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Definition
*Diagnosis by exclusion.
Physiologic Classification
1] Dilated
2] Hypertrophic
3] Restrictive
4] Arrhythmogenic RV cardiomyopathy (ARVC), or
arrhythmogenic RV dysplasia (ARVD)
5] Noncompaction of the ventricular myocardium
Arrhythmogenic RV cardiomyopathy (ARVC), or
arrhythmogenic RV dysplasia (ARVD):
is caused by progressive fibrofatty replacement of the RV
myocardium; occasionally, the LV is involved, with
relative sparing of the septum
the most common cardiomyopathy, [DCM accounts for approximately 25% of the
cases of congestive heart failure in the United States]
systolic dysfunction
Factors Associated with an Adverse Outcome in Dilated Cardiomyopathy
Marked intraventricular
Moderate mitral regurgitation
conduction delay
Women who recover are at increased risk of recurrences with subsequent pregnancies.
Tachycardia-Induced Cardiomyopathy
This cardiomyopathy is notable for the degree to which it resembles idiopathic DCM
phenotypically, yet it is characterized by a remarkable degree of recovery in left
ventricular function once the arrhythmia is controlled.
2. Reduced CO
3. Elevated LV-EDP
DCM: Symptoms
1. Low cardiac output
Complications
A wide QRS complexes a worse prognosis and has now emerged as a clinical
indicator of responsiveness to cardiac resynchronization therapy.
Patients with substantial left ventricular fibrosis may exhibit anterior Q waves even
in the absence of a discrete scar or epicardial coronary artery obstructions.
I] Lifestyle Changes:
Diet: restriction of salt (sodium) intake to 2,000 to 3,000 mg per day. Most salt ingested
comes from processed food.
Exercise: Most people with cardiomyopathy are encouraged to do non-competitive
aerobic exercise. Heavy weight lifting may not be recommended.
II] Medications:
Medications are used for two reasons:
1. To improve cardiac function.
2. To treat symptoms and prevent complications.
by taking a beta-blocker and ACE inhibitor even when not having symptoms. If
symptoms occur and/or worsen, digoxin, diuretics, and aldosterone inhibitors may be
added.
III] Implantable Devices:
1. left ventricular assist device insertion: This procedure requires the patient to meet strict
criteria and have advanced, end-stage heart failure. The VAD can be used as a bridge-to-
transplant, which means it can help a patient survive until a donor heart becomes available for
transplant.
A left ventricular assist device (LVAD) receives blood from the left ventricle and delivers it to
the aorta. A right ventricular assist device (RVAD) receives blood from either the right atrium
or right ventricle and delivers it to the pulmonary artery. Some VADs can perform the functions
of either an LVAD or a RVAD, or both (BiVAD).
2. Heart transplant.