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Cardiomyopathies :<3: (Dilated Cardiomyopathy (Treatment (Medications…
Cardiomyopathies :<3:
Dilated Cardiomyopathy
Signs and Symptoms
Signs
: RV/LV failure, thromboemolic events, arrythmia's rales, decreased arterial pulse, tachycardia, murmurs, and pulsus alternans.
Symptoms
: dyspnea, orthopnea, nocturnal cough, fatigue, pedal edema, low BP, CP, palpitations, hemoptosis, and syncope
Ultrasound Findings
Cardiomegaly, Decreased global LV/RV systolic and diastolic function and valvular regurgitation
2D
: Qualitative size and systolic function. PA systolic function and estimated resistance.
M-Mode
: Reduced AP aortic root motion. Increased EPSS. Delayed mitral valve closure.
Doppler
: Reduced aortic ejection velocity. Reduced rate of rise in ventricular pressure. Mitral regurgitation. Diastolic dysfunction.
Definition
Characterized by four chamber dilatation with ventricular systolic and diastolic dysfunction of unknown origin
Treatment
Medications
Diuretics, Vasodilators, Ace Inhibitors, Beta Blockers
Dietary
Reduce Sodium and Avoid Alcohol
Surgery
Heart Transplant
(
https://youtu.be/Aao_4IfWOuI
)
Restrictive Cardiomyopathy
Definition
A non-compliant LV associated with elevated diastolic pressures. Systolic function usually preserved with impaired diastolic function
Ultrasound Findings
2D; LVH with bright, shiny echogenic appearance, apical obliteration, normal systolic function, with impaired diastolic function, and biatrial enlargement.
Doppler: Moderate to severe MR/TR, pulmonary HTN present, LVOT gradient present, and diastolic dysfunction.
Signs and Symptoms
Sign: Peripheral edema, ascites, atrial enlargement, biatrial enlargement, and MR/TR
Symptoms: Dyspnea, palpitation, fatigue, anorexia, and poor exercise tolerance
Treatments
Medications
ACE inhibitors, calcium channel blockers, diuretics and anticoagulation therapy
Surgery
Pacemaker and Cardiac Transplant
(
https://youtu.be/Vwxco4YvxoQ
)
Hypertrophic Cardiomypaties
Ultrasound Findings
M-Mode
: AoV mid systolic notch, LAE, SAM, and ASH
Doppler
Pulse
Wave
: Find the site of obstruction and determine the diastolic dysfunction
Continuous Wave
: Classic dagger shaped flow profile present. Determine the peak velocities through the valves. Use valsalva maneuver to see if velocities increase upon release.
Color
: Mitral Regurgitation
2D
: Real time LAE, SAM, and ASH
Treatment
Medications
Beta Blockers/Calcium Channel Blockers
Surgery
Septal Myectomy and Cardiac Transplant
Signs and Symptoms
Symptoms
: Chest Pain, Dyspnea, Orthopnea, and Fatigue
Signs
: Murmur, Syncope, and Pulmonary Edema
Definition
May or may not be asymmetric thickening of a non-dilated ventricle.
Types
Obstructive
: Asymmetric
Names:
IHSS
(Idiopathic Hypertrophy Sub-aortic Stenosis.
ASH
(Asymmetric Septal Hypertrophy).
MSS
(Muscular Subaortic Stenosis).
HOCM
(Hypertrophic Obstructive Cardiomyopathy)
Non-Obstructive
: Concentric and apical hypertrophy
Names:
HCM
(Hypertrophic Cardimyopathy
(
https://youtu.be/8RnkKB8xvwA
)