Cardiomyopathy, Myocarditis and Pericardial Disease

Posted by e-Medical PPT Monday, July 2, 2012
Cardiomyopathy
3rd most common form of heart disease in U.S.
2nd most common cause of adolescent sudden death(IHSS or HOCM)
Directly affects cardiac structure and impairs myocardial function
Four types
Dilated Cardiomyopathy(DCM)
Hypertrophied Cardiomopathy(HCM)
Restrictive Cardiomyopathy
Dysrhythmic right ventricular cardiomyopathy

Dilated Cardiomyopathy
Dilation and compensatory hypertrophy of myocardium
Depressed systolic function and pump failure with low cardiac output
80% of DCM cases are idiopathic
African Americans and males have 2.5x increased risk
Most common age of diagnosis 20-50yrs

Hypertrophic Cardiomyopathy
Asymmetric LVH and/or RVH-primarily involves septum-usually without dilation
Abnormal compliance-impaired diastolic relaxation and filling-output usually normal
50% are hereditary
Prevelence 1 in 500, Mortality 1%
Mortality 4-6% in childhood/adolescence

Restrictive Cardiomyopathy
One of least common cardiomyopathies
Ventricular volume and wall thickness is normal
Decreased volume of both ventricles
Mostly idiopathic- sometimes familial
Systemic disorders-amyloidosis, sarcoidosis, hemochromatosis, scleroderma, and carcinoid.

Myocarditis
Inflammation of myocardium
Can be result of systemic disorder or infectious agent
Viral-Coxsackie B, echovirus, influenza, parainfluenza, Epstein-Bar, and HIV
Bacterial-C. Diptheria, N. meningitidis, M. pneumonia, and beta-hemolytic strep
Frequently accompanied with pericarditis

Acute Pericarditis
Loose visceral pericardium and dense parietal pericardium surround heart
Pericardial space may contain up to 50ml normally
Etiologies of acute pericarditis-viral, bacterial, fungal, malignancy, drugs, radiation, connective tissue disorder, uremia, myxedema, post-MI, or idiopathic
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