3 Forms of Cardiomyopathy

Dr Ihab Suliman

Cardiology Morning Presentation

2 IM

7/6/2012

• Sinus Tachycardia + LVH

70 years old lady post operativefor CA Colon

• Sinus Tachycardia, Low VoltaGE Limb Leads Lateral STEMI

Sky High ST elevation with Minimal Rise in Cardaic Enzymes

• Sky High ST Elevation

• Cardiac Enzymes elevation is Much lower than expected with Sky High STEMI

• Ballooned Apex

• Apical Balloon

Tako-tsubo Cardiomyopathy

• May account for up to 2% of suspected ACS• In-hospital mortality ranges 0-8%• Much more common in women (~90%),

especially postmenopausal women (>80% of cases)

• Mean age 58-75 years• Triggers: death of loved one, other catastrophic

news, devastating financial losses, natural disasters, physical illness/ICU, etc.

Proposed Diagnostic Criteria

1. Transient a/dyskinesis of apical and midventricular segments in association with regional wall motion abnormalities that extend beyond the distribution of a single epicardial vessel

2. Absence on angiography of obstructive coronary artery disease or evidence of acute plaque rupture

3. New ST segment elevation or T wave inversions on ECG

4. Absence of recent significant head trauma, intracranial bleeding, pheochromocytoma, myocarditis, or hypertrophic cardiomyopathy

Proposed by Bybee, et al. 2004. Annals of Internal Medicine. 141: 858-865.

The Second Form70 years old with Papitations

• AF

• NSR in contrast to AF

• HTN , LVH

The Third

• 37 years old lady with Familial type of Cardiomyopathy

• HOCM Different echo views

• AICD with atrial lead4 HOCM

• Hypertrophic cardiomyopathy is a genetic disorder that is typically inherited in an autosomal dominant fashion with variable penetrance and variable expressivity.

• HCM is the leading cause of sudden cardiac death in preadolescent and adolescent children.

• The hallmark of the disorder is myocardial hypertrophy that is inappropriate, often asymmetrical, and occurs in the absence of an obvious inciting hypertrophy stimulus. 

Complications of HCM may include the following:

• Congestive heart failure or dilated eventually in 10 %

• Ventricular and supraventricular arrhythmias• Infective mitral endocarditis• Atrial fibrillation with mural thrombus

formation , AF worsen very much their status ,occur up to 25-30, ATC is important

• Sudden death

Cardiology staff at NGHA ,Riyadh ,ksa