Cardiomyopathies are diseases of the heart muscle that hinder its ability to pump blood, with three main types: dilated, hypertrophic, and restrictive cardiomyopathy. Symptoms include tiredness, weakness, shortness of breath, and swelling in various parts of the body, while management includes medication, lifestyle changes, and potential surgical interventions. Nursing management focuses on assessing cardiac output, coping strategies, activity intolerance, and fluid volume management to optimize patient care.

1. CARDIOMYOPATHIES
Mr.Avinash Dhameriya
MSc (N)

2. DEFINITION
• It is the Disease of the heart muscle in which the heart loses its ability to pump blood
effectively
• The heart muscle becomes enlarged or abnormally thick or rigid.
• In rare cases, the muscle tissue in the heart is replaced with scar tissue.
• As cardiomyopathy progresses the heart becomes weaker and less able to pump blood
through the body.

3. TYPES,CAUSES AND PATHOPHYSIOLOGY
The 3 main types of cardiomyopathy are:
1. Dilated cardiomyopathy
2. Hypertrophic cardiomyopathy
3. Restrictive cardiomyopathy

4. TYPES,CAUSES AND PATHOPHYSIOLOGY
HYPERTROPHIC CARDIOMYOPATHY - PATHOPHYSIOLOGY:
Left ventricular hypertrophy (thick ventricular wall)
ventricular chamber size decreases
hold less blood
interfere with the heart's electrical signals, leading to arrhythmias
sudden cardiac arrest
Causes:
• inherited because of a gene mutation
• develop over time because of high blood pressure or aging
• often, the cause is unknown.

5. CLINICAL MANIFESTATIONS
 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

6. ASSESSMENT AND DIAGNOSTIC FINDINGS
1. Patients history.
2. Chest X- ray show cardiomegaly.
3. ECG reveals tachycardia, and ST segment elevation,T Wave flattening or
inversion andVentricular arrhythmia’s
4. Echocardiography.
5. Cardiac catheterization and coronary angiography.

7. 1. HEMODYNAMIC MANAGEMENT
• Diuretic therapy to reduce intravascular volume.
• Potassium supplements are given to replace the potassium loss.
• Nitrates which reduce venous return to the heart. Eg; Nitroglycerine
• Diuretics, which remove excess fluid and sodium from the body.
• Angiotensin-converting enzyme (ACE) inhibitors, which lower blood pressure and reduce stress on
the heart.
• Beta-blockers, which slow the heart rate by reducing the speed of the heart's contractions. These
medicines also lower BP
• Calcium channel blockers, which slow a rapid heartbeat by reducing the force and rate of heart
contractions, decrease BP
• Digoxin - increases the force of heart contractions and slows the heartbeat.
• Anticoagulants, which prevent blood clots from forming.
• Antiarrhythmia medicines, which keep the heart beating in a normal rhythm.
• Antibiotics, which are used before dental or surgical procedures. Antibiotics help to prevent
endocarditis, an infection of the heart walls, valves, and vessels.
• Corticosteroids, which reduce inflammation
MEDICAL MANAGEMENT

8. 2. ENHANCING CONTRACTILITY
E.g. Dopamine
• It improves the contractility by intracellular release and utilization of
calcium.
3. CARDIACTRANSPLANTATION
4. SEPTAL MYECTOMY
• also called septal myomectomy
• is open-heart surgery for hypertrophic obstructive cardiomyopathy
MEDICAL MANAGEMENT

9. NURSING MANAGEMENT
5. LIFESTYLE CHANGES
• The doctor may recommend lifestyle changes to manage a condition that is causing the
cardiomyopathy.These changes may help reduce symptoms. Lifestyle changes may include:
• 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

10. NURSING MANAGEMENT
Nursing Interventions
1. Impaired cardiac output related to decreased ventricular function.
Outcome criteria
 Patient will have adequate cardiac output
Nursing Intervention
 Assess mental status every hour
 Measure and record U/every hour
 Maintain intake and output
 Weigh and record the weight daily
 Administer O2 & medication
 Limit the activity of the patient.

11. NURSING MANAGEMENT
2. Potential or actual ineffective coping related to life threatening illness.
Outcome criteria
Patient will participate in his own care
Nursing Intervention
 Assess the pt ability to cope e illness
 Listen to the pt. & answer question
 Explain about disease & outcome
 Provide flexible visiting hours
 Provide diversion activities.
 Provide adequate rest & sleep

12. NURSING MANAGEMENT
3.Activity intolerance related to low cardiac output
Outcome criteria
 Patient will have little or no discomfort
 Patient will not develop skin break down
Nursing Intervention
 Assess patients level of comfort and report s&s of discomfort
 Monitor signs of skin break down.
 Turn and change position every 2 hours
 Limit the activity.
 Plan and provide adequate rest.

13. NURSING MANAGEMENT
4. Fluid volume Excess related to ventricular dysfunction
Outcome criteria
 Oedema is reduced
 Maintain normal body weight.
 Maintain balance between intake and out put
Nursing Intervention
 Assess CVP.
 Check weight.
 Maintain intake and output change
 Administer diuretics as ordered.