Cardiomyopathy - Dilated Flashcards
What is dilated cardiomyopathy
Dilated flabby heart of unknown cause
What chambers are affected/dilated?
Can be just one but most likely all 4
Does this impair ventricular function?
Yes
What can cause dilated cardiomyopathy?
Genetic - SCN5A gene or muscular dystrophy
Congenital - X linked
Alcohol Haemochromatosis Viral infections Autoimmune Peri/postpartum
Symptoms of dilated cardiomyopathy?
Progressive and slow onset
Fatigue
Dyspnoea - orthopnoea and paraoxymal nocturnal dyspnoea
Oedema due to congestion
Signs on examination?
RV failure A-fib V-tachycardia Increased pulse and JVP Low BP Displaced apex s3 gallop Hepatomelagy Ascities MR and TR
What is ascities?
Fluid in abdomen/ peritoneal
What investigations would be done?
ECG
Bloods
CxR
Echo’s
Why is an ECG done?
Look for left bundle branch block
TAchycardia
Non specific T wave changes
Poor R wave progression
What is looked for in bloods?
BNP as a sign of heart failure
Na - low sodium shows poor diagnosis
What is looked for in a CxR?
Cardiomegaly
Pulmonary oedema
What is looked for in echos?
Dilated heart
The EJ fraction
MR and TR
Thrombus
Treatment for dilated CM?
Most causes are progressive and irreversible - so not much in way of focused treatment
Bed rest Correct any underlying disease Remove any exacerbating drugs - NSAIDs Give ACEIs, ARBs and diuretics Digoxin Spironolactone Anticoagulants as needed ICDs, pacemakers Cardiac transplants
Prognosis?
Generally poor as its influenced by unknown causes
All we can do is treat known causes if any
