Dilated cardiomyopathy natural history, complications and prognosis: Difference between revisions
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==Prognosis== | ==Prognosis== | ||
There are many prognostic factors which can be evaluated in a patient with dilated cardiomyopathy.<ref> Mayo Clinic Cardiology. Concise Textbook. Murphy, Joseph G; Lloyd, Margaret A. Mayo Clinic Scientific Press. 2007.</ref> The most important prognostic indicator is a decreased [[ejection fraction]], in addition increased left ventricular size and right ventricular dilation are independent indicators of a poor prognosis. | There are many prognostic factors which can be evaluated in a patient with dilated cardiomyopathy.<ref> Mayo Clinic Cardiology. Concise Textbook. Murphy, Joseph G; Lloyd, Margaret A. Mayo Clinic Scientific Press. 2007.</ref> The most important prognostic indicator is a decreased [[ejection fraction]], in addition increased left ventricular size and right ventricular dilation are independent indicators of a poor prognosis. As is in most types of [[heart failure]] a poor NYHA functional class and increased PASP (>35mmHg) are also poor prognostic indicators. Other findings that infer a poor prognosis are as follows: Maximal O2 uptake of < 12mL/kg / minute on exercise testing, LBBB ([[left bundle branch block]]), non sustained ventricular [[tachycardia]], [[syncope]], [[hyponatremia]] with a serum sodium less than 135, elevated [[norepinephrine]], ANP ([[atrial natriuretic peptide]]) and [[renin]] levels (not routinely measured in clinical practice), elevated PCWP (pulmonary capillary wedge pressure) > 18mmHg and low [[cardiac index]] < 2.5L/min/m^2. | ||
As is in most types of [[heart failure]] a poor NYHA functional class and increased PASP (>35mmHg) are also poor prognostic indicators. | |||
Other findings that infer a poor prognosis are as follows: Maximal O2 uptake of < 12mL/kg / minute on exercise testing, LBBB ([[left bundle branch block]]), non sustained ventricular [[tachycardia]], [[syncope]], [[hyponatremia]] with a serum sodium less than 135, elevated [[norepinephrine]], ANP ([[atrial natriuretic peptide]]) and [[renin]] levels (not routinely measured in clinical practice), elevated PCWP (pulmonary capillary wedge pressure) > 18mmHg and low [[cardiac index]] < 2.5L/min/m^2. | |||
==References== | ==References== | ||
Revision as of 22:45, 20 January 2013
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Complications
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Kidney: Infarct Remote: Gross external view with capsule removed two old and very typical infarct scars 27 year old person with dilated cardiomyopathy -
Brain: Infarct: Healing large MCA and PICA probably embolic 64 year old female chronic obstructive pulmonary disease and cardiomyopathy with atrial fibrillation
Prognosis
There are many prognostic factors which can be evaluated in a patient with dilated cardiomyopathy.[1] The most important prognostic indicator is a decreased ejection fraction, in addition increased left ventricular size and right ventricular dilation are independent indicators of a poor prognosis. As is in most types of heart failure a poor NYHA functional class and increased PASP (>35mmHg) are also poor prognostic indicators. Other findings that infer a poor prognosis are as follows: Maximal O2 uptake of < 12mL/kg / minute on exercise testing, LBBB (left bundle branch block), non sustained ventricular tachycardia, syncope, hyponatremia with a serum sodium less than 135, elevated norepinephrine, ANP (atrial natriuretic peptide) and renin levels (not routinely measured in clinical practice), elevated PCWP (pulmonary capillary wedge pressure) > 18mmHg and low cardiac index < 2.5L/min/m^2.
References
- ↑ Mayo Clinic Cardiology. Concise Textbook. Murphy, Joseph G; Lloyd, Margaret A. Mayo Clinic Scientific Press. 2007.