dilated cardiomyopathy
DESCRIPTION
From Lily & Cardiology BluebookTRANSCRIPT
Dilated Cardiomyopathy
Aisa Alyanna B. Habib
Dilated Cardiomyopathy
Also called Congestive Cardiomyopathy
Most common type (90% of cases)Characterized by ventricular
chamber enlargement with impaired systolic function.
Ejection fraction <40%
Causes:
Pathophysiology of DCM
Most Common Causes:
Alcohol Beriberi Cocaine, Coxsackie Virus Drugs: Cocaine, Doxorubacin (adriamycin) Pregnancy Idiopathic, Infections (virus) Genetic
• Mnemonics: ABCD PIG
Dilated Cardiomyopathy
Diagnostic Tests
ECG: Non-Specific changes; may show LVH, occasionally LBBB, ventricular & atrial arrhythmias, sinus tachycardia
Chest X-Ray: Multichamber dilatation w/ congestive features
Echocardiography: Multichamber dilatation, LV wall motion abnormalities usually global hypokinesia (diagnostic tool of choice)
Coronary Angiography: Normal coronary arteries Angiography indicated only to rule out ischemic
heart disease Cardiac MRI (involving infiltrative disease)
Clinical Features:
May occur at any ageSlowly progressive signs and symptoms
of CHF (shortness of breath, easy fatigability, & poor exertional capacity)
Pulmonary congestion (Dyspnea, Orthopnea, Rales)
Systemic Congestion (JVD, Hepatomegaly, Edema)
S3 heart soundDeath attributable to progressive cardiac
failure or arrhythmias
Treatment:
Removal of offending agentConventional Therapy for systolic heart
failure (ACE Inhibitors, diuretics, low-dose beta-blockers, and digitalis)
Surgery options:1) Batista procedure2) Mechanical assist device
3) Cardiac transplantation (Best treatment!)4) Others
Some Questions aboutDilated Cardiomyopathy
Questions about DCM
1) What is the most common cause of dilated cardiomyopathy?
A) SmokingB) systolic HTNC) agingD) idiopathicE) LVH
Questions about DCM
1) What is the most common cause of dilated cardiomyopathy?
A) SmokingB) systolic HTNC) agingD) idiopathicE) LVH
Questions about DCM
2) What 2 things that must be present to diagnose dilated cardiomyopathy?
A) LV dilation + RV dilation B) LV dilation + systolic dysfunction C) RV dilation + Right atrial enlargementD) RV dilation + severe diastolic dysfunction
Questions about DCM
2) What 2 things must be present to diagnose dilated cardiomyopathy?
A) LV dilation + RV dilation B) LV dilation + systolic dysfunction C) RV dilation + Right atrial enlargementD) RV dilation + severe diastolic dysfunction
Questions about DCM
3) A 55 yo african american male presents to your clinic with the following physical exam: rales, elevated JVP, S3 gallop, peripheral edema, and a holosystolic musical murmur. What are you suspecting?
A) dilated cardiomyopathyB) hypertrophic cardiomyopathy C) restrictive cardiomyopathy D) myocardial infarctionE) right sided HF
Questions about DCM
3) A 55 yo african american male presents to your clinic with the following physical exam: rales, elevated JVP, S3 gallop, peripheral edema, and a holosystolic musical murmur. What are you suspecting?
A) dilated cardiomyopathyB) hypertrophic cardiomyopathy C) restrictive cardiomyopathy D) myocardial infarctionE) right sided HF
Questions about DCM
4) Which of the following ECG findings would you suspect in dilated cardiomyopathy?
A) LBBBB) sinus bradycardiaC) mobitz type IID) RBBBE) mobitz type I
Questions about DCM
4) Which of the following ECG findings would you suspect in dilated cardiomyopathy?
A) LBBBB) sinus bradycardiaC) mobitz type IID) RBBBE) mobitz type I
Questions about DCM
5) What is the diagnostic tool of choice to diagnose a dilated cardiomyopathy?
A) chest xray B) CBCC) EchocardiogramD) Electrocardiogram
Questions about DCM
5) What is the diagnostic tool of choice to diagnose a dilated cardiomyopathy?
A) chest xray B) CBCC) EchocardiogramD) Electrocardiogram
Questions about DCM
6) What is the diagnostic tool of choice for diagnosing infiltrative disease that may cause dilated cardiomyopathy?
A) Electrocardiogram B) chest radiographC) cardiac MRID) cardiac catheterization
Questions about DCM
6) What is the diagnostic tool of choice for diagnosing infiltrative disease that may cause dilated cardiomyopathy?
A) Electrocardiogram B) chest radiographC) cardiac MRID) cardiac catheterization