Cardiomyopathies

Heart Muscle Diseases (Cardiomyopathies): Test and Diagnosis

1st-order laboratory parameters-obligatory laboratory tests. Dilated (dilated) cardiomyopathy (DCM) NT-proBNP (N-terminal pro brain natriuretic peptide) – for suspected heart failure (heart weakness) Assessment: correlation between NT-proBNP and stage of heart failure/heart weakness (NYHA, median/95th percentile). NYHA I: 342/3,410 ng/l NYHA II: 951 / 6,567 ng/l NYHA III: 1,571 / 10,449 ng/l NYHA IV: 1,707 / … Heart Muscle Diseases (Cardiomyopathies): Test and Diagnosis

Heart Muscle Diseases (Cardiomyopathies): Drug Therapy

Therapeutic Targets Improvement of quality of life or expectancy. Avoidance of complications (eg, malignant arrhythmogenic events/life-threatening cardiac arrhythmias)). Therapy recommendations Dilated Cardiomyopathy (DCM) This is an abnormal enlargement (dilation) of the heart muscle, especially the left ventricle (heart chamber). For therapy: Causal (cause-related) therapy: Cardiomyopathy caused by viruses can be treated with interferon (immunostimulation drug) … Heart Muscle Diseases (Cardiomyopathies): Drug Therapy

Heart Muscle Diseases (Cardiomyopathies): Diagnostic Tests

Mandatory medical device diagnostics. Dilated (dilated) cardiomyopathy (DCM) Echocardiography (echo; cardiac ultrasound) to examine/detect: Primary dilatation (widening) of the left, and later both, ventricles (heart chambers) Decreased amplitude of motion of the ventricular wall with restriction of inward systolic motion Evidence of spontaneous echocontrast (advanced stage). Detection of manifest thrombi (blood clots) in the ventricle … Heart Muscle Diseases (Cardiomyopathies): Diagnostic Tests

Heart Muscle Diseases (Cardiomyopathies): Surgical Therapy

The only causal (cause-related) therapy for cardiomyopathies is heart transplantation (abbreviated HTX; English heart transplantation). Dilated (dilated) cardiomyopathy (DCM) In terminal heart failure: temporary mechanical heart replacement (left ventricular assist device (LVAD)) – For further details, see “Heart failure (heart failure)/Operative therapy“. Heart transplantation (Ultima ratio). Hypertrophic (enlarged) cardiomyopathy (HCM) Transaortic subvalvular myectomy (TSM): excess … Heart Muscle Diseases (Cardiomyopathies): Surgical Therapy

Heart Muscle Diseases (Cardiomyopathies): Prevention

To prevent cardiomyopathies, attention must be paid to reducing individual risk factors. Dilated (dilated) cardiomyopathy (DCM) – “Secondary (acquired/specific) cardiomyopathy” Behavioral risk factors Recreational drug use Chronic alcohol abuse (alcohol abuse) Drug use Cocaine Methamphetamine (“crystal meth”) → methamphetamine-associated cardiomyopathy (appearance of severe heart failure (heart failure)/NYHA stage III or IV) Environmental stress Chemical noxae … Heart Muscle Diseases (Cardiomyopathies): Prevention

Heart Muscle Diseases (Cardiomyopathies): Symptoms, Complaints, Signs

The primary symptom of cardiomyopathy is heart failure (cardiac insufficiency). The following other symptoms and complaints may indicate cardiomyopathy: Dilated (dilated) cardiomyopathy (DCM) Arrhythmias, especially ventricular (arrhythmias originating in the ventricles of the heart). Global heart failure (simultaneous presence of left and right heart failure). Left heart failure (heart failure), progressive (advancing), with exertional dyspnea … Heart Muscle Diseases (Cardiomyopathies): Symptoms, Complaints, Signs

Heart Muscle Diseases (Cardiomyopathies): Causes

Dilated (dilated) cardiomyopathy (DCM) Etiology (causes) In approximately 50% of cases, the cause of dilated cardiomyopathy is unknown (“primary/idiopathic cardiomyopathy”). Biographic Causes Genetic burden-approximately 30% are genetic familial forms X-linked recessive – mutations of the dystrophin gene. Autosomal-dominant – associated with excitation conduction disorder as well as sick sinus syndrome. Autosomal recessive – mutation of … Heart Muscle Diseases (Cardiomyopathies): Causes

Heart Muscle Diseases (Cardiomyopathies): Therapy

General measures Nicotine and alcohol restriction (refrain from tobacco and alcohol consumption) – cardiotoxic (heart damaging) noxae! Review of permanent medication due topossible impact on the existing disease. No drugs – cardiotoxic noxae! Conventional non-surgical therapy methods Dilated (dilated) cardiomyopathy (DCM). For increased risk of ventricular fibrillation: ICD (implantable cardioverter-defibrillator) implantation. Hypertrophic (enlarged) cardiomyopathy (HCM). … Heart Muscle Diseases (Cardiomyopathies): Therapy

Heart Muscle Diseases (Cardiomyopathies): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Of the skin and mucous membranes Neck vein congestion? Edema (praetibial edema?/water retention in the area of the lower leg/before the tibia, ankle; in supine patients: presacral/before the sacrum). … Heart Muscle Diseases (Cardiomyopathies): Examination

Heart Muscle Diseases (Cardiomyopathies): Medical History

Medical history (history of illness) represents an important component in the diagnosis of cardiomyopathies. Family History Is there a history of frequent heart disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). Do you notice shortness of breath when you exert yourself? At what level of exertion does the shortness … Heart Muscle Diseases (Cardiomyopathies): Medical History

Heart Muscle Diseases (Cardiomyopathies): Or something else? Differential Diagnosis

Myocarditis (heart muscle inflammation) is an important differential diagnosis in newly diagnosed cardiomyopathies! Dilated (dilated) cardiomyopathy (DCM) Cardiovascular (I00-I99). Secondary/specific cardiomyopathy – The heart is affected as part of systemic (affecting the entire body) diseases. Hypertrophic (enlarged) cardiomyopathy (HCM) Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Noonan syndrome – genetic disorder with autosomal recessive or … Heart Muscle Diseases (Cardiomyopathies): Or something else? Differential Diagnosis

Heart Muscle Diseases (Cardiomyopathies): Complications

The following are the most important diseases or complications that may be contributed to by cardiomyopathy: Dilated (dilated) cardiomyopathy (DCM) Cardiovascular (I00-I99). Apoplexy (stroke) Arterial or pulmonary embolism (partial or complete occlusion of a blood vessel by an embolus/entrained material) Hypertension (high blood pressure) Sudden cardiac death (PHT) Ventricular tachycardia (arrhythmia occurring in the ventricles … Heart Muscle Diseases (Cardiomyopathies): Complications