Cardiomyopathy Overview and Types

Study Notes

Cardiomyopathy Definition

Cardiomyopathy encompasses various diseases impacting the heart muscle, impairing its blood pumping ability.
The heart becomes enlarged, thickened, or rigid, potentially with scar tissue replacing muscle.
This can lead to heart failure, dysrhythmias, and heart valve disorders.

Cardiomyopathy Classification

Cardiomyopathies are categorized as acquired (develop due to other conditions), inherited (genetic), or uncertain origin.

Dilated Cardiomyopathy

Most common type, frequently causing heart failure.
Affects ages 20-60, more prevalent in males.
Marked by ventricular and atrial dilation, leading to increased end-diastolic and end-systolic volumes.
Decreased left ventricular ejection fraction and cardiac output, with progressive left to right ventricular and atrial enlargement.
Symptoms include shortness of breath, fatigue, lower extremity and abdominal edema, and jugular venous distention
Common causes are often unknown but may be linked to toxins, metabolic conditions, and infections.
Reversible causes include alcohol, cocaine, chemotherapy drugs, pregnancy, and high blood pressure.
Management involves heart failure management with ACE inhibitors, beta-blockers, and ARBs.
Implantable cardioverter-defibrillators (ICDs) may be needed, and cardiac transplantation is a possibility.

Hypertrophic Cardiomyopathy

Involves abnormal thickening of the ventricular muscle, impeding pump function.
Decreases left ventricular compliance, resulting in small end-diastolic volumes and low cardiac output.
Asymmetric septal hypertrophy narrows blood flow to the aorta.
50% of cases have a genetic mutation.
Symptoms include dysrhythmias, shortness of breath, chest pain, syncope, and an S4 heart sound.
High risk of sudden death.
Management includes heart failure management, possible surgical septum excision, and exercise restriction.
Implantable cardioverter-defibrillators and pre-screening for sports eligibility are crucial.

Restrictive Cardiomyopathy

Characterized by rigid ventricular walls that limit filling and cardiac output.
Excessive stiffness and diastolic dysfunction occur with a normal ejection fraction.
Causes include amyloidosis, heart transplant complications, and fibrosis.
Symptoms encompass dyspnea, fatigue, and right-sided heart failure signs.
Management focuses on symptomatic and supportive therapy, along with heart failure symptom management.

Arrhythmogenic Right Ventricular Dysplasia

Replaces right ventricle muscle with fatty and fibrous tissue.
Increases risk of ventricular tachyarrhythmias and sudden death.
Hereditary, linked to mutations in desmosomal proteins.
Common in young athletes, accounting for up to 1/5 of sudden cardiac deaths in those under 65.
Symptoms mimic heart failure, along with potential peripheral neuropathy and carpal tunnel syndrome.
Treatment includes FDA-approved tafamidis (Vyndamax) to stabilize transthyretin protein and heart failure management.

Unclassified Cardiomyopathy

Includes types that don't fit into other categories.
Examples include left ventricular noncompaction (spongy muscle in the left ventricle) and Takotsubo cardiomyopathy ("broken heart syndrome") triggered by severe stress.

Description

This quiz provides an overview of cardiomyopathy, detailing its definition, types, and characteristics. Learn about dilated cardiomyopathy, including its symptoms, prevalence, and impact on heart function. Test your knowledge on the classifications and complications associated with this condition.