seminar ON cardiomegaly FOR NURSING STUDENTS

1. VIVEKANANDA COLLEGE OF NURSING
SEMINAR ON;
PRESENTED BY- APURVA DWIVEDI [M.Sc. Nsg. 2st Yr.]

2. CARDIOMEGALY

3. Introduction
• Cardiomegaly (sometimes Megacardia or Megalocardia) is a medical
condition in which the heart becomes enlarged.
• It is more commonly referred to simply as "having an Enlarged Heart".
• It is usually the result of underlying conditions that make the heart work
harder, such as obesity, heart valve disease, high blood pressure
(hypertension), and coronary artery disease.
• Cardiomyopathy is also associated with cardiomegaly.

4. Conti.
• Cardiomegaly can be serious and can result in congestive heart failure.
• Recent studies suggest that cardiomegaly is associated with a higher risk
of sudden cardiac death.
• Cardiomegaly may diminish over time, but many people with an enlarged
heart (Dilated Cardiomyopathy) need lifelong medication.
• Lifestyle factors that can help prevent cardiomegaly include eating a
healthy diet, controlling blood pressure, exercise, medications, and not
abusing alcohol and cocaine.

5. DEFINITION
Cardiomegaly is a medical condition in which the heart is
enlarged. It is more commonly referred to as an enlarged heart.
An enlarged heart may not pump blood effectively, resulting in
congestive heart failure.

7. ETIOLOGY
• Idiopathic: an enlarged heart can be caused by conditions that caused by
conditions that cause heart to pump harder than usual or that damage
heart muscle. Sometimes the heart enlarges and becomes weak for
unknown reasons.
• Diseases of the heart muscle or heart valves, as the thickening and
stiffening of heart muscles progresses, the heart may enlarge to try to
pump more blood to the body.
• High blood pressure

8. • Arrhythmias: A congenital heart condition, damage from a heart attack or an
abnormal heartbeat can cause heart to enlarge.
• Infectious endocarditis, connective tissue disorders, certain medications or
radiation treatments for cancer, the heart may enlarge.
• Pulmonary hypertension
• Longstanding anemia (Low red blood cell count)
• Thyroid diseases
• Pericardial effusion: Accumulation of fluid in the sac(pericardium) that contains
the heart may cause heart to appear enlarged on a chest x-ray.
Conti.

9. Conti.
• Excessive iron in blood (hemochromatosis): It is a disorder in which
the body doesn’t properly metabolize iron, causing it to build up in various
organs, including heart.
• Rare diseases such as Amyloidosis (It is a condition in which abnormal
proteins circulate in blood and may be deposited in heart, interfering with
heart’s function and causing it to enlarge.
• Viral infection of the heart.

10. Conti.
• Pregnancy, with enlarged heart developing around the time of
delivery (peripartum cardiomyopathy)
• Kidney diseases requiring dialysis
• HIV infection
• Alcohol or cocaine abuse
• Diabetes

11. RISK FACTORS
• High blood pressure : higher than 140/90 millimeters of
mercury
• A family history of enlarged hearts or cardiomyopathy
• Coronary artery disease
• Congenital heart disease
• Valvular heart disease
• Heart attack

12. CLASSIFICATION
Ventricular
hypertrophy
Atrial
enlargement
Dilated
cardiomyopathy
Hypertrophic
cardiomyopathy

13. Ventricular Hypertrophy (VH)
It is thickening of the walls of a
ventricle (lower chamber) of the
heart. Although left ventricular
hypertrophy (LVH) is more
common, right ventricular
hypertrophy (RVH), as well as
concurrent hypertrophy of both
ventricles can also occur.

15. Atrial enlargement
It refers to a condition where the left atrium or right atrium of the
heart is larger than would be expected. It can also affect both
atria.

17. Dilated cardiomyopathy
It is the most common type of cardiomegaly. In this condition, the walls of
the left and/or right ventricles of the heart become thin and stretched. The
result is an enlarged heart. In the other types of cardiomegaly, the heart's
large muscular left ventricle becomes abnormally thick. Hypertrophy is
usually what causes left ventricular enlargement.

19. Hypertrophic Cardiomyopathy
• It is typically an inherited condition.
• Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle becomes
thickened (hypertrophied).
• The thickened heart muscle can make it harder for the heart to pump blood.
• Hypertrophic cardiomyopathy often goes undiagnosed because many people with the
disease have few, if any, symptoms.
• However, in a small number of people with HCM, the thickened heart muscle can
cause shortness of breath, chest pain or changes in the heart's electrical system,
resulting in life-threatening irregular heart rhythms (arrhythmias) or sudden death.

21. Clinical Manifestations
For many people, cardiomegaly is asymptomatic. For
others, if the enlarged heart begins to affect the body's
ability to pump blood, then symptoms associated with
congestive heart failure may arise, including:-

22. Heart Palpitations

23. Severe Shortness Of Breath (Especially Physically
Active)

24. Chest Pain

25. Swelling In Legs

26. Fatigue

27. Weight Gain

28. Fainting

29. DIAGNOSTIC EVALUATION

30. Chest X-Ray

31. Electrocardiogram

32. Stress Test

33. Cardiac computerized tomography or MRI

34. Echocardiogram

35. Cardiac Catheterization

36. Blood Test

37. MEDICAL MANAGEMENT
• Diuretics: To lower the amount of sodium and water in the body, which
can help lowers the pressure in the arteries and heart.
• Angiotensin converting enzyme inhibitors (ACE) : To lower the BP and
improves the heart pumping ability.
• Angiotensin receptor blockers (ARBs): To provide the benefits of ACE
inhibitors for those who cannot take ACE inhibitors.
• Beta blockers: To lower blood pressure and improve heart function.

38. Conti.
• Digoxin: To help improve the pumping function of the heart and
lessen the need for hospitalization for heart failure.
• Anticoagulants: To reduce the risk of blood clots that could
cause a heart attack or stroke.
• Anti-arrythmias: To keep the heart beating with a normal
rhythm.

39. SURGICAL
MANAGEMENT

40. Pacemaker
A pacemaker is a small device that sends
electrical impulses to the heart muscle to
maintain a suitable heart rate and rhythm. It
coordinates the contractions between
the left and right ventricle.

41. Heart valve surgery
To remove the valve
and replace it with
either an artificial
valve from a pig,
cow or deceased
human donor

42. Coronary Bypass Surgery

43. Left ventricular
assist device

44. Heart Transplant

45. COMPLICATIONS
• Heart failure
• Blood clots
• Heart murmur
• Cardiac arrest
• Sudden death

46. LIFESTYLE MODIFICATIONS

47. Try To Sleep Eight Hours Nightly

48. Avoid Or Eliminate Alcohol And Caffeine

49. Lose Excess Weight

50. Modest Exercises

51. Monitor Blood Pressure

52. Control Diabetes

53. Limit Salt Diet

54. Quit Smoking

55. SUMMARY

56. CONCLUSION
• Cardiomegaly (megacardia or megalocardia) is a medical condition
in which the heart is enlarged.
• As such, it is more commonly referred to simply as "having an
enlarged heart".
• It is not a disease, but rather a condition that can result from a host
of other diseases such as obesity or coronary artery disease.

57. BIBLIOGRAPHY
1. Brunner and Sudharth’s, Textbook of Medical Surgical nursing:
Lippincott Publishers: Page no.1208-1212.
2. www.wikipedia.com
3.www.mayoclinic.com
4.www.currentnurses.com
5.https://www.youtube.com/watch?v=RNw3SnfLfYQ

58. Thank you..