Disorders of the Myocardium

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Disorders of the Myocardium

Acute myocarditis:
• complication of infections – viral most common
• myocardium becomes inflamed from direct infection or affect of toxins
• cardiac failure develops

Cardiomyopathy:
Disease of heart muscle.
Three primary major types:
1) Dilated cardiopathy/idiopathic congestive cardiomyopathy:
• both left and right ventricle markedly dilated; myocardium becomes partially relaced with fibrous tissue
• impaired ventricular contraction  heart failure due to reduced ability to pump blood
• autosomal dominant in 20%. M>F
• may be related to alcohol, viral infection, anti-neoplastic drugs; higher risk in third trimester of pregnancy and postpartum
• sporadic chest pain, arrhythmia, thromboembolism
• management – treatment of heart failure; oral anticoagulants

2) Restrictive/obliterative cardiomyopathy:
• fibrosis of heart muscles
• filling of ventricles are impaired due to ventricular stiffness  high atrial pressures, atrial hypertrophy, dilation  atrial fibrillation

3) Hypertrophic cardiomyopathy (HCM):
• left ventricular hypertrophy with malignment of myocardial fibres
• 50% are autosomal dominant
• heart failure may develop; angina, dyspnoea and syncope on effort; pulmonary hypertension can develop
• sudden death with no previous symptoms can occur (most common cause of sudden death in young adults in sport; see Sports Medicine chapter)
• management – beta-adrenoceptor agonists (for angina)

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