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Cardiomyopathy slideshare Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy Unclassified cardiomyopathy
Cardiomyopathy is a disease of the heart muscle that makes it harder for the heart to pump blood. There are several types classified by structural and functional abnormalities. The main types are dilated, hypertrophic, restrictive, and arrhythmogenic right ventricular cardiomyopathy. Dilated cardiomyopathy is the most common type and causes the heart chambers to enlarge and the heart muscle to thin and weaken over time, reducing its ability to pump blood. Management involves identifying underlying causes, treating heart failure symptoms, and controlling arrhythmias.
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Similar to Cardiomyopathy slideshare Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy Unclassified cardiomyopathy
Cardiomyopathy slideshare Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy Unclassified cardiomyopathy
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- 2. INTRODUCTION Cardiomyopathy is agroup of disease that affect the heart muscle. Early on there may be few or no symptoms. As the disease worsens, shortness of breath, feeling tired, and swelling of legs may occur, due to the onset of heart failure. An irregular heart beat and fainting may occur.
- 3. DEFINITION Cardiomyopathy is adisease of the heart muscles that makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy can lead to heart failure.
- 4. CLASSIFICATION Primary cardiomyopathy Secondary cardiomyopathy PRIMARY CARDIOMYOPATHY SECONDARY CARDIOMYOPATHY Etiology of the disease is idiopathic The course of the myocardial disease is known and is secondary to the another disease process. The heart muscles are the only part heart involved, other parts of heart is unaffected.
- 5. TYPES According to thestructural and functional abnormalities of the heart muscle Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy Unclassified cardiomyopathy
- 6. DILATED CARDIOMYOPATHY Mostcommon type It is characterized by a diffuse inflammation and rapid degeneration of the heart fibres. This results in ventricular dilation, atrial enlargement, impaired systolic function, stasis of blood in the left ventricle. CAUSES Cardio toxic agents Alcohol Cocaine Doxorubicin CAD Genetic Hypertension Metabolic disorders Muscular dystrophy Pregnancy Valve disease
- 7. PATHOPHYSIOLOGY Characterized by diffuseinflammation and rapid degeneration of the myocardial fibres Ventricular dilation Impairment of systolic function Atrial enlargement and stasis of blood in the left ventricle. cardiomegaly
- 8. CLINICAL FEATURES Decreasedexercise capacity Fatigue Dyspnea at rest Paroxysmal nocturnal dyspnea Orthopnea Dry cough Palpitation Nausea, vomiting Abdominal bloating, anorexia Abnormal F3 and F4 Dysrhythmias Heart murmurs Pulmonary crackles Edema Weak peripheral pulse Pallor Hepatomegaly Jugular vein distension
- 9. HYPERTROPHIC CARDIOMYOPATHY Lesscommon than dilated cardiomyopathy. Asymmetric left ventricular hypertrophy without ventricular dilation. The septum between the 2 ventricles become enlarged and blocks the blood flow from the left ventricle. 4 main characteristics, Massive ventricular hypertrophy Rapid forceful contraction of the left ventricle Impaired relaxation (diastole) Obstruction to aortic outflow
- 10. Causes: Aortic stenosis Genetic Hypertension Pathophysiology Thickened intraventricular septum and ventricular wall Ventricular hypertrophy Diastolic dysfunction Impaired ventricular filling and obstruction to decreased outflow Decreased cardiac output
- 11. Clinical features: Exertionaldyspnea Fatigue Angina Syncope Dyspnea Supraventricular tachycardia Atrial fibrillation Ventricular fibrillation Ventricular tachycardia
- 12. RESTRICTIVE CARDIOMYOPATHY Leastcommon type of cardiomyopathy It is a disease of the myocardium that impairs diastolic filling and stretch Causes: Specific etiology is unknown Amyloidosis Endomyocardial fibrosis Neoplastic tumor Post radiation therapy Sarcoidosis Ventricular thrombus
- 13. Pathophysiology Etiologic factors Stiffness ofthe ventricular wall with loss of ventricular compliance Ventricles become resistant to filling Decreased cardiac output
- 14. Clinical features: Fatigue Dyspnea Peripheral edema Exercise intolerance Angina Orthopnea Syncope Palpitation Ascites Weight gain Hepatomegaly Jugular vein distension
- 15. ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) It is genetic. It is an uncommon form of inherited heart muscle disease. ARVC occurs when the myocardium of the right ventricle is progressively infiltrated and replaced by fibrous scar and adipose tissue. Initially only localized area of right ventricles are affected, but as the disease progresses, the entire heart is affected. Palpitations or syncope may develop between 15 and 40 years of age.
