CHAPTER 18 CARDIOMYOPATHY AND MYOCARDITIS Cui jie Department of cardiology Zhongshan Hospital, Fudan University Shanghai Institute of Cardiovascular Diseases
Cui Jie Department of Cardiology Zhongshan Hospital, Fudan University
Acquired heart diseases Coronary Hypertension Valvular heart disease Primary heart diseases Shanghai Institute of Cardiovascular Diseases
Coronary Hypertension Valvular heart disease Primary heart diseases
Definition e The cardiomyopathies are a group of diseases that affect the heart muscle itself and are NoT the result of hypertension or congenital or acquired valvular, coronary, or pericardIa abnormalities Shanghai Institute of Cardiovascular Diseases
The cardiomyopathies are a group of diseases that affect the heart muscle itself and are NOT the result of hypertension or congenital or acquired valvular, coronary, or pericardial abnormalities
PRIMARY CARDIOMYOPATHIES (predominantly involving the heart Genetic Mixed Acquired HCM DCM Inflammatory ( myocarditis ARVD/C Restrictive Stress-provoked (non-hypertrophied(tako-tsubo") LVNC and non-dilated) Peripartum PRKAG2\ Glycogen Tachycardia-induced Danon/storage Conduction defects Infants of insulin-dependent diabetic mothers Mitochondrial myopathies lon channel disorders LQTS Brugada SQTS CVPT Asian SUNDS
Ao Ao Normal Dilated cardiomyopathy Ao Ao Hypertrophic cardiomyopathy Restrictive cardiomyopathy Copyright @2006 by The McGraw-Hill Companies, Inc. All rights reserved
DILATED CARDIOMYOPATHY Shanghai Institute of Cardiovascular Diseases
Dilated Cardiomyopathy Normal Heart Dilated Cardiomyopathy Dilation Dysfunction Differentiation Shanghai Institute of Cardiovascular Diseases
Dilated Cardiomyopathy Dilation Dysfunction Differentiation
Shanghai Institute of Cardiovascular Diseases
Symptoms Associated With Heart Failure Fatigue Shortness of breath(at rest or during exercise Dyspnea, paroxysmal nocturnal dyspnea, orthopnea Weight gain or weight loss Edema(of the extremities or elsewhere) Exclude ischemic, valvular, hypertensive, metabolic cardiomyopathy D。 Shanghai Institute of cardiovascular Diseases
Fatigue Shortness of breath (at rest or during exercise) Dyspnea, paroxysmal nocturnal dyspnea, orthopnea Weight gain or weight loss Edema (of the extremities or elsewhere) Exclude ischemic, valvular, hypertensive, metabolic cardiomyopathy …
Physical examination Cardiac dullness enlargement Apical impulse displaced leftward or inferiorly Sa or Sa, gallop(tachycardia) Murmurs of tricuspid or mitral regurgitation Pulmonary congestion Systemic congestion e tachypnea Engorgement of jugular vein Dullness and diminished Hepatomegaly, ascites breath sounds at lung bases Pedal edema Rales Shanghai Institute of Cardiovascular Diseases
Cardiac dullness enlargement Apical impulse displaced leftward or inferiorly S3 or S4 , gallop (tachycardia) Murmurs of tricuspid or mitral regurgitation Pulmonary congestion • Tachypnea • Dullness and diminished breath sounds at lung bases • Rales Systemic congestion • Engorgement of jugular vein • Hepatomegaly, ascites • Pedal edema