内科学教学课件：心肌病，心包炎.pptVIP

Cardiomyopathy Definition The cardiomyopathies are disease that involve the myocardium primarily and are not the result of hypertension or congenital, valvular, coronary, arterial or pericardial abnormalities Etiology classification of CM WHO/ISFC1995 1. The definition of cardiomyopathy : a primary type, consisting of myocardial disease of unknown cause Etiology classification2. Classification of cardiomyopathy:(1) DCM–dilated CM (2) HCM– hypertrophic CM(3) RCM– restrictive CM(4) ARVD/C – arrhythmogenic right ventricular CM Dilated cardiomyopathycharacter: left and/or right ventricular systolic pump function is impaired, leading to cardiac enlargement and often producing symptoms of congestive heart failure. Clinical manifestation 1. symptoms (1) early: asymptom (2) late: symptoms of left and right-sided congestive failure, manifested by dyspnea, peripheral edema and palpitation, hepatomegaly, thromboembolism, sudden death. Clinical manifestation2. Signs: (1) heart enlarge (2) diastolic 3rd sound gallop (3) all kinds of arrhythmia Examanation 1. X-ray: heart/chest 50%, ventricular enlargement, pulmonary effusion2. ECG: Arrhythmia such as atrial fibrillation, block. ST-segment and T-wave abnormalities3. Echocardiography: Left atrial and ventricular dilation with normal or thinned walls and systolic dysfunction, ejection fraction reducing Examanation 4. radionuclide scintigraphy 5.cardiac pipe inspection and angiogram6. endocardial biopsy Treat1. Drugs: the methods of therapy is to control congestive heart failure and arrhythmia. 2. Artifical cardiac pacing(cadiac resynchronization,CRT) ,ICD.3. Surgical therapy, cardiac transplantation Hypertrophic cardiomyopathyCharacter: 1.disproportionate left/ right ventricular hypertrophy, involving septum. 2. diastolic dysfunction Classification： according to obstruction of left