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Cardiac tamponade & Cardiomyopahy (Cardiac tamponade Occurs when…

- - - - Pathophysiology: Hypertrophy of all walls, hypertrophied septrum, relatively small chamber size
        
        Clinical Manifestations:
        
        Asymptomatic until adolescence or adulthood
        
        Exertion dyspnea
        
        Atypical angina
        
        Rapid, pounding heart
        
        Fatigue, syncope, palpitations
        
        Mild cardiomegaly
        
        S4 gallop
        
        Ventricuar dysrhythmias
        
        Sudden death common
        
        Heart failure
        
        Treatment:
        
        Symptomatic treatment of heart failure
        
        Beta blockers
        
        Conversion of atrial fibrillation
        
        Surgery: ventriculomyotomy (cutting into thickened septal muscle and removing some of the ventricular muscle)
        
        Nitrates and other vasodilators contraindicated with the obstructed form
    - - Pathophysiology: hypertrophy of all walls, hypertophied septum, mitral valve incompetance, obstruction of the left ventricle
        
        Clinical Manifestations
        
        Asymptomatic until adolescence or adulthood
        
        Exertion dyspnea
        
        Atypical angina
        
        Rapid pounding heart
        
        Fatigue, syncope, palpitations
        
        Mitral regurgitation murmur
        
        Mild cardiomegaly
        
        S4 gallop
        
        Ventricuar dysrhythmias
        
        Sudden death common
        
        Heart failure
        
        A fib
        
        Diagnostic Testing
        
        Echocardiogram (primary diagnostic tool)
        
        EKG (ST-T wave abnormalities; prominent Q waves)
        
        Radionuclide imaging
        
        angiography during cardiac catheterization
  - - - Clinical Manifestations
        
        May be asymptomatic for years
        
        Fatigue and weakness
        
        Heart failure (left)
        
        Palpitations
        
        Dysrhythmias or pulmonary emboli
        
        S3 and S4 gallops
        
        Pulmonary crackles
        
        Anorexia, N&V
        
        hepatomegaly
        
        JVD
        
        Moderate to severe cardiomegaly
        
        Treatment:
        
        Symptomatic treatment for heart failure
        
        Vasodilators (calcium channel blockers)
        
        Nitrates
        
        Beta blockers
        
        ACE inhibitors
        
        diuretics
        
        Anticoagulation therapy
        
        Control of dysrhythmias
        
        Ventricular Assistive Device (VAD)
        
        Surgery: heart transplant
        
        Diagnostic Testing
        
        Echocardiography
        
        EKG
        
        Cardiac catheterization
        
        Chest Xray
        
        Lab studies (BNP- heart failure)
        
        Goals
        
        Alleviate symptoms of HF
        
        Improve CO and quality of life
  - - - Clinical Manifestations:
        
        Left and right sided heart failure s/s
        
        fatigue
        
        dyspnea
        
        angina
        
        syncope
        
        weight gain
        
        JVD
        
        Diagnostic Testing
        
        Chest Xray (normal or hypertrophy)
        
        EKG (mild tachycardia at rest)
        
        Echocardiography (LV of normal size w/ thickened wall, slightly dilated RV, dilated atria)
        
        Endomyocardial biopsy
        
        There is no specific treatment for treating RCM
        
        Treatment includes therapy for HF and dysrhythmias
        
        Heart transplant may be a consideration
        
        Teach pts to avoid strenuous activity and dehydration