Please enable JavaScript.
Coggle requires JavaScript to display documents.
Cardiomyopathy, References: Ignatavicius, D., Workman, L., Rebar, C.,…
Cardiomyopathy
Patient Education
Teach the patient to report any palpitations, dizziness, fainting, which could indicate a dysrhythmia
in patients with obstructive HCM strenuous exercise is contraindicated because it can cause sudden death
encourage patients after heart transplant to follow diet and exercise changes similar to patients with CAD
Tell patient that strict adherence to nutritional modifications and drug regimens following heart transplant
Tell the patient about the importance of exercise regimen
Avoid excessive alcohol intake and dehydration
Pathophysiology
subacute or chronic disease of cardiac muscle and the cause can be unknown
Divided into 4 categories on the basis of abnormalities in structure and function
Dilated Cardiomyopathy
structural abnormality which causes extensive damage to the myofibrils and interference with myocardial metabolism
Both ventricle are dilated, and systolic function is impaired
Causes: alcohol abuse, chemo, infection, inflammation, and poor nutrition
Decreased CO from not enough pumping of the heart can cause s/s of dyspnea on exertion, decreased exercise capacity, fatigue and palpitations
Hypertrophic Cardiomyopathy
asymmetric ventricular hypertrophy and disarray of myocardial fibers, can lead to a stiff left ventricle which leads to abnormal diastolic filling. Obstruction is also seen as well as mitral valve structural abnormalities
Is a single gene autosomal dominant trait occurring in 1 in 500 people
some patients have no symptoms, some will have DOE, syncope, dizziness and palpitations
Restrictive Cardiomyopathy
rarest, stiff ventricles that restrict filling during diastole, s/s are similar to those of L or R HF or both. Can be caused by endocarditis of myocardial disease
Arrhytmogenic right ventricular cardiomyopathy
replacement of myocardial tissue with fibrous and fatty tissue, 1/3 of patients also have L ventricle involvement, this one has familial association
can be caused by CAD, infection or inflammation of heart muscles, cancer treatments, prolonged alcohol use, and heredity
Assessment
Some patients will have dyspnea on exertion, palpitations, orthopnea, activity intolerance, angina, chest pain taht usually occurs at rest and is not related to exertion
Sudden death can also be the first manifestation of the disease
Ask the patient about any chest pain, shortness of breath, or any difficulty catching their breath after exertion. Ask the patient if they have experienced any palpitations or feel like their heart is beating out of their chest.
Interventions
nonsurgical management
diuretics, vasodilating agents, and cardiac glycosides to increase CO
beta blockers can also be used
HCM- beta adrenergic blocking agents (carvedilol) and calcium antagonists (verapamil).
vasodilators, diuretics, nitrates, and cardiac glycosides are contraindicated in patients with obstructive HCM
implantable cardioverter defibrillator could also be implanted to prevent sudden cardiac death
surgical management
Myectomy and ablation
heart transplantation (patients with severe DCM and may be considered for pts with restrictive cardiomyopathy
References:
Ignatavicius, D., Workman, L., Rebar, C., & Heimgartner, N. (2021). Medical-surgical nursing:
Patient-centered collaborative care.
Evolve
, (10th ed.). ISBN: 978-0-323-61242-5
Holman, H. C., Williams, D., Johnson, J., Ball, B. S., Wheless, L., Leehy, P., & Lemon, T. (2019). RN Adult medical surgical nursing: Review module. Assessment Technologies Institute