CARDIOMYOPATHIES

REPORTED BY: CHARLENE DOROTHY TABIGNE

CARDIOMYOPATHY•is a heart muscle disease associated with cardiac dysfunctions.

•CLASSIFICATIONS:

Dilated Cardiomyopathy

Restrictive Cardiomyopathy

Hypertrophic Cardiomyopathy

DILATED CARDIOMYOPATHY

• Distinguished by significant dilation of ventricles without simultaneous hypertrophy and systolic dysfunction.

• Ventricles have increased systolic and diastolic volumes but decreased ejection fraction.

• Chambers dilate and muscle walls become thinner.

• Diminished contractile elements of the muscle fibers and diffuse necrosis of myocardial cells. The result is poor systolic function.

RESTRICTIVE CARDIOMYOPATHY•Characterized by diastolic dysfunction caused by rigid

ventricular walls that impair diastolic filling and ventricular stretch. These changes cause the heart to fill poorly.

•May be assoc. with amyloidosis and other infiltrative diseases.

HYPERTROPHIC CARDIOMYOPAT

HY-the heart muscle (myocardium) becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood. Often, one part becomes thicker than other parts (asymmetric) causing blockage to the blood flow.

ASSESSMENT & DIAGNOSIS:•Patient’s medical history

•Physical examination (early stage: tachycardia, extra heart sound)

• echocardiogram

•ECG

•chest x-ray

•Cardiac catheterization

•endomyocardial biopsy

GENERAL SIGNS AND SYMPTOMS:

RIGHT HEART:

• OUTFLOW TO THE LUNGS:SHORTNESS OF BREATH ( RR)

COUGH

• BACK UP OF THE BLOOD TO THE BODY EDEMA

LEFT HEART:

• OUTFLOW TO THE BODY:

ANGINA

• WEAKNESS / FATIGUE

• SYNCOPE / FAINTING

• BACK UP OF BLOOD TO THE LUNGS

PULMONARY EDEMA

SIGNS AND SYMPTOMS:

DILATED CM:

• JUGULAR VENOUS PRESSURE – DISTENDED

VEINS

• S3 HEART SOUND

• CARDIOMEGALY - CXR

RESTRICTIVE CM:

• JVP

• S4 HEART SOUND

HYPERTROPHIC CM:

• S4 HEART SOUND

• MURMUR (SYSTOLIC EJECTION MURMUR) INCREASING WITH

VALSALVA

TREATMENT OF CARDIOMYOPATHY:AIMS TO:

1. SLOW PROGRESSION OF THE DAMAGE

2. IMPROVE HEART FUNCTION

3. REDUCE SYMPTOMS

4. TREAT ASSOCIATED PROBLEMS

MANAGEMENT: BACK UP OF BLOOD

DILATED CARDIOMYOPATHY NA DIET (TO DECREASE FLUID

RETENTION)

DIURETICS

ACE INHIBITORS

LIMIT ORAL FLUID INTAKE

RESTRICTIVE CARDIOMYOPATHY NA DIET (TO DECREASE FLUID

RETENTION)

DIURETICS

ACE INHIBITORS

LIMIT ORAL FLUID INTAKE

HYPERTROPHIC CARDIOMYOPATHY

PUMPING FAILUREDILATED

CARDIOMYOPATHYBETA BLOCKERS / CALCIUM

CHANNEL BLOCKERS

DIGOXIN

PACEMAKERS

RESTRICTIVE CARDIOMYOPATHY

PACEMAKERS

HYPERTROPHIC CARDIOMYOPATHY

BETA BLOCKERS / CALCIUM CHANNEL BLOCKERS

SEPTAL REDUCTION

PACEMAKERS

DECREASED OUTFLOWDILATED

CARDIOMYOPATHYACE INHIBITORS

RESTRICTIVE CARDIOMYOPATHY

ACE INHIBITORS

HYPERTROPHIC CARDIOMYOPATHY

•Septal Myectomy – is a surgical procedure performed to reduce the muscle thickening that occurs in patients with hypertrophic cardiomyopathy (HCM). Septal myectomy is one treatment option for HCM when symptoms persist despite optimal treatment with medications, or if obstruction severely restricts blood ejection from the heart.

WHAT TESTS ARE NEEDED BEFORE THE SURGERY?•A detailed echocardiogram (echo) provides information about heart

function and septal wall thickness. Specialized echo tests may include exercise or the use of special drugs and may be needed to define the severity of obstruction and to assess the mitral valve.

• If you do not have an implantable defibrillator or pacemaker, an MRI may also be obtained to evaluate the mitral valve structure and function.

•A diagnostic cardiac catheterization should be performed. Routine blood tests, a chest X-ray and an electrocardiogram will also be performed.

POST SEPTAL MYECTOMY:• AT A HEART-HEALTHY DIET THAT INCLUDES FOLLOWING A 2,000 MG SODIUM (SALT) DIET

• RESTRICT FLUIDS TO 8 CUPS OR LESS PER DAY

• QUIT SMOKING AND USING TOBACCO

• TREAT HIGH CHOLESTEROL

• MANAGE HIGH BLOOD PRESSURE AND DIABETES

• EXERCISE REGULARLY

• MAINTAIN A HEALTHY WEIGHT

• WEIGH YOURSELF EVERY DAY AND MONITOR FOR SUDDEN WEIGHT GAIN OF MORE THAN 2 POUNDS IN A DAY OR 5 POUNDS IN A WEEK; CALL YOUR DOCTOR IF THIS OCCURS

• CONTROL STRESS AND ANGER

• PARTICIPATE IN A CARDIAC REHABILITATION PROGRAM, AS RECOMMENDED

• FOLLOW UP WITH YOUR DOCTOR REGULARLY, AS SCHEDULED

“

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THE MOST CHRONIC HEART DISEASE IS CAUSED BY HAVING GREEDINESS IN YOUR

HEART. GO FOR CHECK UPS REGULARLY AND LEARN HOW TO SWALLOW THOSE LUMPY PILLS OF GENEROSITY. BE KIND AND BE

HEALTHY.

THANK YOU!