Cardiomyopathy: Difference between revisions

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*Fibrofatty degeneration of the RV .
*Fibrofatty degeneration of the RV .
*Myocardial degeneration leads to RV dilation and poor RVF .
*Myocardial degeneration leads to RV dilation and poor RVF .
*Ventricular fibrillation by slow conduction velocities , guide block and spatial variation in conduction velocity .
*Ventricular fibrillation by slow conduction velocities, guide block and spatial variation in conduction velocity.
*Aneurysms of the RV free wall .
*Aneurysms of the RV free wall.
*Echo Dens moderator band and myocardial RV free wall .
*Echodense moderator band and myocardial RV free wall.
*Genetic component
*Genetic component
*Rare 1 : 5000 people.
*Rare 1:5000 people.
|Video
|Video
|-
|-
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!Decreased RV strain in ARVC
!Decreased RV strain in ARVC
|-
|-
!rowspan="6" valign="top"|Dilated cardiomyopathy ( DCM )
!rowspan="6" valign="top"|Dilated cardiomyopathy (DCM)
|rowspan="6" valign="top"|
|rowspan="6" valign="top"|
*It is the most common form of cardiomyopathy.  
*It is the most common form of cardiomyopathy.  
*Also known as congestive cardiomyopathy called
*Also known as congestive cardiomyopathy.
*Poor LVF and LV dilatation.  
*Poor LVF and LV dilatation.  
*Arrhythmias (atrial fibrillation 20-30%).  
*Arrhythmias (atrial fibrillation 20-30%).  
*Clot formation, which may lead to thrombo-embolic complications.  
*Clot formation, which may lead to thrombo-embolic complications.  
*Often accompanied by pulmonary hypertension, dilation of other compartments, and an insufficiency of mitral and / or tricuspid valve  
*Often accompanied by pulmonary hypertension, dilation of other compartments, and an insufficiency of mitral and/or tricuspid valve  
*Familial DCM's common to autosomal dominant, autosomal recessive and sex-linked inheritance.  
*Familial DCM's common to autosomal dominant, autosomal recessive and sex-linked inheritance.  
*Causes:  
*Causes:  
**(post-) infectious: various viruses and bacteria, as the final stage of myocarditis.  
**(post-) infectious: various viruses and bacteria, as at the final stage of myocarditis.  
**intoxication: cocaine, alcohol abuse.  
**intoxication: cocaine, alcohol abuse.  
**iatrogenic: some chemostatica, X-ray radiation.  
**iatrogenic: some chemostatica, X-ray radiation.  
**Metabolic: vitamin B1 deficiency.  
**Metabolic: vitamin B1 deficiency.  
**-idiopathic: In approximately 30% of cases, no cause is found
**-idiopathic: In approximately 30% of cases, no cause is found
||[[Image:DCM01.jpg|400px]]
|[[Image:DCM01.jpg|400px]]
|-
|-
|Dilated LV on AP4CH
!Dilated LV on AP4CH
|-
|-
||[[Image:LVF slecht05.jpg|400px]]
|[[Image:LVF slecht05.jpg|400px]]
|-
|-
|Dilated LV on PLAX
!Dilated LV on PLAX
|-
|-
||[[Image:EPSS01.jpg|400px]]
|[[Image:EPSS01.jpg|400px]]
|-
|-
|EPSS is a useful measurement at follow up DCM
!EPSS is a useful measurement to follow up DCM
|-
|-
|
!rowspan="6" valign="top"|Hypertrophic cardiomyopathy (HCM)
|
|rowspan="6" valign="top"|
|
*65% asymmetric hypertrophy of the myocardium, usually ventricular septum sometimes apical involvement.
DCM
*35% symmetrical hypertrophy of the myocardium (not to be confused with aortic stenosis or hypertension).
Dilated LV on AP4CH
*Small LV lumen.
DCMplax
*Preserved systolic LV function ( EF normal or slightly decreased)
Dilated LV on Plax
*Diastolic dysfunction.
EPSS
*Autosomal dominant progressive deviation from nature.
EPSS is a useful measurement at follow up DCM
*May include associated with sudden cardiac death due to ventricular fibrillation, an increased risk of thromboembolism.
Hypertrophic cardiomyopathy ( HCM )
*Heart failure can be caused by the rigidity of the thickened heart muscle (diastolic heart failure), by an obstruction in the LVOT (SAM ) is associated with mitral valvular insufficiency. The course of the disease is progressive.
 
*Occurs in persons 1:500-1000
65% Asymmetric hypertrophy of the myocardium, usually ventricular septum sometimes apical involvement .
35 % Symmetrical hypertrophy of the myocardium ( not to be confused with Aortic stenosis or hypertension ) .
Small LV lumen .
Preserved systolic LV function ( EF normal or slightly decreased)
Diastolic dysfunction .
Autosomal dominant progressive deviation from nature .
May include associated with sudden cardiac death due to ventricular fibrillation , an increased risk of thromboembolism .
Heart failure can be caused by the rigidity of the thickened heart muscle ( diastolic heart failure ) , by an obstruction in the LVOT (SAM ) is associated with mitral valvular insufficiency . The course of the disease is progressive .
Occurs in persons 1:500-1000
asympHCM
asympHCM
asymmetric hypertrophy
|[[Image:Asym.cmp1.jpg|400px]]
HCM
|-
symmetrical hypertrophy
!Asymmetric hypertrophy  
apicaleHCM
|-
apical hypertrophy
|[[Image:HCM01.jpg|400px]]
Non - compaction cardiomyopathy ( NCCMP )
|-
!Symmetrical hypertrophy  
|-
|[[Image:ApicHCM.jpg|400px]]
|-
!Apical hypertrophy
|-
|Non - compaction cardiomyopathy ( NCCMP )


