Special forms of cardiomyopathy 762012

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Apical Ballooning ,HOCM, HTN

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Special forms of cardiomyopathy 762012

  1. 1. 3 Forms of Cardiomyopathy Dr Ihab Suliman Cardiology Morning Presentation 2 IM 7/6/2012
  2. 2. • Sinus Tachycardia + LVH
  3. 3. 70 years old lady post operative for CA Colon
  4. 4. • Sinus Tachycardia, Low VoltaGE Limb Leads Lateral STEMI
  5. 5. Sky High ST elevation withMinimal Rise in CardaicEnzymes
  6. 6. • Sky High ST Elevation
  7. 7. • Cardiac Enzymes elevation is Much lower than expected with Sky High STEMI
  8. 8. • Ballooned Apex
  9. 9. • Apical Balloon
  10. 10. Tako-tsubo Cardiomyopathy• May account for up to 2% of suspected ACS• In-hospital mortality ranges 0-8%• Much more common in women (~90%), especially postmenopausal women (>80% of cases)• Mean age 58-75 years• Triggers: death of loved one, other catastrophic news, devastating financial losses, natural disasters, physical illness/ICU, etc.
  11. 11. Proposed Diagnostic Criteria1. Transient a/dyskinesis of apical and midventricular segments in association with regional wall motion abnormalities that extend beyond the distribution of a single epicardial vessel2. Absence on angiography of obstructive coronary artery disease or evidence of acute plaque rupture3. New ST segment elevation or T wave inversions on ECG4. Absence of recent significant head trauma, intracranial bleeding, pheochromocytoma, myocarditis, or hypertrophic cardiomyopathy Proposed by Bybee, et al. 2004. Annals of Internal Medicine. 141: 858-865.
  12. 12. The Second Form70 years old with Papitations
  13. 13. • AF
  14. 14. • NSR in contrast to AF
  15. 15. • HTN , LVH
  16. 16. The Third• 37 years old lady with Familial type of Cardiomyopathy
  17. 17. • HOCM Different echo views
  18. 18. • AICD with atrial lead4 HOCM
  19. 19. • Hypertrophic cardiomyopathy is a genetic disorder that is typically inherited in an autosomal dominant fashion with variable penetrance and variable expressivity.
  20. 20. • HCM is the leading cause of sudden cardiac death in preadolescent and adolescent children.• The hallmark of the disorder is myocardial hypertrophy that is inappropriate, often asymmetrical, and occurs in the absence of an obvious inciting hypertrophy stimulus.
  21. 21. Complications of HCM may include the following:• Congestive heart failure or dilated eventually in 10 %• Ventricular and supraventricular arrhythmias• Infective mitral endocarditis• Atrial fibrillation with mural thrombus formation , AF worsen very much their status ,occur up to 25-30, ATC is important• Sudden death
  22. 22. Cardiology staff at NGHA ,Riyadh ,ksa

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