Cardiomyopathy (main): Difference between revisions
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Revision as of 04:44, 21 March 2014
Dilated Cardiomyopathy
Background
- Idiopathic form accounts for 25% of CHF
Diagnosis
- CHF symptoms
- CXR
- Cardiomegaly, pulm venous htn
- ECG
- LV hypertrophy, poor R wave progression
Treatment
- Similar to CHF exacerbation
- Ensure exacerbation not due to ischemia
Hypertrophic Cardiomyopathy
Background
- "HOCM"
- Abnormal LV diastolic function due to decr compliance
Diagnosis
- Exertional dyspnea, chest pain, syncope
- Systolic murmur that increases w/ valsalva
- ECG
- LV hypertrophy, deep Qs in 1, avL, V5-6 (daggers of death)
Treatment
- If decompensated presents as hypotensive CHF
- Preserve preload
- Careful hydration
- Avoid high airway pressure if intubate
- Limit tachycardia
- Beta blockers
- Avoid vasodilators (no nitrates)
- Maintain sinus rythm (i.e. cardiovert A. fib)
- Increase afterload (hypotensive only)
- Phenylephrine
- Preserve preload
Restrictive Cardiomyopathy
Background
- Must distinguish from constrictive pericarditis
Diagnosis
- Consider if CHF but no e/o cardiomegaly or systolic dysfunction
Treatment
- Symptom directed (diuretics and ACEI)
See Also
Source
Tintinalli