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Cardiomyopathy Diseases of the heart muscle Lots of different types and terms Enlarged, thinned walled and ‘baggy’ Thickened walls Rigid/stiff walls Combination Inherited Acquired Heart muscle’s ability to act as a pump (the engine of the body) becomes poor >>>>>heart failure Heart failure Effort intolerance Breathless Chest pain Fatigue Leg and /or abdominal swelling Symptoms of congestion- ‘congestive cardiac failure’ Can lead to rhythm disturbance ( electrical problems) Can lead to heart valve problems Can affect any age, but becomes more common as you get older Dilated Cardiomyopathy Big, baggy heart- ‘low EF%’ - Ischaemic (Coronary artery disease ( plumbing)) -Burnt out hypertension - Familial /inherited - Alcohol cardiomyopathy - Post viral (myocarditis) - Unknown (idiopathic) - Pregnancy related (peripartum) - due to rhythm disturbance (tachycardia mediated) - due to severe heart valve problem - due to chemotherapy or radiotherapy - dysynchrony OMT- Optimal medical therapy ACE I/ ARB BB MRA Water tablets Disease specific treatment Revascularization- controversial Valve surgery Reduce alcohol Control heart rhythm problem More later with stiff and thick hearts! Hypertrophic cardiomyoathy Thickened heart wall- very thick to very minor thickening- often asymmetric Abnormal ECG Inherited, but can ‘pretend’ to skip generations 1:500 High blood pressure can ‘mimic’ Lots of other rare mimics Stiff hearts High blood pressure Type II diabetes Amyloid Haemochromatosis Sarcoidosis Idiopathic restrictive cardiomyopathy Radiotherapy Right sided heart failure As a consequence to left sided heart failure As a consequence to chronic lung disease- Cor Pulmonale ARVC- arrhythmogenic right ventricular dysplasia Non –compaction Takotsubo cardiomyopathy- broken heart syndrome Prevention/ risk factors Family history Coronary disease- lipids/smoking/ Blood pressure Diabetes Obesity Alcohol Exercise Treatment Family history Coronary disease- lipids/smoking/ Blood pressure Diabetes Obesity Alcohol Exercise Optimal medical therapy Disease specific therapy Cardiac surgery Device therapy Transplant