RDIOMYOPATH

CA Y
Definition
Cardiomyopathy is a dysfunction of
cardiac muscle that can be associated
with coronary artery disease,
hypertension, cardiotoxic agents,
valvular disorders, and vascular or
pulmonary diseases.
Cardiomyopathy can make the heart
stiffen, enlarged or thickened and can
cause scar tissue. As a result, the heart
can’t pump blood effectively to the rest
of the body.
Causes of cardiomyopathy are classified as PRIMARY
or SECONDARY:

1. Primary cardiomyopathies
-genetic, mixed, or acquired etiologies. Causes
2. Secondary cardiomyopathies
-infiltrative, toxic or inflammatory causes
Types of cardiomyopathies
Cardiomyopathies classified according to the structural
abnormalities of the heart muscle.
1. Dilated cardiomyopathy (DCM)
2. Hypertrophic cardiomyopathy (HCM)
3. Restrictive or Constrictive cardiomyopathy (RCM)
 Dilated Cardiomyopathy
Dilated cardiomyopathy is the most common form of cardiomyopathy. It can be divided into two
types ischemic and non ischemic cardiomyopathy.
1. Ischemic cardiomyopathy :
- It is caused by inadequate oxygen supply due to obstruction in coronary artery.

2. Non ischemic cardiomyopathy:

a) Cause is idiopathic
b) 10 to 50 % of cases are identified by genetic mutation
c) Both the RV & LV enlarge significantly.
Causes Risk Factors
Idiopathic Alcoholism
Genetic mutations/conditions Past family history of diseases implicated in DMD
Myocarditis
Infection
Alcoholism
Complications
Drugs Systolic heart failure
Wet Beriberi - Valve regurgitation
Peripartum cardiomyopathy Arrythmias
Sarcoidosis
Signs & symptoms Treatment
Fatigue dyspnea Medications (ACE Inhibitor, angiotensin
Lateral displaced point of maximum receptor blocker, beta blocker)
impulse (PMI) Surgery
Chest pain on exertion Other interventions (LVAD)
Holosystolic murmur
S3 sound
 characterized by inappropriate
Hypertrophic myocardial hypertrophy without
ventricular dilation.

cardiomyopathy Obstruction to left ventricular

outflow may or may not be present.
Causes Risk Factors
Genetic missense mutation, (+) family history of HCM/ conditions known to be
inherited as autosomal dominant associated with HCM (e.g. Friedreich’s ataxia)
trait
Hypertrophic obstructive
cardiomyopathy (subtype)
Complications
Sudden death
Arrhythmias
Signs & symptoms
Many individuals are asymptomatic
crescendo-decrescendo murmur
Symptoms arise as complications arise
-Dyspnea
-Fatigue
-Exertional chest pain
-Syncope with exertion
-Palpitations
-Sudden cardiac death
May exhibit bifid pulse
Treatment
Medications (Beta blockers, calcium
channel blockers, Disopyramide)
Surgery ( surgical septal myectomy, septal
abaltion and heart transplant)
Other interventions(Lifestyle change-
cessation of high intensity athletics)
 is characterized by abnormally
Restrictive rigid ventricles with decreases
diastolic compliance.

cardiomyopathy The ventricular cavity is

decreased, and clinical
manifestations are similar to
constrictive pericarditis.
 Causes Complications
Infiltrative diseases, storage diseases Diastolic heart failure
and endomyocardial diseases
-Amyloidosis
-Sarcoidosis
-Endocardial fibroelastosis
-Loffler syndrome
-Hemochromatosis
Other causes
- Heart tissue radiation
Signs & symptoms Treatment
Stiff ventricle (S4 heart sound) Medications (Loop diuretics, beta blocker,
Presents as congestive heart failure: calcium channel blocker, ACE inhibitors )
dyspnea; paroxysmal nocturnal dyspnea; Surgery (heart transplant)
orthopnea; crackles; intraalveolar
hemorrhage; fatigue; inability to
exercise; appetite loss; abdomen
swelling; swelling of feet, ankles;
uneven/rapid pulse; chest pain; low
urine output; nocturia