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Cardiomyopathies: Umar Zein
Cardiomyopathies: Umar Zein
Umar Zein
Definition
Familial/Genetic Non-familial/Non.genetic
DCM ARVC
Restrictive
cardiomyopathy
HCM
ACC/AHA classification
Pathophysiology
Mutation Exogenous insult
Activation of compensatory
neurohumoral mechanisms
Apoptosis
Fibrosis
Hypertrophy
Dyspnoe
Chest pain
Palpitation
Syncope
Symptoms of stroke
Sudden death
Work up
ECG
ECHO
MRI
Stress test
Ambulatory ECG monitoring
Heart failure
Betablockers
Diuretics
ACE inhibitors, sartans (systolic dysfunction)
Aldosterone receptors blockers (systolic dysfunction)
Septal reduction therapy
Surgical myectomy
Mixed etiology
Toxic
Inflammatory
Peripartal
Pathology
Outcomes
Heart failure
Arrhytmias
Sudden death
Work up
ECG
ECHO
Selective coronary angiography
MRI
Endomyocardial biopsy
Therapy
Sudden death prevention
Based on symptoms and severe systolic dysfunction
Replacement of myocardium by
adipose and fibrous tissue
Outcomes
Heart failure (of both ventricles)
Arrhytmias
Sudden death
Work up
ECG
MRI
ECHO
Endomyocardial biopsy
Therapy
Sudden death prevention
Rare
Non-compacted myocardium,
especially in the apical part of
the left ventricle
Restrictive cardiomyopathy
Rare
Mixed etiology
Sarcomeric genes
Restrictive physiology of
diastolic filling
ECG
MRI
ECHO
Laboratory diagnosis of amyloid protein – free light chains,
paraprotein
Endomyocardial biopsy
Scintigraphy – tnasthyretin amyloidosis
Therapy
Heart failure therapy (including heart transplant)
Liver transplant
Hematology