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Myocardial diseases
Hypertrophic cardiomyopathy:
high EF
it can contract but can’t relax
Results in diastolic dysfunction
...

This hypertrophy will obstruct the blood flow when preload
decreases or dilation of peripheral vessels (e
...
during exercise)
presents with syncope and sometimes sudden death (due to
ventricular arrhythmias)
Autosomal dominant usually
chromosome 14
S4 Gallop not present & have fewer sign of backward heart failure
like pulmonary edema, right heart failure, and hepatomegaly
...
5 times posterior wall
...
5 times:
Avoid heavy physical activity
B-blockers are the drug of choice (will decrease heart rate –
increases preload by prolonging diastole)
...

Avoid - Inotropes like Digoxin, Dobutamine, Norepinephrine
(Increase in heart contractility might totally block outflow),
vasodilators (reflex tachycardia) in HOCM
...

Ablation of Septum in HOCM – Inject alcohol in hypertrophic
muscle & it will lead to infarction in that area and thus reducing
hypertrophy
Only done when everything else fails or severe dyspnea or
exertional syncope that interferes with daily life
...

Dilated cardiomyopathy:
low EF
it can relax but can’t contract
biventricular dilation
systolic dysfunction, diminished contractility
common in young people
...

Interventricular conduction delays (e
...
Left Bundle Branch Block) can occur due
to cardiac dilation
Treat:
Diuretics + Digoxin is frequently use to control symptoms
B blockers (lower mortalility)
ACE inhibitor (lower mortalility)
Na restriction

Restrictive cardiomyopathy:
can’t relax can’t contract
doesn’t fill at all
reduced compliance due to infiltration of the myocardium
Least common cardiomyopathy
Causes:
Sarcoidosis
Amyloidosis
hemochromatosis
cancer
fibrosis (myocardial fibroelastosis)
Symptoms:
dyspnea on exertion
all cardiomyopathies
edema
elevated JVP
hepatomegaly
ascites
S4 and S3 gallop
Kussmaul sign
seen here and constrictive pericarditis
Diagnosis:
Xray: mild cardiomegaly and pulmonary congestion
these signs are seen in all cardiomyopathies and valvular disorders
with the exception of Mitral valve prolapse
Echo:
best since it shows myocardium that doesn’t move
Treat:
no good treatment
Diuretics are frequently used to control symptom



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