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » Cardiomyopathy

Cardiomyopathies are a group of diseases which involve the heartAcute Myocardial Infarction CLINICAL PRESENTATION. Read more ... » muscles and affect cardiacAcute Myocardial Infarction CLINICAL PRESENTATION. Read more ... » functions.

Any diseaseOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » that affects the heart muscle, diminishing cardiac performance

There is primary involvement of heart muscles. There is no evidence of any heart disease like hyper­tensionAshwagandha Withania somnifera Ayurvedic Drug of Impotency, Spermatorrhoea, Nervous Tonic and Tension. Read more ... », congenital heart diseaseCYANOTIC CONGENITAL HEART DISEASE (Tetralogy of Fallot, Truncus arteriosus ). Read more ... », valvular heart dis­ease, coronary artery disease, or pericardial disease.

• Primary cardiomyopathies, which may be genetic, mixed (genetic or non genetic), or acquired,
• The heart muscle disease or caradiomyopathy result­ing from chronic ischemia is called ischemic cardi­omyopathy.
• secondary cardiomyopathies, which are accompanied by other organ systemOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » involvement.
• Dilated cardiomyopathy
• Hypertrophic cardiomyopathy
• Restrictive cardiomyopathy
• Arrhythmogenic right ventricular cardiomyopathy
• Unclassified cardiomyopathies

• Cardiomyopathy is primary disease of the heart muscles.

 

Cardiomyopathy is of three types:

 

 

• Dilated caradiomyopathy
• Hypertrophic cardiomyopathy
• Restrictive cardiomyopathy.

 

Etiology of Cardiomyopathy

 

 

• 1. Idiopathic
• 2. Familial
• 3. Eosinophilic restrictive cardiomyopathy
• 4. Endomyocardial fibrosis
• 5. Infective causes:
• a.Viral e. Metazoal
• b.Bacterial f. Spirochetal
• c.Fungal g. Rickettsial
• d. Protozoal
• 6. Metabolic
• 7. Deficiency
• 8. SLE
• 9. Polyarteritis nodosa
• 10. Rheumatoid arthritis
• 11. Progressive systemic sclerosis
• 12. AmyloidosisAmyloidosis Symptoms Diagnosis Prognosis and Treatment. Read more ... »
• 13. SarcoidosisSarcoidosis Causes Diagnosis Symptoms and Treatment. Read more ... »
• 14. Muscular dystrophy
• 15. Friedreich’s ataxia
• 16. Alcoholic
• 17. Radiation
• 18. Drugs
• 19. Peripartum cardiomyopathy.

 

DILATED CARDIOMYOPATHY (DCMP)

 

 

• There is dilatation of the left and / or right ventricles. Ventricular systolic Pump functionis impaired. There isprogressive increase in heate size.
• The Ventricular wall becomes thinned out this process is called remodeling . -

 

Cardiomyopathy Etiology:

 

 

• Etiology is:
• Toxic, metabolic, infectiousFicus Religiosa Pipal tree Ayurvedic Medicine Ficus religiosa Pipal Medicine of gastric problems diabetes diarrhea. Read more ... ».
• Viral myocarditis is a common cause of OeM!!..

 

DCMP is common in

 

 

• Middle aged men
• Alcohol abuse
• Pregnancy
• ThyroidHYPOTHYROIDISM Causes Diagnosis and Treatment. Read more ... » disease
• Cocaine abuse
• Chronic tachycardias.
• Geneticall it may be autosomal recessive X-linked inheritance. ‘

 

Cardiomyopathy ClinicalOphthalmologic Complications of DM (Diabetes Mellitus). Read more ... » features: symptoms :

 

• Chest painApproach to Chest Pain Differential diagnosis of chest pain. Read more ... »,
• dypnoea fatigue,
• palpita­tions syncopes
• stemic embolism

 

Signs: -

 

1. LV dilatation
2. Signs of CHF
3. Narrow pulse pressure
4. Raised JVPExamination of arterial pressure pulse with Jugular Venous Pulse (JVP). Read more ... »
5. S3, S4
6. MR, TR.

 

Cardiomyopathy Diagnosis:

 

 

 

Cardiomyopathy Chest x-ray may show

 

• - Cardiomegaly
• - LV dilatation
• - Pulmonary hypertensionLABORATORY TESTS FOR ADRENAL FUNCTIONS. Read more ... »
• - Interstitial edema

 

Cardiomyopathy ECGAcute Myocardial Infarction CLINICAL PRESENTATION. Read more ... » may show -

 

• Sinus tachycardiaSinus Tachycardia and Sinus Bradycardia Definition Causes and Treatment. Read more ... »
• Atrial fibrillationAtrial fibrillation Causes and Treatment Indications of DC Cardioversion. Read more ... »
• Ventricular arrhythmiasCOMPLICATIONS OF Acute Myocardial Infarction (AMI) AND TREATMENT -2. Read more ... »
• Left atrial enlargement
• ST-T changes
• Conduction defects
• Low voltage ECG

 

Cardiomyopathy Echocardiography :

 

 

• - LV dilatation
• - Systolic dysfunction
• - Reduced ejection fraction.

 

BNP:

 

 

• - Brain natriuretic peptide is elevated.

 

Cardiac catheterization: for-

 

• - AngiographyCoronary Angiography -Indications of Coronary Arteriography (Angiography). Read more ... »
• - LV, and coronary
• - MR seen
• - Ejection fraction is measured
• - Transvenous endomyocardial biopsy.

