BY:Simranpreet Kaur

Cardiomyopathy constitutes a
group of disease that directly
affect the structural and
functional ability of the
myocardium
1. Dilated cardiomyopathy
2. Hypertrophic cardiomyopathy
3. Restrictive cardiomyopathy
 Dilated cardiomyopathy:
It is characterized by a diffuse
inflammation and rapid degeneration of
myocardial fibers which results in
ventricular dilation and loss of systolic
function.
 Cardio toxic agents like alcohol, cocaine
doxorubicin
 Hypertension
 Ischemia
 Muscular disorders
 Myocarditis
 Genetic disorder
 Pregnancy and valve disease
 Due to any of the above causes

Inflammation to the myocardium

Degeneration of myocardial fibers

Ventricular dilation

Impaired systolic function

Atrial enlargement

Stasis of blood in the left ventricle

Contractile dysfunction
 History collection related to alcoholism,
familial tendency
 P/E reveals dyspnea, tachycardia, weakness
 Echocardiogram to identify structural
abnormality
 Chest X- ray shows cardiomegaly
 ECG reveals dysarrythmias
 Nuclear imaging studies to identify ejection
fraction
 Cardiac catheterisation to rule out CAD.
 Fatigue
 Weakness
 Palpitations Dyspnea
 Cardiomegaly
 Tachycardia
 Dysarrythmias
 Decreased cardiac output.
 Atrio ventricular valve impotence
 Admn β- adrenergic blockers like metaprolol
And aldosterone
 Digoxin to treat fibrillation
 Anticoagulants like Heparin to prevent embolisation
 ACE inhibitors like captopril to reduce after load
 Antidysarrythmias like amiadarone to treat
dysarrythmias.
 Low salt and low cholesterol diet
 Intermittent Dobutamine and milrinone infusions to
treat multiple episodes of heart failure.
 Provide complete bed rest
 Cardiac resynchronization therapy:
This co-ordinates with RT and LT
ventricle contractility through biventricular
pacing. This helps to have normal electrical
conduction with in the RT and LT ventricles
and increase LT ventricular function and
cardiac output.
CARDIAC TRANSPLANTATION:
It is the procedure involving the transfer of
heart from one person to another.
 It
is formerly called as idiopathic
hypertrophic sub aortic stenosis
which is an asymmetric left
ventricular hypertrophy without
ventricular dilation.
 The main 4 characteristic of hypertrophic
cardiomyapathy are
1. Massive ventricular Hypertrophy
2. Rapid forceful contraction of the left ventricle
3. Impaired relaxation
4. Obstruction of the aortic outflow.
 Aorticstenosis
 Hypertension
 Genetic disorders
 Due to conditions like aortic stenosis

Obstruction to the outflow of blood from left ventricles

Impaired ejection of blood from LV to Aorta

Decreased cardiac out

Increased ventricular function

Multiplication of tissues

Hypertrophy of the myocardium

 Dyspnea
 Fatigue Angina
 Syncope
 Palpitation
 Cardiomegaly
 Dysarrythmias
 Decreased cardiac output
 History collection related to Hypertension and
familial tendency
 P/E reveals dyspnea, tachycardia, weakness
and syncope.
 Echocardiogram helps to reveal LT ventricular
Hypertrophy.
 Chest X- ray shows cardiomegaly
 ECG reveals dysarrythmias
 Cardiac catherization reveals decrease
chamber size.
 Admn β-adrenergic blockers like metoprolol
 Calcium channel blockers like verapamil to
improve ventricular filling and relive LT
ventricular outflow obstruction
 Digitalis to treat atrial fibrillation
 Antidysarrythmias like amiadarone to treat
dysarrythmias.
 Low salt and low cholesterol diet
 TED stockings to prevent DVT.
 Implantable cardioverter defibrillator is used
to treat dysarrythmias.
 Atrio ventricular pacing is used for patients
hypertrophic cardiomyopathy to treat outflow
obstruction.
 Myomectomy:
It involves the incision of the hypertrophied
septal muscle and removal of hypertrophied
ventricular muscles.
 Percutaneous transluminal septal myocardial
ablation:
This procedure involves administering
alcohol in to the first septal artery branching off
ant. descending artery which causes ischemia
and septal wall MI. Ablation of septal wall
decrease obstruction to flow the pt symptoms
will decrease.
It is a refers to the changes in weakening of the
heart muscle that impairs diastolic filling and
stretch.
 Amyloidosis
 Emdomyocardial fibrosis
 Neoplastic tumor
 Sarcoidosis
 Ventricular thrombus
 Scarring after radiation therapy and
chemotherapy
Due to any of the pathological processes

Fibrosis deposition on the myocardium

Myocardial hypertrophy

Stiffness of the ventricular wall

Loss of ventricular compliance

Ventricles are resistant to filling

 Dyspnea
 Fatigue
 Mild cardiomegaly
 Atrio ventricular incompetence
 Dysarrythmias
 Angina
 Orthopnea
 Syncope
 Palpitations
 Periperal edema
 Ascities
 Hepatomegaly
 Jugular venous distension
 Chest x-ray may be normal or mild
cardiomegaly, RT heart enlargement, pleural
effusion and pulmonary congestion
 ECG reveals tachycardia, atrial fibrillation,
supra ventricular dysarrythmias
 Echocardiogram shows thickened ventricular
walls and slight dilation in RT ventricle and
dilated atria.
 Endomyocardial biopsy to identify
sarcoidosis, Amyloidosis of myocardial tissue
 CT and nuclear imaging to confirm diagnosis.
 Administer prophylactic antibiotics like
penicillin.
 Admn β-adrenergic blockers like metoprolol
 Calcium channel blockers like verapamil to
improve ventricular filling and relive LT
ventricular outflow obstruction
 Digitalis to treat atrial fibrillation
 Antidysarrythmias like amiadarone to treat
dysarrythmias.
 Low salt and low cholesterol diet
 TED stockings to prevent DVT.
 Administer diuretics to remove excess fluid.
 Administer anti coagulants like Heparin to
prevent clot formation.
 Implantable cardioverter defibrillator is used
to treat dysarrythmias.
 Instruct patient to take all medicines as
prescribed and to follow with health care
provider.
 Encourage the Patient to use low sodium diet.
 Unless the fluid is restricted patients should
be encouraged to drink 6 to 8 glasses of
water every day
 Advise the patient to avoid alcohol, caffeine,
diet pills and over the counter drugs
 Advise the patient to take rest in between the
activities
 Instruct the patient to avoid lifting of heavy
weights and vigorous activities
 Encourage the use of stress reduction activities
like relaxation to relieve tension.
 Instruct the patient to report any signs of heart
failure like increased weight gain, edema,
shortness of breath and increased fatigue.
 Teach the family members on CPR because of
sudden cardiac arrest.
 Instruct the patient to notify the health care
provided before any dental and medical
procedures to be done as it risk for endocarditis.