General information about the cardiomyopathies
Cardiomyopathy - a collective name for a number of diseases, the main manifestation of which is the change in the heart muscle. The exact causes of this process - known, but now doctors have learned quite accurately differentiate cardiomyopathy from other pathologies and malformations of the cardiovascular system. The diagnosis of primary or secondary cardiomyopathy put in those cases when a change in the heart muscle is not associated with congenital abnormalities, valvular, systemic vascular disease, pericarditis, hypertension and rare disease that affects the conducting system of the heart.
Currently, there are three types of lesions of the heart muscle: dilated, hypertrophic cardiomyopathy and restrictive. As a rule, experts can make an accurate diagnosis in the early stages of the disease process, or at least have an idea of the direction in which they move to establish the causes of the disease. Note that in some cases to determine why there was a cardiomyopathy in children - is not possible. In this situation, the doctors say about the development of idiopathic form of the disease. Despite significant differences, all of the above cardiomyopathy have a number of common features:
- no signs of inflammatory reactions;
- tendency to form blood clots;
- the increased size of the heart;
- difficulties in treating heart failure, which usually cause cardiomyopathy.
So you've got some idea of the characteristic features of the disease in question, or rather - a group of diseases. Now let's talk about each form of heart disease in more detail, but first will focus on the methods of diagnosis
Diagnosis of cardiomyopathy
The basic method of determining the presence of cardiomyopathy is a cardiac ultrasound. In 40% of cases ultrasound allows accurate diagnosis already at the first examination. Increased heart can identify and radiographically. ECG, in turn, does not show any specific signs of cardiomyopathy, and therefore unsuitable for diagnosis. Not providing data and laboratory studies. Thus, when the diagnosis of cardiomyopathy, causes of disease are identified only by means of ultrasound and X-ray part of the study. We also note that in the process of diagnosis, doctors may use some other methods, but only for monitoring the efficiency of ongoing medical treatment.
Violation of myocardial contractility, and at the same time expressed the expansion chambers of the heart - a sign of the fact that there was a common man now dilated cardiomyopathy (symptoms occur in 5-10 cases per 100 000 population). The emergence of this form is usually associated with a genetic predisposition and a bad heredity. This partly explains why the dilated cardiomyopathy is common in children.
The causes of disease are not fully understood. In recent years, more and more often expressed the idea that it is triggered by the development of a variety of infectious agents, toxic poisoning, metabolic disorders, and immune processes in the body. Nevertheless, in spite of serious progress in the diagnosis, the diagnosis of dilated cardiomyopathy treatment is still a problem because of the inability to understand the cause of disease in more than half of the reported cases.
If you talk about the most common precipitating factors, in our day to those, of course, are spirits. Alcoholic cardiomyopathy - one of the most common type of secondary dilatation cardiomyopathy. it is quite dangerous, because if patients continue to consume alcohol, despite the ban on the doctor, 75% of them will die within the next 3 years. This is associated with poor prognosis in that alcoholic cardiomyopathy affects not only the myocardium, but other sections of the cardiovascular system, causing multiple pathologies.
Dilated cardiomyopathy - disease symptoms
- shortness of breath;
- blue skin;
- signs of heart failure
Dilated cardiomyopathy - disease treatment
The main therapeutic measures are aimed at combating heart disease and preventing complications. Blood pressure is reduced with the help of ACE inhibitors (the most used drug - enalapril). Also on the myocardium affected by low doses of alpha and beta blockers. At the same time patients received diuretics. Since dilated cardiomyopathy has a poor prognosis, patients are considered as candidates for heart transplant.
With an increase in left ventricular wall thickness in patients diagnosed with hypertrophic cardiomyopathy. The most likely cause of disease are genetic defects, but in recent years more and more is revealed not only congenital cardiomyopathy in children, but also acquired form in adults, whose relatives had never suffered from such heart defects. Symptoms gipetroficheskoy form:
- shortness of breath;
- pain in the left side of the chest;
- unstable heart rhythm;
- tendency to faint.
Gipetroficheskaya cardiomyopathy is very dangerous, because it leads to irregular heartbeat and sudden fatal. In some patients rapidly developing heart failure, which also represents a serious threat to life. Accordingly, in the diagnosis of hypertrophic cardiomyopathy, treatment is aimed at improving the functions of the left ventricle and restore its normal operation. For this purpose, patients are administered verapamil, beta-blockers, pacemaker for pacing constant. In contrast to the dilated form, gipetroficheskaya cardiomyopathy have a more favorable prognosis and treatment of patients with a low mortality rate.
Relaxation wall infarction and dysfunction of the heart muscle - are the main symptoms of restrictive cardiomyopathy. Causes of the disease in most cases can not be identified. Furthermore, the secondary rekstriktivnaya cardiomyopathy, symptoms similar to those of many other diseases of the cardiovascular system is very complex in terms of correct diagnosis. In fact, many patients complaints of cardiac abnormalities arise only in the later stages of the disease, when it is already under way in the process of developing heart failure. Keep in mind that in the case with the majority of patients the cause of the complaints began swelling and shortness of breath at the slightest physical exertion.
As dianostika treatment restrictive cardiomyopathy is a complex task because of the late correct diagnosis. During this period, heart transplant rarely leads to the desired result, not to mention the standard medication, the effectiveness of which tends to zero. As a result, the mortality rate of patients with restrictive cardiomyopathy as high as 70% during the first 5 years after treatment.