Dilated Cardiomyopathy Flashcards
What is cardiomyopathy?
Idiopathic myocardial disease
What is dilated cardiomyopathy? (DCM)
A dilated flabby heart with unknown cause. There is dilation of the ventricular chambers and systolic dysfunction with preserved wall thickness.
Myocardial disease characterised by ventricular dilation and global myocardial dysfunction (EF <40%)
Causes are divided into ischaemic or non-ischaemic
Ischaemic -> Massive anterior STEMI
Non-ischaemic -> Idiopathic or viral myocarditis
It is associated with;
Alcohol
HTN
Chemotherapy
Haemochromatosis
Viral infection
Autoimmune
Post-partum
Thyrotoxicosis
Congenital
Clinical features of DCM.
Fatigue
Dyspnoea
Pulm oedema
RVF
Emboli
AF
VT
Signs of DCM.
Tachycardia
Low BP
Raised JVP
Displaced and diffuse apex beat
S3 gallop, mitral or tricuspid regurg.
PLeural effusion
Oedema
Jaundice
Hepatomegaly
Ascites
Investigations of DCM.
Bloods
CXR
ECG
Echo
CXR findings in DCM.
Cardiomegaly
Pulm oedema
ECG findings in DCM.
Left ventricular hypertrophy
Tachycardia
Non-specific T wave changes
Poor R-wave progression.
Echo findings in DCM.
Globally dilated hypokinetic heart and low ejection fraction.
look for MR, TR, LV mural thrombus
Management of DCM.
Bed rest
Diuretics
B-blockers
Basically heart failure treatment.
ACEi
Anticoag
Biventricular pacing
ICDs
LVADs
Transplantation
