Cardiomyopathy and Cardiac Valves

Study Notes

Aortic valve location: Second intercostal space (ICS) right of the sternum
Pulmonic valve location: Second ICS left of the sternum
Tricuspid valve location: Fourth ICS left of the sternum
Mitral valve location: Fifth ICS left mid-clavicular line
Erbs point is situated at the third ICS left of the sternum, here aortic and pulmonic regurgitation are heard

Dilated cardiomyopathy is characterized by a decrease in oxygen levels (↓O₂)
Symptoms include restlessness, agitation, shortness of breath, fatigue, angina, and heart block
It's caused by heart failure, where the heart doesn't pump blood forward effectively.
Dilated cardiomyopathy affects the left ventricle, resulting in lung-related signs like crackles and pulmonary edema.
It also affects the right ventricle, leading to edema, ascites, and jugular venous distention (JVD)
Tricuspid and bicuspid regurgitation can occur, leading to a narrow pulse pressure due to a reduced ejection fraction.

Restrictive cardiomyopathy involves stiff heart muscles that don't stretch properly, leading to problems with heart filling.
Scar tissue formation also hinders proper blood flow and filling.
Reduced blood inflow results in reduced blood outflow
Symptoms include decreased oxygen levels, fatigue, and shortness of breath.

Heart failure can be caused by Amyloidosis, a build-up of abnormal proteins
Sarcoidosis, a disorder characterized by inflamed cell deposits, can also lead to heart failure.
Hemochromatosis, an iron overload disorder, can contribute to heart failure.
Radiation therapy to the heart can also cause heart failure

Genetic hypertrophic cardiomyopathy is caused by genetic mutations
Thickened heart muscle walls, particularly the septum, are characteristic of this condition.
Reduced blood inflow and outflow occur as a result of the thickened septum.
The thickened septum can obstruct the aortic valve.
Strain during exercise can worsen symptoms.
Individuals are often asymptomatic until they experience sudden strain on the heart.
Decreased oxygen levels lead to symptoms like shortness of breath, fatigue, weakness, syncope, altered level of consciousness, and chest pain.

Diagnosis involves detecting a heart murmur and utilizing an electrocardiogram (ECG)
Treatment involves beta-blockers, calcium channel blockers (CCB, like Verapamil), digoxin, antiarrhythmic drugs, diuretics, and vasodilators.
These medications are aimed at treating the underlying cause of the conditions.
First-line treatment includes beta-blockers, CCB, digoxin, anti-dysrhythmic drugs, diuretics, and vasodilators.
Potential treatments include heart transplantation, surgical myectomy (widening the septum), and alcohol ablation (remodeling the septum).

Patients with these conditions should avoid activities that put strain on the heart, like lifting heavy weights, straining during bowel movements, and sudden changes in positions.