西安交通大学医学院循环系统疾病课件 Cardiomyopathy.pptVIP

Cardiomyopathy 一.Definition Cardiomyopathy is the diseases involving the heart muscle that are of unknown cause, but exclude: 二、Classification Idiopathic (primary) cardiomyopathy: unknown of cause Secondary cardiomyopathy: specific heart muscle diseases Classification by WHO/ISFC Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy Arrhythmogenic right ventricular dysplasia Unclassified cardiomyopathy Specific heart muscle diseases Dilated Cardiomyopathy (DCM) Characterized by cardiac enlargement and impaired systolic function of one or both ventricles. Myocardial cell degeneration, atrophy and fibrosis. Enlargement and dilatation of all four chambers，some cases have left ventricular hypertrophy Intracavitary thrombi Etiology ? mostly virus myocarditis others：familial and genetic factors immunological abnormality cytotoxic Hypothesis to explain the pathogenesis of DCM Clinical Manifestation Symptoms usually develop gradually Symptoms： Congestive heart failure arrhythmias embolism (artery and pulmonary) Signs： Distended jugular veins Cardiac enlargement HR ? S3、S4 gallop SM in mitral and tricuspid Fine rales peripheral edema and ascites ECG Findings Arrhythmias：atrial fibrillation, A-V block, premature beat Others：LV and/or LA enlargement ST－T changes Q-waves Echocardiography The size of the ventricular cavity The thickness of the ventricular walls Diffuse or rigional decrease in wall motion Cardiac Catheterization and Angiocardiography LVDP?、LAP ? 、PCWP ? CO?、CI ? LV enlargement, wall motion decrease diffusely, LVEF ? Diagnosis Cardiac enlargement With or without heart failure and/or arrhythmias UCG findings Exclude other etiology Management Principle：Congestive heart failure