7/24/2019 Seminar Cardiomyopathy
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7/24/2019 Seminar Cardiomyopathy
2/19
ARRYTHMOGENIC RIGHT VENTRICUCARDIOMYOPATHY
7/24/2019 Seminar Cardiomyopathy
3/19
Inherited condition(chances to get it ar!" The ce##s o$ the heart &'sc#e are he#d together ! )rotein
In )eo)#e +ith ARVC, these )roteins do not de e#o))ro)er#! and so cannot -ee) the heart &'sc#e ce##stogether* The &'sc#e ce##s eco&e detached and $att!de)osits 'i#d ') in an atte&)t to re)air the da&age*
Us'a##! &ore a.ected on right sided 't can a.ect othsided
Lead to entric'#ar arr!th&ia(i&)'#se distr')ted as it )assthe a.ected area"
https://www.bhf.org.uk/heart-health/how-your-heart-workshttps://www.bhf.org.uk/heart-health/how-your-heart-works7/24/2019 Seminar Cardiomyopathy
4/19
I&)ortant ca'se o$ s'dden cardiac death (/CD" in !o'ng ad'#ts,acco'nting $or 001 o$ a## cases and 221 o$ cases a&ongath#etes*
Ma#e 3 4e&a#e 5 036 T!)ica##! )resent et+een the teenage !ears and the $orties*
7/24/2019 Seminar Cardiomyopathy
5/19
CLINICAL PRESENTATION
Most#! as!&)to&atics Co&&on s!&)to&s 3 Pa#)itation (2718971" /!nco)e (2918621"
Di::iness(#o+ CO" /O;(i$ #e$t entric#e a.ected" Ascites Pitting ede&a
7/24/2019 Seminar Cardiomyopathy
6/19
ECG8's'a##! nor&a# 't so&eti&es can see R;;; Echocardiogra)h!8&a! de&onstrate right entric'#ar
di#atationsho+s genetic a nor&a#ities in the
genes that encode $or these des&oso&a# )roteins Right Heart Catheteri:ation +ith Heart Tiss'e ;io)s!
7/24/2019 Seminar Cardiomyopathy
7/19
2 major criteria or 1 major and 2 minor criteria or 4minor criteria.
7/24/2019 Seminar Cardiomyopathy
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MANAGEMENT
/'))ression o$ s!&)to&atic cardiac arrh!th&iasContro# heart rate8 #oc-er,ca channe# #oc-erContro# heart rh!th&8a&iodarone
Heart trans)#ant8#ong ter& treat&ent
7/24/2019 Seminar Cardiomyopathy
9/19
H PERTENSI!ECAR"IOM OPATH
7/24/2019 Seminar Cardiomyopathy
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ETIOLOG
H!)ertensi e heart disease is ca'sed ! chronica##!e#e$ated %#ood &re''(re . It can e d'e to )*&rimar+,e''entia# -+&eten'ion *mo't common*'econdar+ -+&erten'ion
7/24/2019 Seminar Cardiomyopathy
11/19
H PERTENSI!E HEART "ISEASE
A nor&a#ities in h!)ertensi e heart disease that inc#'desLe/t $entric(#ar -+&ertro&-+
S+'to#ic 0 "ia'to#ic d+'/(nction
C#inica# )resentation3- Arr-+t-mia' , )a#)itation, s!nco)e"- S+m&tomatic -eart /ai#(re (shortness o$ reath, red'ced
e.ort to#erance, $atig'e, ortho)nea, )aro?!s&a# noct'rna#d!s)nea"
/!&)to&atic
7/24/2019 Seminar Cardiomyopathy
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LE T !ENTRIC LARH PERTROPH
7/24/2019 Seminar Cardiomyopathy
13/19
ARRH THMIAS Occ'rs eca'se the e#ectro&-+'io#o3ica# c-an3e'
a''ociated it- #e/t $entric(#ar -+&ertro&-+ are not(ni/orm t-ro(3-o(t t-e -+&ertro&-ied ti''(e
M+ocardia# 5%ro'i' co'#d a#so ca'se #oca# ariations incond'ction e#ocities )reci)itating arrh!th&ias
7/24/2019 Seminar Cardiomyopathy
14/19
IN!ESTIGATION CHEST 6*RA ,A 7 C " E- Di#ated )ro&inent '))er #o e
esse#s- Cardio&ega#!- A# eo#ar oede&a (;at@s +ing"
- Interstitia# oede&a ( er#e! ;#ines"
- P#e'ra# e.'sion (;#'nting o$costo)hrenic ang#e"
7/24/2019 Seminar Cardiomyopathy
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7/24/2019 Seminar Cardiomyopathy
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7/24/2019 Seminar Cardiomyopathy
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ECHOCAR"IOGRAM Le/t $entric(#ar
-+&ertro&-+ > s!&&etrica# di#ated L! #o L! ejection /raction '(a##+ a''ociated it-
dia'to#ic d+'/(nction Increa'ed #e/t atri(mdiameter T+o8di&ensiona# echocardiogra&()arasterna# #ong a?is ie+" $ro&
o#d +o&an sho+ing concentric #eentric'#ar h!)ertro)h! and #e$t at
en#arge&ent*
7/24/2019 Seminar Cardiomyopathy
18/19
Ta## R a$e' in V and V +ith do+n s#o)ing ST 'e3ment de&re''ion and T a$ein$er'ion are s'ggesti e o$ #e/t $entric(#ar -+&ertro&-+ ,L!H it- 'train &attern.+ith strain )attern 's'a##! occ'rs in )ress're o er#oad o$ the #e$t entric#e as in s!ste&ich!)ertension or aortic stenosis*
LVH s
ELECTROCARDIOGRAM
7/24/2019 Seminar Cardiomyopathy
19/19
MANAGEMENT
Li$est!#e &odi cation (diet, e?ercise, +eight #oss" Phar&aco#ogica# inter ention
ACEi;8 #oc-erCC;s
AR;sDi'retics
Anti8 arrh!th&iasAnti8 coag'#ant
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