Cardiomyopathy

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Cardiomyopathy
Classification and external resources

Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium.
ICD-10I42.0
ICD-9425.4
DiseasesDB2137
MedlinePlus001105
MeSHD009202
 
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Cardiomyopathy
Classification and external resources

Opened left ventricle of heart shows a thickened, dilated left ventricle with subendocardial fibrosis manifested as increased whiteness of endocardium.
ICD-10I42.0
ICD-9425.4
DiseasesDB2137
MedlinePlus001105
MeSHD009202

Cardiomyopathy (literally "heart muscle disease") is the measurable deterioration of the function of the myocardium (the heart muscle) for any reason, usually leading to heart failure; common symptoms are dyspnea (breathlessness) and peripheral edema (swelling of the legs). People with cardiomyopathy are often at risk of dangerous forms of irregular heart beat and sudden cardiac death.[1] The most common form of cardiomyopathy is dilated cardiomyopathy.[2][3]

Contents

Classification

Although in theory the term "cardiomyopathy" could apply to almost any disease affecting the heart, in practice it is usually reserved for "severe myocardial disease leading to heart failure".[4] Cardiomyopathies can be categorized as extrinsic or intrinsic.[5]

It is also possible to classify cardiomyopathies functionally, as involving dilation, hypertrophy, or restriction.[6]

Types

Signs and symptoms

Symptoms and signs may mimic those of almost any form of heart disease. Chest pain is common. Mild myocarditis or cardiomyopathy is frequently asymptomatic; severe cases are associated with heart failure, arrhythmias, and systemic embolization. Manifestations of the underlying disease (e.g., Chagas' disease) may be prominent. Most patients with biopsy-proven myocarditis report a recent viral prodrome preceding cardiovascular symptoms.

EKG abnormalities are often present, although the changes are frequently nonspecific. A pattern characteristic of left ventricular hypertrophy may be present. Flat or inverted T waves are most common, often with low-voltage QRS complexes. Intraventricular conduction defects and bundle branch block, especially left bundle branch block, are also common. An echocardiogram is useful to detect wall motion abnormalities or a pericardial effusion. Chest radiographs can be normal or can show evidence of congestive heart failure with pulmonary edema or cardiomegaly.

Treatment

Treatment depends on the type of cardiomyopathy and condition of disease, but may include medication (conservative treatment) or iatrogenic/implanted pacemakers for slow heart rates, defibrillators for those prone to fatal heart rhythms, ventricular assist devices (LVADs) for severe heart failure, or ablation for recurring dysrhythmias that cannot be eliminated by medication or cardioversion. The goal of treatment is often symptom relief, and some patients may eventually require a heart transplant. Treatment of cardiomyopathy (and other heart diseases) using alternative methods such as stem cell therapy is commercially available but is not supported by convincing evidence.

References

  1. ^ Kasper, Denis Lh. et al. (2005). Harrison's Principles of Internal Medicine, 16th edn. McGraw-Hill. ISBN 0-07-139140-1.
  2. ^ Cardiopulmonary Pharmacology for Respiratory Care, Jahangir Moini, Ch.2; page 24
  3. ^ http://www.nhlbi.nih.gov/health/health-topics/topics/cm/types.html
  4. ^ Gabriel A. Adelmann (12 November 2010). Cardiology Essentials in Clinical Practice. Springer. pp. 158–. ISBN 978-1-84996-304-6. http://books.google.com/books?id=o3j9bNpQ2poC&pg=PA158. Retrieved 11 November 2010.
  5. ^ a b Richardson, P. et al.; McKenna, W; Bristow, M; Maisch, B; Mautner, B; O'Connell, J; Olsen, E; Thiene, G et al. (1996). "Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies". Circulation 93 (5): 841–2. doi:10.1161/01.CIR.93.5.841. PMID 8598070. (Full text)
  6. ^ Valentin Fuster; John Willis Hurst (2004). Hurst's the heart. McGraw-Hill Professional. pp. 1884–. ISBN 978-0-07-143225-2. http://books.google.com/books?id=eWQAJDrVV7gC&pg=PA1884. Retrieved 11 November 2010.
  7. ^ Improvement in Hypertrophic Cardiomyopathy; http://www.medscape.com/viewarticle/457562_4
  8. ^ Elliott, P.; Andersson, B.; Arbustini, E.; Bilinska, Z.; Cecchi, F.; Charron, P.; Dubourg, O.; Kuhl, U. et al. (2007). "Classification of the cardiomyopathies: a position statement from the european society of cardiology working group on myocardial and pericardial diseases". European Heart Journal 29 (2): 270–276. doi:10.1093/eurheartj/ehm342. PMID 17916581. edit
  9. ^ Maron, B. J.; Towbin, J. A.; Thiene, G.; Antzelevitch, C.; Corrado, D.; Arnett, D.; Moss, A. J.; Seidman, C. E. et al. (2006). "Contemporary Definitions and Classification of the Cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention". Circulation 113 (14): 1807–1816. doi:10.1161/CIRCULATIONAHA.106.174287. PMID 16567565. edit

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