Cardiomyopathy

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Classification 4 Etiology 5 Radiology 6 More General Terms 7 References

More Specific Terms

• dilated cardiomyopathy
• hypertrophic cardiomyopathy (HCM), including idiopathic hypertrophic subaortic stenosis (IHSS)
• peripartum cardiomyopathy
• rate-related cardiomyopathy
• restrictive cardiomyopathy

Introduction

• Primary heart muscle disease, often of obscure or unknown etiology, not associated with coronary disease, hypertension, valve disease, etc.

Classification

• dilated or congestive (D)

• left &/or right ventricular enlargement
• ventricular systolic dysfunction
• congestive heart failure
• arrhythmias
• emboli

• restrictive (R)

• endomyocardial scarring or myocardial infiltration
• restriction to left &/or right ventricular filling

• hypertrophic (H)

• disporportional left ventricular hypertrophy
• generally involves septum more than free wall
• with or without intraventricular systolic pressure gradient
• left ventricular cavity generally non dilated

Etiology

• primary

• idiopathic (D, R, H)
• familial (D, H)
• eosinophilic endomyocardial disease (R)
• endomyocardial fibrosis (R)

• secondary

• infective (D)

• viral myocarditis
• bacterial myocarditis
• fungal myocarditis
• protozoal myocarditis
• metazoal myocarditis
• spirochete-induced myocarditis
• rickettsial-induced myocarditis

• metabolic (D)

• hyperthyroidism

• familial storage disease (D,R)

• glycogen storage disease
• mucopolysaccharidosis

• deficiency (D)

• electrolytes
• nutritional ( thiamine)

• connective tissue disorder (D)

• systemic lupus erythematosus ( SLE)
• polyarteritis nodosa
• rheumatoid arthritis
• progressive systemic sclerosis
• dermatomyositis

• infiltrations & granulomas (R, D)

• amyloidosis
• sarcoidosis
• malignancy
• hemochromatosis

• neuromuscular (D)

• muscular dystrophy
• myotonic dystrophy
• Friedreich's ataxia (H,D)
• Refsum's disease

• hypersensitivity & toxic reactions (D)

• alcohol
• radiation
• pharmaceutical agents

• adriamycin
• daunorubicin
• emetine
• lithium
• phenothiazines
• sulfonamides
• sympathomimetics

• peripartum heart disease (D)
• endocardial fibroelastosis (R)

• * D = dilated cardiomyopathy R = restricted cardiomyopathy H = hypertrophic cardiomyopathy Cardiology:

• electrocardiogram

• dilated: ST segment & T wave abnormalities
• restrictive: low voltage, conduction defects
• hypertrophic: ST segment & T wave abnormalities, LVH, Q waves

• echocardiogram

• dilated: LV dilatation & systolic dysfunction
• restrictive:

• increased LV wall thickness
• normal or mildly reduced LV systolic function

• hypertrophic:

• asymmetric ventricular septal hypertrophy
• systolic anterior motion of mitral valve

• cardiac catherization

• dilated:

• LV dilatation & dysfunction
• elevated left & often right-sided filling pressures
• diminished cardiac output

• restrictive:

• normal or mildly reduced systolic function
• elevated left & right-sided filling pressures

• hypertrophic:

• vigorous systolic function
• dynamic left ventricular outflow obstruction
• elevated left & right-sided filling pressures

Radiology

• chest X-ray

• cardiac enlargement

• greatest with dilated cardiomyopathy
• least with restictive cardiomyopathy

• radionucliide studies

• evaluate systolic function
• asymmetric interventricular septal hypertrophy

More General Terms

• heart disease (cardiac disease)

References

1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39
2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 252-255
3. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1089

cardiomyopathy