2. Introduction
• Cardiomyopathy is a heart muscle disease associated
with cardiac dysfunction.
• It is classified according to the structural and functional
abnormalities of the heart muscle:
Dilated cardiomyopathy (DCM)
Hypertrophic cardiomyopathy (HCM)
Restrictive or constrictive cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
(ARVC)
Unclassified cardiomyopathy
3. Dilated Cardiomyopathy
• In dilated cardiomyopathy the size of the ventricular
cavity enlarges.
• Contractile function decreases as the myocardial tissue is
destroyed.
• Blood moves more slowly through the left ventricle,
which often results in blood clot formation.
• Dilated cardiomyopathy is the most frequent type.
• Dilated cardiomyopathy may be hereditary, follow
infectious myocarditis, or be caused by chronic alcohol or
cocaine use, HIV, thiamine or zinc deficiencies, or
infections.
4.
5.
6. Hypertrophic Cardiomyopathy
• Hypertrophic cardiomyopathy is enlargement of the
muscle walls of the left ventricle.
• The ventricular walls are rigid, which decreases
ventricular filling.
• If the enlarged septum obstructs the outflow of blood
through the aortic valve, it is known as obstructive
hypertrophic cardiomyopathy.
• Hypertrophic cardiomyopathy can be a hereditary
disorder that is transmitted as a dominant trait.
• Sudden death in young athletes may be due to this
condition and is often the first sign of the disease.
7.
8. Restrictive Cardiomyopathy
• Restrictive cardiomyopathy impairs ventricular stretch
and limits ventricular filling.
• Cardiac muscle stiffness is present, although systolic
emptying of the ventricle remains normal.
• Restrictive cardiomyopathy is the rarest form of
cardiomyopathy.
• It may be caused by infiltrative diseases such as
amyloidosis that deposit the protein amyloid within the
myocardial cells, which makes the muscle stiff.
9. Clinical Manifestations
• Remain stable and without symptoms for many
years
• Dilated and restrictive cardiomyopathy presents with
signs and symptoms of heart failure
• Paroxysmal nocturnal dyspnea, cough (especially
with exertion), and orthopnea
• Fluid retention, peripheral edema, and nausea
caused by poor perfusion of the gastrointestinal
system
• Chest pain, palpitations, dizziness, nausea and
syncope with exertion
10. Diagnostic Investigations
• Physical examination in the early stage may reveal
tachycardia and extra heart sounds
• Echocardiogram for observation of structure and
function of the ventricles
• ECG demonstrates dysrhythmias
• Chest x-ray film reveals heart enlargement
• Cardiac catheterization is used to rule out coronary
artery disease
• An endomyocardial biopsy is performed to analyse
myocardial tissue cells
11. Medical Management
• Correcting the heart failure with medications, a low-
sodium diet, and an exercise-rest regimen.
• Controlling dysrrhythmias with antiarrhythmic
medications and an implanted electronic device, such as
an implantable cardioverter-defibrillator.
• If patients exhibit signs and symptoms of congestion,
their fluid intake may be limited to 2 litres each day.
• Limit physical activity in case of HCM to avoid a life-
threatening dysrhythmia.
• A pacemaker may be implanted to alter the electrical
stimulation of the muscle.
12. Surgical Management
• Left Ventricular outflow tract Surgery
• Heart Transplantation
• Mechanical Assist Devices and Total Artificial
Hearts
13. Nursing Management
Nursing Diagnosis
• Decreased cardiac output related to structural disorders
or to dysrhythmia from the disease process and medical
treatments
• Ineffective cardiopulmonary, cerebral, peripheral, and
renal tissue perfusion related to decreased peripheral
blood flow
• Impaired gas exchange related to pulmonary congestion
caused by myocardial failure (decreased cardiac output)
• Activity intolerance related to decreased cardiac output
or excessive fluid volume
