Dilated cardiomyopathy resident survival guide: Difference between revisions
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:❑ Medications that may exacerbate HF<br> | :❑ Medications that may exacerbate HF<br> | ||
❑ Diet (restriction of sodium and fluid intake?)</div>}} | ❑ Diet (restriction of sodium and fluid intake?)</div>}} | ||
{{familytree | | | | | | | | D01 | |D01=<div style="text-align: left;"><b><u> | {{familytree | | | | | | | | D01 | |D01=<div style="text-align: left;"><b><u>Physical examination:</u></b><br> | ||
❑ Vital signs: | ❑ Vital signs: | ||
:❑ Pulse (strength and regularity?) | :❑ Pulse (strength and regularity?) | ||
:❑ Blood pressure (supine and upright) to reflect adequacy of cardiac output | :❑ Blood pressure (supine and upright) to reflect adequacy of cardiac output | ||
:❑ Respiratory rate | :❑ Respiratory rate | ||
❑ General appearance: | ❑ General appearance: | ||
:❑ BMI(weight loss/weight gain) | :❑ BMI(weight loss/weight gain) | ||
:❑ Peripheral edema | :❑ Peripheral edema | ||
❑ Heart: | ❑ Heart: | ||
:❑ Extra heart sounds and murmurs (S³ associated with adverse prognosis, valvular heart disease?) | :❑ Extra heart sounds and murmurs (S³ associated with adverse prognosis, valvular heart disease?) | ||
:❑ Orthostatic changes in blood pressure and heart rate (volume status/vasodilation?) | :❑ Orthostatic changes in blood pressure and heart rate (volume status/vasodilation?) | ||
:❑ Jugular venous pressure at rest and following abdominal compression (to identify congestion) | :❑ Jugular venous pressure at rest and following abdominal compression (to identify congestion) | ||
:❑ Size and location of point of maximal impulse (ventricular enlargement?) | :❑ Size and location of point of maximal impulse (ventricular enlargement?) | ||
:❑ Right ventricular heave (right ventricular dysfunction and/or pulmonary hypertension?) | :❑ Right ventricular heave (right ventricular dysfunction and/or pulmonary hypertension?) | ||
❑ Lungs: | ❑ Lungs: | ||
:❑ Rales | :❑ Rales | ||
:❑ Pleural effusion | :❑ Pleural effusion | ||
❑ Abdomen: | ❑ Abdomen: | ||
:❑ Hepatomegaly and/or ascites (volume overload) | :❑ Hepatomegaly and/or ascites (volume overload) | ||
❑ Extremities: | ❑ Extremities: | ||
:❑ Temperature of lower extremities</div>}} | :❑ Temperature of lower extremities</div>}} | ||
Revision as of 16:07, 5 March 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Steven Bellm, M.D. [2]
Dilated cardiomyopathy resident survival guide Microchapters |
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Overview |
Causes |
Diagnosis |
Treatment |
Do's |
Dont's |
Overview
Dilated cardiomyopathy (DCM) relates to a group of heterogeneous myocardial disorders and is characterized by dilatation and impaired contraction and systolic function of the left or both ventricles. Atrial and/or ventricular arrhythmias can occcur, and there is a risk for sudden death. [1] The weight of the heart is increased but the maximal thicknesses of the left ventricular free wall and septum are usually normal as a result of the abnormally dilated chambers.[2]
Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[3]
- Life-threatening causes:
- Common causes:
- Idiopathic
- Myocarditis
- Ischemic heart disease
- Infiltrative disease
- Peripartum cardiomyopathy
- Hypertension
- Human immunodeficiency virus (HIV) infection
- Connective tissue disease
- Substance abuse
- Doxorubicin
- Other
Complete Diagnostic Approach
A complete diagnostic approach should be carried out after a focused initial rapid evaluation is conducted and following initiation of any urgent intervention.[4]
Symptoms of heart failure | |||||||||||||||||||||||||||||||||
History and symptpms: ❑ Hints for etiology (family history, and others)
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Physical examination: ❑ Vital signs:
❑ General appearance:
❑ Heart:
❑ Lungs:
❑ Abdomen:
❑ Extremities:
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A01 | |||||||||||||||||||||||||||||||||
B01 | B02 | ||||||||||||||||||||||||||||||||
C01 | |||||||||||||||||||||||||||||||||
Treatment
shown
hidden
Do's
Dont's
References
- ↑ "Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies". Br Heart J. 44 (6): 672–3. 1980. PMC 482464. PMID 7459150.
- ↑ Tazelaar HD, Billingham ME (1986). "Leukocytic infiltrates in idiopathic dilated cardiomyopathy. A source of confusion with active myocarditis". Am J Surg Pathol. 10 (6): 405–12. PMID 3521345.
- ↑ Felker GM, Thompson RE, Hare JM, Hruban RH, Clemetson DE, Howard DL; et al. (2000). "Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy". N Engl J Med. 342 (15): 1077–84. doi:10.1056/NEJM200004133421502. PMID 10760308.
- ↑ Yancy, C. W.; Jessup, M.; Bozkurt, B.; Butler, J.; Casey, D. E.; Drazner, M. H.; Fonarow, G. C.; Geraci, S. A.; Horwich, T.; Januzzi, J. L.; Johnson, M. R.; Kasper, E. K.; Levy, W. C.; Masoudi, F. A.; McBride, P. E.; McMurray, J. J. V.; Mitchell, J. E.; Peterson, P. N.; Riegel, B.; Sam, F.; Stevenson, L. W.; Tang, W. H. W.; Tsai, E. J.; Wilkoff, B. L. (2013). "2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 128 (16): e240–e327. doi:10.1161/CIR.0b013e31829e8776. ISSN 0009-7322.