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Cardiomyopathy by rohma asghar roll no.190. Cardiomyopathy. The 3 main types of cardiomyopathy are: Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy . Dilated Cardiomyopathy. heart muscle dilates
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Cardiomyopathy The 3 main types of cardiomyopathy are: Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy
Dilated Cardiomyopathy heart muscle dilates Ventricular chamber size the heart becomes weaker heart failure can also lead to heart valve problems (regurgitation), arrhythmias, and blood clots in the heart (poor blood flow), emboli formation a common reason for needing a heart transplant.
Types and Causes: Ischemic cardiomyopathy Idiopathic cardiomyopathy Hypertensive cardiomyopathy Infectious cardiomyopathy Alcoholic cardiomyopathy Toxic cardiomyopathy Peripartum cardiomyopathy Radiotherapy(cobalt) diabetes and thyroid disease
Hypertrophic Cardiomyopathy occurs when the heart muscle thickens abnormally (left ventricle) 1.) obstructive type 2.) non-obstructive type
Hypertrophic Cardiomyopathy Pathophysiology: Left ventricular hypertrophy ventricular chamber size less blood CO pressure in the ventricles and lungs changes in the cardiac muscles interfere with the heart's electrical signals sudden cardiac arrest Causes: inherited develop over time often, the cause is unknown.
Restrictive Cardiomyopathy the ventricles become stiff and rigid due to replacement of the normal heart muscle with abnormal tissue. . Causes: radiation treatments,infections or scarring after surgery Sarcoidosis Hemochromatosis Amyloidosis
Major Risk Factors Having a family history Having a disease or condition that can lead to cardiomyopathy Diseases that can damage the heart Long-term alcoholism Long-term high blood pressure Diabetes and other metabolic diseases
Signs and Symptoms some have no symptoms in the early stages of the disease as cardiomyopathy progresses and the heart weakens, signs and symptoms of heart failure usually appear. These signs and symptoms include: Tiredness Weakness Shortness of breath after exercise or even at rest Swelling of the abdomen, legs, ankles, and feet Other signs and symptoms: dizziness, lightheadedness, fainting during exercise, abnormal heart rhythms, murmurs
Interventions The main goals of treating cardiomyopathy are to: Manage conditions that cause to the cardiomyopathy Control symptoms so that the person can live as normally as possible Stop the disease from getting worse Reduce complications and the chance of sudden cardiac death Medications: Diuretics Angiotensin-converting enzyme (ACE) inhibitors Beta-blockers Calcium channel blockers Digoxin Anticoagulants Antiarrythmics Antibiotics
Surgery Septal myectomy - also called septal myomectomy - is open-heart surgery for hypertrophic obstructive cardiomyopathy Surgical implanted devices - a left ventricular assist device (LVAD) -an implantable cardiverter defibrillator (ICD)
Lifestyle Changes : Quitting smoking Losing excess weight Eating a low-salt diet Getting moderate exercise, such as walking, and avoiding strenuous exercise Avoiding the use of alcohol and illegal drugs Getting enough sleep and rest Reducing stress Treating underlying conditions, such as diabetes and high blood pressure
Heart Transplant 90% of heart transplants are performed on patients with end-stage heart failure Survival rates: 88 % of patients survive the first year after transplant 72 % survive for 5 years 50 % survive for 10 yrs. 16 % survive 20 years.
Heart Transplant (cont.) CONTRAINDICATIONS Advanced age Poor blood circulation Diseases of the kidney, lungs, or liver History of cancer Inability or unwillingness to follow lifelong medical instructions after a transplant. Pulmonary arterial hypertension Active infection
Heart Transplant (cont.) Organs are matched for blood type and size of donor and recipient. The Donor Heart Guidelines on how a donor heart is selected : the donor meet the legal requirement for brain death consent forms are signed younger than 65 years of age have little or no history of heart disease or trauma to the chest not exposed to hepatitis or HIV donor heart must be transplanted w/in 4 hrs. after removal from the donor
Heart Transplant (cont.) Preventing Rejection Immunosuppressants used: cyclosporine, tacrolimus, MMF (mycophenolate mofetil), and steroids such as prednisone. Watching for Signs of Rejection Shortness of breath Fever Fatigue Weight gain Reduced amounts of urine Preventing Infection
What Are the Risks of a Heart Transplant? Failure of the donor heart Primary Graft Dysfunction Rejection of the Donor Heart Cardiac Allograft Vasculopathy Complications from medicines Infection Cancer – lymphoma and skin cancer (due to suppression of the immune system)