- 16. UNCLASSIFIED CARDIOMYOPATHY Unclassified cardiomyopathieshave characteristics of more than one of the possibly described types Causes: Fibro elastosis Non combated myocardium systolic dysfunction with minimal dilation Mitochondrial disease
- 17. DIAGNOSTIC MEASURES Historycollection Physical examination Doppler echocardiography Chest X-ray Electrocardiogram H type natriuretic peptide test Cardiac catheterization Endomyocardial biopsy Transthoracic echocardiogram Cardiac MRI
- 18. MANAGEMENT Medical management: Medicalmanagement is directed towards identifying and managing possible underlying or precipitating causes. Correcting the heart failure with medications. Low sodium diet Controlling dysrhythmias with anti-arrhythmic medications Exercise or rest Possibly with an implanted electronic device such as implantable cardioverter defibrillator.
- 19. Systemic anticoagulation Fluid intake should be limited to 2 liters/day in case of congestion Maintain cardiac output Patients with HCM should avoid dehydration and may need beta-blockers. Minimize the risk of left ventricular outflow tract obstruction during systole. Patients with HCM or RCM may need to limit physical activity and avoid excessive weight gain to avoid life-threatening dysrhythmia. Pace maker implantation to alter the electrical stimulation of the muscles and prevent the forceful hyper dynamic contractions that occur with HCM.
- 20. Non surgicalseptal reduction therapy: also called as alcohol septal ablation, used to treat obstructive HCM Pharmacological management: Nitrates e.g. isosorbitrate Loop diuretics e.g. furosemide ACE inhibitors e.g. captopril Beta adrenergic blockers e.g. atenolol Aldosterone antagonist e.g. spironolactone. Control the neuro hormonal stimulation Cardiac glycoside e.g. digoxin Anticoagulation therapy Anti dysrhythmic drugs e.g. amiodarone Calcium channel blocker e.g. verampil Steroids e.g. hydrocortisone
- 21. Surgical management: Myotomy Septal myectomy Septal ablation Implantable cardioverter defibrillator Left ventricular assist device Heart transplantation
- 22. Nursing management: Nursing diagnosis: Decreased cardiac output related to structural disorders caused by cardiomyopathy Impaired gas exchange related to pulmonary congestion Activity intolerance related to decreased cardiac output Anxiety related to the change in health status and role functioning Risk for ineffective cardiac, cerebral, peripheral and renal tissue perfusion
- 23. Interventions: Assessing patientoxygen saturation at rest and during activity Monitor vital signs Provide rest If patient have DCM provide sitting up with their legs down is more comfortable than lying down in a bed. Oxygen administration with nasal cannula Ensuring that medications are taken as prescribed Ensure that patients with DCM avoid verampil, patients with HCM avoid diuretics and the patients with RCM avoid nifidipin
- 24. Provide lowsodium diet Determine patients weight everyday Patients with HCM must be taught to avoid dehydration Spiritual, emotional and psychological support to be provided Teach the patient to balance activity and rest Instruct patient to avoid vigorous activities and exercise Encourage to perform stress reduction activities Teach about breathing and coughing exercise Suggest the family members to learn about CPR
- 25. COMPLICATIONS Heart failure Heart valve regurgitation Fluid buildup (edema) Abnormal heart rhythms Sudden cardiac arrest Blood clots (emboli) Death