COLLEGE OF NURSING

NATIONAL HOSPITAL DHA LAHORE.

CARDIOMYOPATHY
SESSION 2013

Presented to Mrs. Zahida Zahoor

Presented by

ABIDA NASREEN

CARDIOMYOPATHY
BY ABIDA NASREEN

CONTENTS OF MY TOPIC
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Objectives Introduction Anatomy & physiology of the organ (Heart) Definition of my topic CARDIOMYOPATHY and its types. Pathophysiology of Cardiomyopathy. Causes of Cardiomyopathy & its symptoms. Diagnostic Procedures Medical treatments Nursing care Summary References

OBJECTIVES
At the end of my presentation we will be able to: Understand what is Cardiomyopathy? Differentiate types of Cardiomyopathy. Identify the causes of Cardiomyopathy. Enumerate the symptoms of Cardiomyopathy. Familiarized diagnostic Procedure of Cardiomyopathy. 6. Gain knowledge about the treatment of Cardiomyopathy. 7. Develop idea regarding Nursing care of Cardiomyopathy
1. 2. 3. 4. 5.

INTRODUCTION

ANATOMY & PHYSIOLOGY OF THE HEART

What is Cardiomyopathy?
Cardiomyopathy is a condition where the heart

muscles become enlarged. These enlarged muscles turn thick and rigid. Thus, forming a scar tissue and affecting the pumping action of the heart. This causes the heart to become weak and develop abnormal electrical rhythm. The abnormality leads to arrhythmia and heart failure. Thiene, G et al. (1996). "Cardiology Essentials in Clinical Practice" http://en.wikipedia.org/

Cardiomyopathy (literally "heart muscle disease") is the measurable deterioration of the function of the myocardium (the heart muscle) for any reason, usually leading to heart failure.

Kasper, Denis Lh. et al. (2005). Harrison's Principles of Internal Medicine, 16th edn.

PATHOPHYSIOLOGY

Types of Cardiomyopathy
There are basically three types of cardiomyopathy. These include: Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy

Contd.

Dilated Cardiomyopathy

Hypertrophic Cardiomyopathy (HCM)

Restrictive Cardiomyopathy

Causes of Cardiomyopathy

High blood pressure Metabolic disorders like diabetes, thyroid problems Heart tissue damage Heart valve abnormalities Drinking excessive alcohol Hemochromatosis Complications during pregnancy Toxins in the body like cobalt Use of drugs like cocaine Connective tissue disorders Sarcoidosis

Symptoms of Cardiomyopathy

Chest pain Breathlessness Bloating Swelling of the legs, ankles Irregular heartbeats Fatigue Heart murmur Fainting and dizziness spells

Diagnostic Procedure of Cardiomyopathy

Chest X-ray

An echocardiogram
Electrocardiogram Coronary angiogram, and

Cardiac MRI

Treatment for Cardiomyopathy

The treatment differs according to the condition that affects the

heart. In case of dilated cardiomyopathy, medications given include Angiotensin-converting enzyme (ACE) inhibitors, Beta blockers, diuretics. Hypertrophic cardiomyopathies are treated with calcium channel blockers & beta blockers.
Other than medications, there are various surgeries that involve:

placement of defibrillators, pacemakers, valve replacement, septal myectomy. In severe cases, the patient may be recommended a heart transplant.

NURSING CARE IN PATIENTS WITH CARDIOMYOPATHY

Assessment: Respiratory: shortness of breath, sleep half sitting, use lots of pillows, cough with no sputum, breath Crekles, Ronky (+), history of chronic lung disease, use breathing aids. Neuro Sensory: weakness, dizziness, fainting, disorientation, behavioral changes, irritability.

Social interactions: decreased participation in social activities.

NURSING DIAGNOSIS
1. Decrease in cardiac output associated with myocardial muscle damage. 2.Activity intolerance related to decreased cardiac output. 3. Lack of knowledge related to lack of information. 4. Impaired gas exchange associated with congestive polmunal.

NURSING GOAL/INTERVENTION
GOAL: Reduce the burden of heart.
Criteria: Vital sign within normal limits, free from the symptoms of heart failure, decreased dyspnea. INTERVENTION1. Auscultation apical pulse RATIONAL: assess the frequency, heart rhythm. INTERVENTION 2. Record heart sounds, peripheral pulse palpation, blood pressure monitor. 3. Assess against pale skin, and cyanosis. 4. Provide supplemental oxygen as indicated. 5. Elevate the legs, avoid skin pressure on the knee EVALUATION: 1. Patients can perform their daily activities. 2.Can participate in activities, to meet its own needs, vital sign during activity is within normal range.

Summary

References
1. 2. 3.

4.

Kasper, Denis Lh. et al. (2005). Harrison's Principles of Internal Medicine, 16th edn. McGraw-Hill. ISBN 0-07-139140-1. Cardiopulmonary Pharmacology for Respiratory Care, Jahangir Moini, Ch.2; page 24 http://www.nhlbi.nih.gov/health/healthtopics/topics/cm/types.html Gabriel A. Adelmann; McKenna, W; Bristow, M; Maisch, B; Mautner, B; O'Connell, J; Olsen, E; Thiene, G et al. (1996). "Cardiology Essentials in Clinical Practice".Circulation 93 (5). pp. 841 2. doi:10.1161/01.CIR.93.5.841. PMID 8598070. Retrieved 11he 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies.