Cardiomyopathy Flashcards
cardiomyopathy
Contraction and relaxation of the myocardial muscle fibers are impaired
primary causes of cardiomyopathy
Pathological process in heart muscle
Secondary causes of cardiomyopathy
result of systemic disease processes
Hypertension, valve disease, amyloidosis, toxicity, inflammatory
types of cardiomyopathies
Dilated- dilation of ventricles/ backing up of fluid (cardiomegaly)
Hypertrophic- increased wall thickness/ impaired filling, impaired ventricular diastolic pressure, increased left atrial pressure
Restrictive- stiff heart, cant relax, replaced with scar tissue, decreased output, S4
What is the most common cause of congestive heart failure?
CMD
Cardiac muscle dysfunction
cause of CMD
Abnormality of cardiac structure or function
CMD
Impaired aerobic capacity
Impaired endurance due to cardiovascular pump dysfunction or failure
Etiology of CMD
hypertension, heart failure, CAD, cardiac arrhythmias
Renal insufficiency, heart valve abnormalities, acquired heart disease
Pericardial effusion , myocarditis, spinal cord injury, pulmonary embolism
Pulmonary hypertension , age related changes
heart failure and CMD
Left ventricular hypertrophy
Hypertension and CMD
increased arterial pressure leads to ventricular hypertrophy
Leads to overstretched contractile fibers, and less effective pump
Coronary artery disease and CMD
myocardial infarction ischemia
Second most common cause
Dysfunction of left or right ventricle or both from MI
Renal insufficiency and CMD
acute or chronic insufficiency produces fluid overload on the heart
Primary treatment is to decrease reabsorption of fluid from kidneys
Diuretics Lasix
Dialysis
Heart valve abnormalities, and CMD
blocked valve or incompetent valves, cause heart muscle to contract more forcefully
Associated with myocardial, dilation, and hypertrophy
Surgeries include valve replacement, valvuloplasty valvulotomy
congenital or acquired heart disease and CMD
Altered embryonic development of normal structure, or failure of structure to develop
Most common abnormalities are congenital bicuspid, aortic valve and leaflet abnormality associated with mitral valve prolapse
Pericardial effusion or myocarditis and CMD
injury to pericardium inflammation of pericardial sac
Pericarditis leads to pericardial effusion
Cardiac tamponade, elevated cardiac pressures, limited ventricular diastolic filling, reduced stroke volume
Medical management nonsteroidal, anti-inflammatory agents or cortical steroids pericardiocentesis
Spinal cord injury, and CMD
typical in cervical spine injuries
Causes imbalance in parasympathetic and sympathetic control
Lack cardiovascular adaptations
Neurogenic edema in lungs
Cardiac filling pressures must be monitored
pulmonary embolism and CMD
elevated pulmonary artery pressures increase right ventricular work
Potentially life threatening
Medical management
rapidly acting fibrinolytic agent like heparin
Sedative to decrease anxiety and pain
Oxygen
Embolectomy
pulmonary hypertension and CMD
Defined by mean pulmonary artery pressure
Abnormal if greater than 25 mm Hg
in patients with COPD if greater than 20 mm Hg
age Related changes and CMB
Aging decreases cardiac output by altering contraction and relaxation of cardiac muscle
Higher prevalence of heart, disease, hypertension, and other pathological processes in older population
increase systolic arterial pressure
Decreased aortic distensibility
Develop left ventricular hypertrophy
Selective decrease in beta adrenergic receptor
Increase pericardial and myocardial stiffness and delayed relaxation