 

Cardiomyopathy Treatment

 

 

• A majority die within 3 yrs of symptoms
• Salt restriction
• ACE inhibitorsHeart Failure Treatment Heart Failure GENERAL PRINCIPLES. Read more ... »
• Digitalis
• Diuretics
• Angiotensin receptor blockersHeart Failure Treatment Heart Failure GENERAL PRINCIPLES. Read more ... » (ARBs) Spirinolactone
• Beta blockersMANAGEMENT of Acute Myocardial Infarction (AMI) -1. Read more ... »
• Stop alcohol and cardiotoxic drugs Stop NSAIDs
• Biventricular pacing or CRT – cardiac resynchronization therapy
• Implantable cardioverter defibrillator
• Cardiac transplantation.
• Stem cell therapy

 

Alcoholic Cardiomyopathy

 

 

• Alcohol is cardiotoxic and ma cause heart failureHeart Failure Causes Symptoms NYHA classification with Heart Failure Treatment. Read more ... » or fatal ventricular tachyarrh thmias.
• Holiday Heart Syndrome - After a bout of heavy drinkinging, atria fibrilation Or VPCs are seen. -

 

Peripartum Cardiomyopathy

 

 

• ardiac dilatation and heart failure occurs from 3 months before deliver to 6months after delivery. ommon in multipara. Age usually more than-3D

 

There is DCMP.

 

 

• There is progressive increase in heart size with each pregnancy.

 

HYPERTROPHIC CARDIOMYOPATHY

 

 

• There is left ventricular hypertrophy without known cause.
• LV is not dilated .
• There is asymmetric LVH and h ertrophy ..Qf int~r­ventricuar septum.
• There is dynamic LV outflow obstruction (obstruction during contraction of the heart). -
• Dynamic LV obstruction is due to hypertrophy of out­flow tract which reduces the outflow from left ven­tricle during midsystole.
• There is systolic anterior motion of the anterior mi­tral leaflet. It is also called Idio atbic Hypertrophie Subaortic Stenosis IHSS . -
• there is diastolic dysfunction.

 

Clinical features

 

 

• · There may be mild symptoms
• · However, sudden death can occur.
• · Dyspnoea, angina, fatigue, syncope may occur
• · There may be double or triple apical cardiac im-

 

pulse

 

• · Rapid carotid upstroke
• · S4
• · There is a harsh, diamond-shaped murmur after the fi rst hea rt sou nd.

 

Diagnosis ECG:

 

 

• Dee waves in Vl & V2
• Atrial and ventricular arrhythmias

 

Chest x-ray:

 

 

• - May be normal.

 

Echocardiography:

 

 

• - LVH
• Septum 1.3 times the thickness of posterior
• LV free wall
• S stolic AntruQ otion (SAf1) of mitral valv~
• LV cavity is small in HOCM.

 

Treatment

 

 

• Beta blockers
• Prevent dehydration
• Amiodarone, and Disopyramide for ventricular arrrhythmias
• Verapamil, Diltiazem
• Cardiac resynchronization therapy (CRT)
• Injection of ethanol in interventricular septum to shrink it
• Septal myectomy
• Implantable cardioverter defibrillator. ~Digitalis, diuretics, nitratesManagement of Unstable Angina (UA) / NSTEMI Anti-ischemic treatment. Read more ... », vasodilators, are not used.

 

RESTRICTIVE CARDIOMYOPATHY

 

 

• Restrictive Cardiomyopahty is characterized by ab­normal diastolic function. The ventricular walls are rigid a-nd revent proper filling. – –

 

Etiology :-

 

• Amyloid infiltration
• Glycogen
• Hemochromatosis
• Endomyocardial fibrosis
• Sarcoidosis
• Scleroderma
• Eosinophilia.

 

CIinical features

 

 

• – Dyspnoea
• – Pedal edema
• – Tender liver
• – Kussmaul’s sign – JVP is raised during inspiration
• – Distant heart sounds (soft, faint heart sounds)
• S3,S4
• MR.

 

ECG

 

• ST-T changes,
• arrhythmias

 

Echocaradiography:

 

 

• Symmetrical, thickened LV walls
• Decreased cardiac output, decreased ejection fraction
• Increased End diastolic pressure (EDP).
• It can be differentiated from constrictive pericarditis by a palpable apex beat and mitral regurgitation.

 

ENDOMYOCARDIAL FIBROSIS

 

 

• Common in Africa.
• · There is restrictive cardiomyopathy
• · There are fibrous endocardial changes in AV valves (mitral valve, tricuspid valves)
• · There is MR, TR
• There is apical fibrosis
• Treatment is surgical excision of fibrotic endocar­dium.

 

EOSINOPHILIC ENDOMYOCARDIAL DISEASE

 

 

• Also called Loeffler’s endocarditis.
• There is hypereosinophilic syndrom~.
• · Endocardium of RV and LV is thickened.
• There is restrictive cardiomyopathy.
• · There are large thrombi in venericles with em­bolization.
• Liver and spleen are enlarged.
• There is eosinophilic infiltrati~ of many organs. Treatment is diuretics anticoa ulation glucocor­ticoids, hydroxyurea.

 

RIGHT VENTRICULAR DYSPLASIA

 

 

• Familial cardiomyopathy resembling dilated car­-iomyopathy.
• Right ventricular wall is re laced b adi ose tis­~.
• Ventricular arrhythmias and sudden death may occur.
• · Implantable cardioverter defibrillator is im­planted.

 

NEUROMUSCULAR DISEASE WITH CARDIAC IN­VOLVEMENT

 

 

• · Duchenne’s progressive muscular dystrophy, myotonic dystrophy, Friedreich’s ataxia may show hypertrophic cardiomyopathy (HOCM) or dilated cardiomyopathy (DCMP).
• Death often occurs due to ventricular arrhythmias.

 

DRUGS AND CARDIOMYOPATHY

 

• nthracycline derivatives
• Adriamycin
• yclophosphamide
• Cocaine.