Limited pathology of cardiomyopathy

2021-01-28 12:00 AM

Expression of two ventricular heart failure and embolism, the ultrasound showed local heart wall thickening, mitral valve deviation back, atrial dilatation, atrioventricular valve opening.

Define

Restrictive cardiomyopathy is a symptom associated with impaired ventricular filling with diastolic dysfunction (dilatation of the myocardium) due to endocardial, subendocardial, and myocardial disease.

Causes

Endocardial fibrosis is a common cause of restrictive cardiomyopathy in the tropics. Loeffler disease: common in Europe. It is necessary to distinguish 3 stages through myocardial biopsy: early necrosis stage, embolism stage, and late fibrosis stage.

Other causes: sepsis, septicemia, sarcoidosis, scleroderma, glycogen disease, K, irradiation, transplant rejection.

Clinical

Asked the disease

History (allergies, going away ...).

Symptoms: weakness, strenuous breathing difficulties, RV failure, oedema.

Clinical

Regularly measure blood pressure, sinus tachycardia, detect signs of heart failure (P) (easy to mistake spasmodic pericarditis) and heart failure (T).

Subclinical

Chest radiograph: Large, moderate cardiac balloon, pleural effusion, signs of atrial dilatation, pulmonary congestion.

ECG: Ventricular thickening (P), ventricular (T), ST-T segment variation, a potential decrease in voltage may be present.

Biology: Formula blood has increased eosinophils in endocardial fibrosis. Quantification of serum iron, ferritin. Immune bilan (scleroderma).

Cardiac Doppler ultrasound:

Two-plane echocardiography and IV.

Endocardial fibrosis: Image of left and/or right ventricular jagging, atrial dilatation, dilated TM, blood clot in the heart chamber

Evaluation of ventricular condition, heart function, valves, and pericardium.

Cardiac Doppler: Detection of mitral regurgitation and other valves, diastolic dysfunction such as ventricular dilatation and dilatation.

Other special tests such as cardiac catheterization, angiogram, myocardial biopsy, Holter ...

Special genres

Endocardial fibrosis: Disease in Africa and subtropical, fibrosis in the head in the muzzle, then spread, the clinical situation depending on the location of the damage.

Loeffler endocarditis: temperate zone, young patient, eosinophilia, manifestations of biventricular heart failure and embolism, ultrasound reveals focal wall thickness, posterior mitral valve deflection, atrial dilatation, atrioventricular valve opening.

Development

Severe asystole, atrial and ventricular arrhythmias, embolism.

Amylose: Death within 6 months of treatment. Sarcoidosis: heart failure, sudden death. Scleroderma: left cardiomyopathy, pulmonary hypertension. Loeffler: heavy.

Differential diagnosis

Spasmodic pericarditis.

Dilated cardiomyopathy.

Hypertrophic cardiomyopathy.

Treatment

Non-specific treatment

Do not use diuretics and vasodilators. Digital only for atrial loss. Pacing: in severe bradycardia. Anticoagulant when a blood clot, embolism.

Specific treatment

Sarcoidosis: Corticoid.

Scleroderma: Corticosteroids and immunosuppressants.

Hemoglobinemia: Extracting blood. Beneficial if done early. Deferoxamine helps to reduce myocardial iron infection.

Surgical treatment

When medical treatment fails. Cleansing the fibrous endothelium and replacing the heart valves are affected by the disease. Useful for some patients

Heart transplant.

Prevent

Should be detected early in children under 15 years of age via agranulocytosis.