心肌病 ppt课件

Chest X-ray
Cardiac enlargement, cardiothoracic ratio >0.6, pulmonary congestion
Electrocardiogram
ECG is almost always abnormal: pathological Q waves, low QRS voltage, Af, ST-T changes, AVB, LBBB
Introduction
•Primary cardiomyopathy Classifications: •Dilated cardiomyopathy •Hypertrophic cardiomyopathy •restrictive cardiomyopathy •arrhythmogenic right ventricular dysplasia or cardiomyopathy (ARVD/ARVC).
Endomyocardial biopsy
Myocytes are hypertrophied and their nuclei appear bizarre. Variable fibrosis may be present
Cardiac catheterization
LVEDV↑, LVEDP ↑, pulmonary arterial pressure ↑ , EF ↓, CO ↓, Coronary angiography - normal
Diastolic function: Myocardial stiffness or, chamber stiffness or
Clinical manifestation
The hallmark of DCM was congestive heart failure of unknown etiology
Pathology
Dilated ventricular cavities, fibrosis and thin ventricular wall
Pathophysiology
Dilated ventricular cavities with depressed systolic function
Introduction
• Specific cardiomyopathy: • Infective--Viral, bacterial, fungal myocarditis • Endocrine, nutritional or metabolic disorder--hyperor hypothyroidism, alcoholic cardiomyopathy. • Systemic, (SLE), genetic, toxic disease, and others (peripartum cardiomyopathy).
When patients first seek medical attention the disease is often far advanced. three principle symptoms
fatigue, weight gain (edema), dyspnea. Embolism, sudden cardiac death
Left ventricular volume: End-diastolic , End-systolic Left ventricular mass , Volume/mass ratio
Systolic function: CO/end-diastolic pressure , Ejection fraction
Cardiomyopathy
Lianjun Gao M.D.，Ph.D. Department of Cardiology The First Affiliated Hospital of DMU
Introduction
Cardiomyopathy is a group of disease of unknown etiology of the myocardium. Other specific cardiac disease is absent. It consists primary (idiopathic) and specific (secondary) cardiomyopathy.
Echocardiogram
Dilatation of LV and other chambers, diminished wall motion
Echocardiogram
Dilatation of LV and other chambers, diminished wall motion
Supplementary exam
Clinical manifestation
wide spectrum of clinical findings depending on the stage and development of
DCM
Signs of dilatation of the cardiac chambers and congestive heart failure. S3, S4 Functional regurgitation of the mitral and tricuspid valves Sinus tachycardia, Af
Introduction
Normal Dilated Restrictive Hypertrophic
Systolic Diasopathy
Etiology
The etiology and pathogenesis--- Uncertain Myocarditis----preceding viral myocarditis Myocardial injury Familial cardiomyopathy