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SFCC A&R LP4
Question | Answer |
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Cardiomyopathy | a heart muscle disease associated with cardiac dysfunction. It is classified according to the structure and functional abnormalities of the heart muscle. |
Dilated Cardiomyopathy | -Occurs more in men and African Americans -Significant dilation of the ventricles without increased muscle wall thickness. -Ventricles have elevated systolic and diastolic volumes but a decrease in ejection fraction. |
Causes of dilated cardiomyopathy | Major cause - heavy alcohol intake or viral infection. |
Dilated cardiomyopathy signs and symptoms | (left-sided heart failure) fatigue dysrhythmias ventricular dilation impairment of systolic function atrial enlargement stasis of blood in the left ventricle |
Hypertrophic Cardiomyopathy | autosomal dominant condition (rare). The heart muscle asymmetrically increases in size and mass, especially along the septum. HCM may be obstructive or nonobstructive. |
Hypertrophic obstructive cardiomyopathy | If the increased septal size causes misalignment of the papillary muscles of the left ventricle the septum and the mitral valve can obstruct blood flow from the left ventricle. |
Hypertrophic cardiomyopathy signs and symptoms | -dyspnea -fatigue -angina -syncope -sudden death syndrome |
Restrictive cardiomyopathy | is characterized by diastolic dysfunction caused by rigid ventricular walls that impair diastolic filling and ventricular stretch. Systolic funcition is usually normal. Least common cardiomyopathy. The cause is idiopathic. |
Restrictive cardiomyopathy signs and symptoms | (right sided heart failure) -dypnea -non-productive cough -chest pain (angina) -fatigue Most clients are asymptomatic until late adolescence or early adulthood. |
Arrhythmogenic right ventricular cardiomyopathy | occurs when the right ventricle is progressively infiltrated and replaced with fibrous scar and adipose tissue. |
Cardiomyopathy clinical manifestations | -dyspnea on exertion -c/o fatigue -cough especially with exertion -orthopnea (which may lead to misdiagnosis of pneumonia or bronchitis) -chest pain -palpitations -dizziness -syncope on exertion -fluid retention -peripheral edema -nausea |
Diagnosis of cardiomyopathy | Patient history, by ruling out MI as a cause for heart failure, the echocardiogram is the most helpful diagnostic tool because the structure and function of the ventricles can be observed |
Cardiac catherization | used to rule out CAD as a causitive factor |
Chest x-ray | will reveal an enlargement of the heart and possibly pulmonary congestion |
Endomyocardial biopsy | may be performed to analyze the myocardial tissue cells to identify fibrous tissue and infiltrates that may have caused the cardiomyopathy |
Medical management of cardiomyopathy | is directed toward determining and managing possible underlying or precipitating causes |
Correct the heart failure | medications, low sodium diet, and exercise (this is difficult because of the fatigue and dyspnea on exertion)/rest (patients can't lie down they try to rest in a high fowlers or in a recliner). Fluid limitation of 1.5 to 2 liters per day. |
Correct the dysrhythmias | with medications and an implanted cardiac defibrillator |
Prophylatic treatment of infective endocarditis | antibiotics, rest, and antipyretics |
Prophylatic treatment of stasis of the blood in the left ventricle | systemic anticoagulation to prevent thromboembolic events due to the stasis of blood in the left ventricle |