CARDIOMYOPATHY.

Presenter: Nr Sulaiman Umar

MNSc, BNSc, RN.
From Department of Nursing Science, College of Health Sciences, Federal University
Birnin Kebbi.
Slides Created By: IDRIS IBRAHIM From Department of Nursing Science, Zamfara
State University, Talata Mafara.
CARDIOMYOPATHY
Definition:
• Cardiomyopathy can be defined as abnormalities of the myocardium
in which there is impairment of the contractility of cardiac muscles. It
includes any disease that affect the heart muscles resulting
diminished cardiac performance.
Causes
1. Some causes of cardiomyopathy are primary or idiopathic (unknown),* in unknown
cause the cardiac dysfunction is not associated with systemic disease. They may be due
to: # Abnormalities of the cell function of the cardiac myocyte.
*2. Some known causes of secondary cardiomyopathy are:*
#. Family history of heart failure, cardiomyopathy or sudden cardiac arrest.
#. Conditions that damage the heart such as high cholesterol diseases, hemochromatosis
(excess iron store) or sarcoidosis.
#. Endocrine conditions, such as diabetes or thyroid disease.
#. Autoimmune disease, such as connective tissue disease.
#. Previous history of heart attack.
• #. Drug toxicity such as antineoplastic.
Types of cardiomyopathy
1. Dilated cardiomyopathy.
2. Hypertrophic cardiomyopathy.
3. Constrictive cardiomyopathy.
4. Congestive heart cardiomyopathy.
• 5. Secondary cardiomyopathy.
Dilated cardiomyopathy
Is also known as idiopathic dilated cardiomyopathy (IDC), this condition
is characterized by ventricular dilation with greatly decreased in
contractility and weakness of the heart muscles. Cause of this disease is
mainly uncertain or may be due to familial inheritance or due to viral
infection and toxic exposure.
• *Hypertrophic cardiomyopathy:* It is characterized by an increase in
heart muscles mass without an increase cavity size usually in left
ventricle. There is excess and disorganized growth of myofibrils and
impaired filling of heart with reduction in the size of ventricle cavity.
Half of these people have familial inheritance.
Constrictive cardiomyopathy:* Is also known as restrictive
cardiomyopathy. This condition is caused by endocardial and myocardial
disease or both due to lack of flexibility of ventricular walls. It may be
found in case of hemochromatosis or amyloidosis. The client usually
presented with congestive heart failure.
*Congestive cardiomyopathy:* It is found in myocardial disease
associated with enlargement of left ventricle of the heart and congestive
heart failure.
• *Secondary cardiomyopathy:* This condition usually associated with
well-defined systemic disease, such as inflammation, toxic chemicals,
metabolic abnormalities and inherited muscles disorders.
Clinical manifestations
1. Fatigue.
2. Dyspnea.
3. Palpitation.
4. Hiccup.
• 5. Pedal edema.
Diagnostic investigations
1. Ambulatory monitoring.
2. Cardiac CT.
3. Cardiac MRI
Echocardiogram.
4. Electrocardiogram (EKG).
5. Exercise stress test.
6. Cardiac catheterization.
• 7. Myocardial biopsy.
Therapeutic management
1. Treatment should be according to the specific cause.
• 2. Aim of treatment is management of congestive cardiac failure, and
dysrhythmias.
Medical management

1. Beta blockers eg Propranolol (Inderal)

2. Anticoagulant eg Warfarin (Coumadin) to reduce risk of thrombolytic
events.
3. IV Dobutamine in case of worst heart failure.
4. Oxygen therapy and mechanical ventilation for severely ill patient.
Surgical management
1. Open heart surgery,
2. Cardiac transplant.
• 3. Pacemaker implantation.
Nursing management
1. Problem oriented nursing management is important for better prognosis of the condition.
2. General positive therapy should include rest and weight control.
3. Avoidance of strenuous physical exercise.
4. Salt restricted diet.
5. Administer oxygen therapy and other prescribed medications.
*Complications*
1. Stroke
2. Arrhythmias
3. Endocarditis
4. Heart block
5. Heart failure.