LVwand has a spongy appearance .
LVwand has a spongy appearance .
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==References==
==References==
<biblio>
<biblio>
#1 Nelson B Schiller, Xiushui Ren, Bryan Ristow, "Echocardiographic recognition of cardiomyopathies" 2013.
#1 [http://www.uptodate.com/contents/echocardiographic-recognition-of-cardiomyopathies?source=search_result&search=cardiomyopathy+echo&selectedTitle=1~150| Echocardiographic recognition of cardiomyopathies]
</biblio>
</biblio>

Revision as of 06:07, 25 January 2014

Cardiomyopathy (CMP) is a collective term for various diseases of the heart muscle (myocardium). For various reasons, the function of the myocardium decreased (see table). The different variants of a CMP are generally classified on the basis of echocardiographic characteristics.

LV function decline in most common cardiomyopathy
Systolic function Diastolic Function
Dilated CMP =/↓
Hypertrophic CMP
Restrictive CMP =

Click here for detailed information on various cardiomyopathy. Listed below are the main disorders and their characteristics with examples.

Condition Features Example
Arrythmogene right ventricular cardiomyopathy (ARVC)
  • Fibrofatty degeneration of the RV .
  • Myocardial degeneration leads to RV dilation and poor RVF .
  • Ventricular fibrillation by slow conduction velocities, guide block and spatial variation in conduction velocity.
  • Aneurysms of the RV free wall.
  • Echodense moderator band and myocardial RV free wall.
  • Genetic component
  • Rare 1:5000 people.
Video
Echodense RV free wall for suspected ARVC
ARVC1.jpg
Decreased RV strain in ARVC
Dilated cardiomyopathy (DCM)
  • It is the most common form of cardiomyopathy.
  • Also known as congestive cardiomyopathy.
  • Poor LVF and LV dilatation.
  • Arrhythmias (atrial fibrillation 20-30%).
  • Clot formation, which may lead to thrombo-embolic complications.
  • Often accompanied by pulmonary hypertension, dilation of other compartments, and an insufficiency of mitral and/or tricuspid valve
  • Familial DCM's common to autosomal dominant, autosomal recessive and sex-linked inheritance.
  • Causes:
    • (post-) infectious: various viruses and bacteria, as at the final stage of myocarditis.
    • intoxication: cocaine, alcohol abuse.
    • iatrogenic: some chemostatica, X-ray radiation.
    • Metabolic: vitamin B1 deficiency.
    • -idiopathic: In approximately 30% of cases, no cause is found
DCM01.jpg
Dilated LV on AP4CH
LVF slecht05.jpg
Dilated LV on PLAX
EPSS01.jpg
EPSS is a useful measurement to follow up DCM
Hypertrophic cardiomyopathy (HCM)
  • 65% asymmetric hypertrophy of the myocardium, usually ventricular septum sometimes apical involvement.
  • 35% symmetrical hypertrophy of the myocardium (not to be confused with aortic stenosis or hypertension).
  • Small LV lumen.
  • Preserved systolic LV function ( EF normal or slightly decreased)
  • Diastolic dysfunction.
  • Autosomal dominant progressive deviation from nature.
  • May include associated with sudden cardiac death due to ventricular fibrillation, an increased risk of thromboembolism.
  • Heart failure can be caused by the rigidity of the thickened heart muscle (diastolic heart failure), by an obstruction in the LVOT (SAM ) is associated with mitral valvular insufficiency. The course of the disease is progressive.
  • Occurs in persons 1:500-1000

asympHCM

Asym.cmp1.jpg
Asymmetric hypertrophy
HCM01.jpg
Symmetrical hypertrophy
ApicHCM.jpg
Apical hypertrophy
Non - compaction cardiomyopathy ( NCCMP )

LVwand has a spongy appearance . Jenni criteria ( Heart 2007) . Also called insulated non compaction of the ventricular myocardium ( INVM ) , is a rare form of congenital heart disease in which the tissue of the ventricular myocardium is constructed in terms of texture well.  After HCM DCM and the most common cause of primary cardiomyopathy in children. It is a congenital defect , which occurs in the 20th week of pregnancy . The condition is expressed by heart failure, arrhythmias, and an increased risk of thrombus formation. The disorder often manifests itself later in life and has a high mortality rate due to heart failure and arrhythmias . NCCMP NCCMP with crypts and apical midventriculair   NCCCMP on PSax restrictive cardiomyopathy  

Stiffened myocardium. This form comes after at least 1 and is usually associated with storage diseases , such as sarcoidosis , amyloidosis , and the like. Preserved systolic LVF . LV is not dilated . Diastolic dysfunction ( see fig.) LV and RV may be hypertrophied . Dilated atria and VCI . Pulmonary hypertension . Myocardial echo during and amyloidosis speckled restr_cmp_TVI Abnormally low É in restrictive cmp Tako- tsubo cardiomyopathy Tako- tsubo are octopus lure often used in Japan . Apical ballooning , akinesia of the apex. This gives the LV configuration octopus lure . manifests itself as an acute myocardial infarction with ST elevations , however, no significant coronary artery disease. Is more common in women than in men , the average age of 62 to 75 years . Stressgeïnduceerd , is triggered by an acute illness or intense emotional or physical stress Also called "broken heart syndrome" or " Stress CMP " called . LV normalized to several weeks in few days . takotsubocmp Apical ballooning

References

  1. [1]