Cardiomyopathy

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Cardiomyopathy

• Abnormality of the heart muscle
• Affects function
• Three types
• Dilated
• Hypertrophic
• Restrictive

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Dilated Cardiomyopathy

• Most common
• Causes
• Idiopathic
• Chronic alcohol or cocaine
• Systemic hypertension
• Genetic

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• Patho
• Scarring and atropy of cardiac cells
• Thickening of the walls
• Dilation of heart chambers
• Ventricle contraction impaired

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Manifestations

• Heart failure
• Symptoms that go along with this?
• Cardiomegaly
• Dysrhythmias
• SVT
• Atrial fib
• S3 S4 are heard
• AV regurgitation murmur
• Blood clots form within the heart wall and can
  travel

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Treatment

• Control the symptoms and the dysrhythmias
• Prognosis is very poor
• Clients get progressively worse
• 50 die within the first 5 years after diagnosis
• Most common disease requiring a heart transplant

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Hypertrophic Cardiomyopathy

• Causes
• Hereditary
• Secondary to HTN
• Patho
• Hypertrophy of the ventricle muscle
• Septal wall usually grows faster than the free
  wall
• Decreased compliance of the left ventricle
• Impairs ventricle filling
• Why?
• What does this cause?

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Manifestations

• Absent for many years
• Heart failure
• Dyspnea
• Angina
• Syncope
• Dysrhythmias
• Sudden death
• Most common cause of sudden death in young
  athletes

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Treatments

• Anti-dysrhythmic meds
• Beta blockers
• Calcium channel blockers

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Restrictive Cardiomyopathy

• Least common
• Causes
• Radiation
• Endocardial myofibrosis
• Patho
• Very stiff and rigid ventricle walls
• Decreases ventricle compliancy
• Impairs filling
• Contractility remains normal

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Manifestations

• Dyspnea
• Fatigue
• Rt. Sided heart failure
• Cardiomegaly
• S3, S4, JVD

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Treatment

• Very little can be done
• Most die within 3 years
• Manage symptoms of heart disease as best we can
• Restrict exercise
• Fluid restriction

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Surgery

• Heart transplant
• Die waiting for a heart
• How far down on the list are they?

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Nursing Care

• Help adjust to decrease level of activity
• Dietary changes
• Heart friendly diet
• Pharmacology
• End of life issues
• Advance directives
• Informed decisions
• Emotional support
• Community resources